Table 1.

A summary of innovative practices

Practice	Implementation experience	Evidence from China	Evidence from Georgia
Talent cultivation for key decision-makers and other important stakeholders in the health system	Vertical alignment: Training and mentoring within a project governance structure well-connected to the domestic health system across practical, policymaking and ideational levels Wide coverage: Multistakeholder Cross-departmental Cross-sectoral Multi-donor collaboration Multiple modalities: Traditional on-the-job training Regional, nationwide and inter-provincial knowledge-sharing workshops, forums, site visits, etc. Short-term study tours relevant to address the health bottlenecks, as well as longer-term overseas research, courses or degrees Educational programmes established in higher education institutions	World Bank (WB) and the UK Department for International Development (DFID) Basic Health Services Project: Introduced a wide range of standardized, improved project management techniques and tools, such as planning, financial management and result-oriented effectiveness, to national and subnational health officials Provided funding for academic disciplinary development and training, such as health economics, public health administration, sociology and other social sciences, etc., alongside project implementation Gavi Hepatitis B vaccination project and Global Fund HIV/AIDS Rolling Continuation Channel project: Introduced project management techniques and tools and provided training for financing, Health Management Information System (HMIS), procurement, Monitoring & Evaluation, etc. Participatory training for managers and service providers Three projects: Provided Chinese project managers and civil society organizations with diverse learning opportunities, such as through onsite external–domestic co-supervision	National Immunization Program (NIP) with Gavi: Capacity-building activities for programme managers, epidemiologists, primary care professionals, cold chain specialists, administrative staff responsible for procurement and budgeting, HMIS personnel and National Immunization Technical Advisory Group experts Opioid substitution therapy (OST) programme with the Global Fund: The EU-supported project ‘Development of Human Resources, Evidence-Based and Quality Standards in Addictology in Georgia’ helped develop human resources and expert capacity in the field of addictology via university-level and lifelong education in Georgia, in which multiple EU member states have provided technical assistance. The Institute of Addiction Studies and a master’s programme in addiction at Ilia State University were established in 2013 The bilateral cooperation with the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has enhanced the capacity of national authorities to plan, implement and manage drug use policy
Long-term partnerships between external and domestic experts	A long-term, accompanying and sustained approach for localizing external expertise: An expert group system in which subnational, national and international experts in the same thematic areas could be paired up for long-term technical support during project/programme design and implementation Direct peer-to-peer sharing of knowledge, coaching and mentoring Long-term relationship building throughout and beyond the donor-supported project/programme	WB/DFID project and Gavi project: A large pool of consultants paired with local technical experts for consulting on national policymaking enabled the latter to build the capacity to contribute after the project transition External experts provided continuous policy consultancy during or after the project transition Gavi project: Resident international co-managers working alongside national co-managers	NIP: International experts, partner organizations and national stakeholders worked jointly during repeated assessment exercises (Joint Appraisals) to reach a consensus on transition gaps, priorities and further actions OST: Georgia collaborated with San Francisco University on key population size estimation surveys to strengthen national research capacity
Evidence-based policy advocacy nurtured by local experiences	Contextual analyses for better project/programme design, implementation and adjustment, as well as for informing policymaking Introduction of novel evidence-based research approaches to generate research evidence for policy and decision-making	WB/DFID project: The WB Analytical and Advisory Activities studies helped analyse China’s situation and informed broader health planning for China’s healthcare system reform since the 1990s Gavi project: WHO, as Gavi’s partner, conducted a costing study that helped understand the out-of-pocket cost of childhood vaccination and prompted the Chinese government’s new policy on free immunization Global Fund project: Supported empirical studies on the effectiveness of community-based interventions, which were used as a basis for its community-based organization projects and the multistakeholder approach in China’s national HIV/AIDS response	NIP: WHO, as Gavi’s partner, supported a vaccine cost–benefit analysis that helped convince the Georgian government to deploy new vaccines OST: The Global Fund supported size estimation studies for drug use that helped advocate drug-user and OST needs with the Georgian government EMCDDA supported and eventually institutionalized periodic surveys for monitoring drug scenes and drug use