Innovative Philanthropy: Having intervention that improves health outcomes AND sustains gains

For David Zuellig, trustee of the Zuellig Family Foundation, the decision to focus on health leadership and local governance to improve the health of the rural poor in the Philippines was logical yet counter-intuitive.

Zuellig spoke about the Foundation’s strategy in the session on innovative philanthropy during the Regional World Health Summit in Singapore, the first time the annual meeting was held outside Berlin since it started in 2009.
The summit’s theme, “Health for Sustainable Development in Asia,” underscored the challenge for governments and healthcare providers to meet the increasing demands for better healthcare at lower costs in the region. Amid Asia’s growing economy, public-private collaborations become more vital in coming up with sustainable strategies that will bring quality healthcare even to low-income populations.

According Zuellig, access of the Filipino rural poor is usually limited to those offered in the rural health units. So the Foundation focused on improving local health systems.

Zuellig said their strategy had the municipal mayor as the key element in improving the system. He said this was a logical move since mayors had the power to implement ordinances to improve rural health services. But Zuellig added that local politicians are generally perceived to be unresponsive to health and that is why their strategy also seemed counter-intuitive.

Yet, the Foundation proceeded to work with local chief executives, picking those who show genuine commitment for health reforms. In a relatively short time, their efforts paid off. Since piloting the strategy in 2009, 30 partner-municipalities have brought their maternal mortality ratio closer to the targeted Millennium Development Goal of 52. The MMR, accordingly, is a surrogate indicator of the quality of a health system.

To make sure gains are sustained, Zuellig emphasized the need to have a continuity protocol. “Policies that support the continuation of health programs must be in place. The motivation to improve health must come from leaders and the community itself, with or without external influencers.”

The rapid improvements in health outcomes in the municipalities came as a pleasant surprise to Zuellig himself. “I was pleasantly surprised to realize that health outcomes have improved faster than I thought was possible.” Such positive changes also caught the interest of other groups, including the Philippines’ lead agency in health. Partnership with the Department of Health will bring its health change strategy to 609 priority local government units. There are also existing partnerships with the United Nations Population Fund and global healthcare company Merck Sharp & Dohme.

For Zuellig, a number of lessons learned along the way also served as factors for their success. First, the Foundation focused on health because this was their area of expertise, further refining it to rural health because of serious inequities in rural areas. Then, there was the identification of a strategic intervention, which in this case was working with local health executives. Third lesson was the choice to have a systems approach over short-term interventions that do not address the root causes of problems. Lastly, Zuellig said they realized they had to take a long-term perspective because transforming systems take time.

In closing, Zuellig expressed optimism that for as long as the Foundation’s current crop of leaders hold public office, they will also continue to use its leadership and governance framework to address development challenges beyond health.