Hallmarks of good practice:

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A memorandum of understanding is a formal document that sets out the purpose of the Partnership, defines roles and responsibilities, and broad aims.

Many Health Partnerships choose to sign a Memorandum of Understanding (MoU), either at the start of the Partnership or to formalise the work of an existing Partnership. Developing an MoU can be an important way to ensure that both partners agree on the broad purpose of the Partnership, as well as setting out how the two sides will work together. An MoU can encourage a greater feeling of ownership by both partners – provided that the process of developing and drafting the MoU is a true collaboration, rather than being driven from the UK.



1. Guidance to creating a formal written agreement or memoradum of understanding.

Some Partnerships choose to write a brief one-page MoU, while others prepare a more formal and lengthy document. This example is based on a range of MoUs developed by real partnerships. It is intended to serve as an example only and you should ensure that any MoU you sign has been adapted to fit with your specific needs and that it also meets the laws and regulations of any relevant bodies operating in the countries involved.

2. Sample of an MoU

This is an example of an MoU between the Royal College of Paediatrics and Child Health and a professional paediatric association in East Africa. It should be treated as an example only as your own MoU should be written to fit your own context and partnership.  For more guidance on writing an MoU, see tool 1 'Guidance to creating a formal written agreement or memorandum of understanding'.

3. How to start a health partnership

A needs assessment is a systematic process that the partnership undertakes to understand the current conditions at the developing country institution and the desired conditions.  The needs assessment is the rationale for the capacity building intervention, both in terms of its design and how it is delivered.



1. A Guide to Assessing Need - The World Bank.

This is a detailed guide on needs assessments, written by the World Bank.  It includes explanation of different methods you can use to do your needs assessment, such as types of data collection tools.

2.  Community Tool Box: Assessing Community Needs and Resources

Chapter 3: Assessing Community Needs and Resources. The chapter is broken down into multiple sections, providing detailed information on a range of different data collection tools that you can use to carry out your needs assessment. Each tool comes with an explanation of what it is, who should use it, and how to use it.


CASE STUDY: Assessing needs to create effective plans

Challenges or opportunities that arise during project implementation can expose weaknesses in the original needs assessment so make time to reflect and compare your experiences with your expectations.  It is important to do this regularly so that the partnership's plans remain relevant. 


1. After Action Review

After Action Review is a simple process of group reflection for learning from experiences, with the goal of improving future performance.  This tool works best when used shortly after an activity while the experience is still fresh in people's minds.

2. Better Evaluation: Rainbow Framework  

This is a comprehensive framework for planning an evaluation, which you can use either for a whole programme of activity or a sub-section of it. For example, the tools described in the frame work could help the Partnership review progress, particularly in relation to the need that was originally defined.Visit the site. 

“Outcomes are defined as changes in the behaviour, relationships, activities, or actions of the people, groups, and organizations with whom a program works directly.” S. Earl, F. Carden and T. Smutylo (2001).



1. Outcomes: what they are and how to approach measuring them in a health partnership project

Adapted from a workshop delivered by THET, this resource focuses on ways to address the challenge of measuring outcomes in a health partnership project.  

2. THET Project Planning: Theory of Change

A Theory of Change (ToC) is a planning tool that a partnership can use to think through the steps of a change process - from the current conditions to the desired conditions. A ToC uses a graphical representation of change to articulate the causal links between different steps in the change process and to test those links. A ToC can also highlight threads of activity that do not fit into the overall change framework, which will help to clarify the partnership's objectives, from activities through to longer-term impact.

3. Outcomes measurement

Health partnerships face challenges gathering data that demonstrates long-term change in skills, behaviour, and practice –known as Outcomes. This presentation takes different monitoring challenges in turn to consider a) what the challenge might tell you about the health system; and b) how you might deal with the challenge.

An Exit Strategy is a partnership's plan describing how and when the partners intend to responsibly end their support while ensuring that achievement of the project goals is not jeopardised and that progress towards these goals will continue into the future. Exit strategies, when planned with partners in advance, ensure better project outcomes and encourage commitment to sustainable results. 
Adapted from What We Know About Exit Strategies. Practical Guidance For Developing Exit Strategies in the Field. A. Gardner, K. Greenblott, E. Joubert (2005)

Has your partnership developed an exit strategy of any kind?  We would like to hear from partnerships who have done this and who would be willing to talk to us about their approach and experiences.