Appendix 4: Evaluation of the Active and Safe Injury Prevention Initiative 2011–2012 to 2012–2013 – Case study on healthy living and chronic diseases' multi–sectoral partnerships approach

Appendix 4 – Case Study on Healthy Living and Chronic Diseases' Multi-Sectoral Partnerships Approach

Background

The Public Health Agency of Canada provides funding to organizations through various funding authorities. Although grants and contributions programs aim to address specific and distinct priorities, best practices can be learned from the experiences of others. Future initiatives similar to the Active and Safe Initiative could consider adopting a multi-sectoral approach to addressing or promoting health issues.

The following case study highlights the design and delivery of activities, and best practices from the Public Health Agency's Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease, the first Public Health Agency program that makes public-private partnerships a requirement for Agency funding.

Program Context

The Ministers of Health and of Health Promotion/Healthy Living endorsed two initiatives that focus on the prevention of disease, disability and the promotion of health: the Declaration on Prevention and Promotion (September 2010), and Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework for Action to Promote Healthy Weights (November 2011). The Ministers, through these agreements, recognize that all sectors of society – not only government and the health sector – need to be involved to promote health and prevent disease. The Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease is one of the Public Health Agency of Canada's contributions to these agreements.

In February 2012, following the Summit on Healthy Weights, the Public Health Agency launched the Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease. The Boys and Girls Club of Canada/Sun Life partnership for the Get BUSY Program was the first project funded under this new approach. It was formally announced following the Health Ministers' meeting in September 2012 and progress was recently communicated to Canadians through Towards a Healthier Canada – 2013 Progress Report on Advancing the Federal/Provincial/Territorial Framework on Healthy Weights.

Program Design and Delivery

Operating under the Integrated Strategy on Healthy Living and Chronic Disease (ISHLCD) and the Federal Tobacco Control Strategy (FTCS) policy authorities, the Multi-sectoral Partnerships approach funds projects that focus on common risk factors, such as unhealthy diet, physical inactivity and tobacco use. Projects are required to be applicable nation-wide and to involve a wide variety of partners, including the private sector. (Public Health Agency of Canada Website, Multi-sectoral Partnerships to Promote Healthy Living and Prevent Chronic Disease)

Under this approach, there are no time-limited solicitation processes. Instead, there is an open and on-going Letter of Intent (LOI) process, by which organizations can submit an abbreviated proposal as a first step. The LOI undergoes a standard process for both screening and review. During the LOI screening, review and full proposal stages, a Program Consultant and a Policy Analyst work in collaboration on each file to provide program support and a policy lens. Only organizations with LOIs deemed to be a best fit with the overall goals and objectives of the multi-sectoral approach are invited to submit full proposals.

A key component of the multi-sectoral approach is the requirement for matched funding. Projects must obtain matched funding in terms of contributions from non-taxpayer funded sources or private sector partners. Confirmation of matched funding is required only at the full proposal stage, and project approval will not proceed until matched funding is secured. A matched funding ratio of 1:1 is required for funding under the ISHLCD, and 1:3 for project funding under the FTCS. Private sector, whether the applicant or a project partner, must match the Public Health Agency's funding according to the appropriate ratio either by contributing cash or contributions that are deemed essential to the project. Examples of two contributions are provided below. If proposals are evaluated favorably but are unable to provide secured funding from the private sector for the project's first year, the Public Health Agency will not sign the contribution agreement.

The Multi-sectoral Partnership Approach has also introduced a pay-for-performance model where funded projects only receive payment when planned outputs/outcomes are achieved. The outputs/outcomes are negotiated with the recipient before the project begins.

Although requiring the private sector's financial contribution to a project is a key aspect of this program's design, a shift in the Centre for Chronic Disease Prevention's staff activities is another important element. Program Consultants and Policy Analysts can now play a partnership broker role. Staff are encouraged to: generate and share ideas on potential funding projects; match not-for-profit organizations with private sector partners where appropriate and possible, and suggest potential partners to interested applicants.

To ensure that staff continue to learn from each other and improve their practices, the Centre for Chronic Disease Prevention holds ‘ideas factory' meetings. Staff share ideas on various subjects, including their new brokering role in addition to bringing partners from within the Public Health Agency and Health Canada to share expertise.

In addition, given that this is a new approach within the Public Health Agency, the Centre also continuously addresses new issues through the development or updating of guidelines or policies and the upcoming development of a database on partnerships.

Funded Projects

As of December 2013, nine projects have received funding through the Multi-sectoral Partnerships. The following two projects provide a good indication of the types of projects funded by the Public Health Agency.

Right to Play Canada is receiving funding from the Public Health Agency of Canada for the Play for Diabetes Prevention project. Between May 2013 and July 2015, the project will use Right to Play's activity-based approach to youth empowerment to address the diabetes prevention needs of urban First Nations, Inuit and Métis populations. Right to Play Canada's main private sector partner is Maple Leafs Sports and Entertainment. Other partners (Tim Horton's Foundation and Jamie MacDonald Photography) provide in-kind contributions.

From September 2012 until September 2014, the Boys and Girls Clubs of Canada are offering the Get BUSY program across Canada. Sunlife Financial is the private sector partner that is matching the Public Health Agency's contribution to this two-year project. The Get BUSY program is providing youth leadership opportunities through a range of physical activities and healthy eating information and training sessions. The youth leadership groups then transfer their learnings by offering a structured health and wellness program to younger children, across 22 Boys and Girls Clubs of Canada locations.

Both of these funded projects are able to deliver these programs across Canada given the funding they are receiving from the Public Health Agency and their private sector partners. In addition to having the intent to improve the wellbeing of children, these projects also have the intent of developing tools and approaches/interventions that may be replicated by other organizations in the future.

Best Practices

Matched funding from the private sector is a requirement - the requirement is made clear from the start. The Public Health Agency will not sign a contribution agreement for projects that have not matched funding from a non-taxpayer funded source.

Public-private partnerships extend the reach of a project - funded projects receive double the amount of funding they would normally receive from a government agency because they are asked to leverage from the private sector. For instance, instead of offering their Get BUSY programs to 10 locations, the Boys and Girls Clubs of Canada are able to reach 22 locations across Canada. 

Staff facilitate the development of partnerships - Not-for-profit organizations are not used to partnering with the private sector. Soliciting funds to match Public Health Agency funding may be challenging for some groups that do not have the capacity to initiate and develop partnerships. This is why the Centre for Chronic Disease Prevention's new partnerships broker role in this area is so crucial to the success of the multi-sectoral approach. Staff act as a link and an idea generator that bring credibility to the development of new projects.

Project ideas are given time to grow - The open and on-going Letter of Intent process allows the channels of communication between organizations and the Public Health Agency to start early, allowing time to find the matched funding partnerships required and fully develop their project ideas. The LOI process also reduces administrative burden to applicant organizations as they can vet their project ideas with the Public Health Agency prior to the completion of the lengthier proposal submission.

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