Write a 4–5-page proposal for a health improvement initiative, including a Balanced Scorecard,
which addresses one aspect of an identified health issue. You will include a proposal for how to
assess outcomes.
Instructions
For this assessment, assume the role described in the scenario below:
Scenario: Imagine you are working for a nongovernmental organization (NGO) and you have
been tasked with examining a specific health problem in a country and determining how the NGO
could combat the problem. How could the organization best supplement or complement services
already in existence? What evidence-based tools for tracking outcomes would you suggest?
1. Country: Choose a country which has identified one of the issues below as a central problem
facing its population. Be sure that you have reasonable access to this country’s health care
information.

2. NGO: Choose a specific NGO with a global health mission to investigate.
3. Health Issue: Choose one of the global health care issues listed below. Consider choosing an
issue that is of particular interest or relevance to your career.
o Infant and child mortality.
o Substance abuse.
o Infectious diseases (Zika virus, cholera, AIDS, malaria, flu, et cetera).
o Noninfectious diseases (cardiovascular disease, diabetes).
o Malnutrition.
o Maternal and reproductive health.
4. Gap Analysis: Identify gaps in services by examining one of the following areas in detail:
o Affordability and funding.
o Patient access and equity.
o Education programs.
o Prevention programs.
o Service positioning (delivery).
o Health care workforce.
o Monitoring of the disease.
Structure your proposal as follows:
Part 1: Executive Summary
Examine a global health care issue within the context of a country.
Summarize the action(s) you are recommending for the NGO’s involvement in a country (one
page).

• Propose specific ways in which nonprofit financial resources could fill a gap in health care
services.
o Explain the rationale for the action. Why is this necessary?
o Explain why the NGO is best positioned to address this need, as opposed to governmental or
private organizations.
o Explain how the proposal aligns with the NGO’s mission and/or existing services in the country.
Part 2: Need
Analyze the services of government, private, and nongovernmental providers to address the
identified health issue.
• What existing services address this issue? Who is providing these services?
• What existing funding amounts and sources are dedicated to this issue?
• What is a gap in these services that you can identify?
Part 3. Balanced Scorecard
Appraise current performance indicators and outcome measures for potential improvements.
Create a balanced scorecard that addresses a proposal to fill a health service gap.
• Financial Perspective: Differentiate the services of private and nongovernmental providers from
those of governmental entities.
o How would the NGO would supplement or complement existing initiatives (or address an
unmet need)?
• Customer Perspective (Expectations).
• Internal Processes.
• People Development Perspective.

Part 4: Project Evaluation
Propose an approach to measure NGO outcomes.
• What evidence-based tools for tracking outcomes would you suggest?
Part 5: Conclusion
Summarize how the NGO is uniquely positioned to meet this need in a country (one paragraph).
Additional Requirements
Your proposal should meet the following requirements:
• Formatting: Use current APA standards for style and formatting.
• Number of Resources: Minimum of 3 peer-reviewed resources.
• Length: 4–5 double-spaced pages, not including title and reference page.
• Font and size: Times New Roman, 12-point.
• Communication: Write clearly and concisely, with well-organized communication that is
supported with relevant evidence. Use bullet points, phrases, or tables or charts to convey
information succinctly.
Preparation
Writing an effective proposal, including a balanced scorecard, is an important professional skill.
Proposals are deliverables used in many fields, the purpose being to gain the support of decision
makers for a project by providing accurate and succinct information. Proposals are written to
persuade a specific audience, and should be clear and to the point. Do not repeat information
that the audience already knows. Determine the key information they need to know in order to
make a decision, and back it up with references. There are many examples for learning how to
write a proposal on the Internet, as well as many types of templates that may be helpful as you write this assessment. Review the links in the Resources for support in completing this
assessment.
Balanced Scorecards are also used in many professions. Refer to the Balanced Scorecard
course file in the Resources for links and pertinent information. A balanced scorecard of a
nonprofit can look very different from one for a commercial enterprise as it undertakes activities
that serve altruistic ends.
Example of a Nonprofit’s Balanced Scorecard
This balanced scorecard of the Victoria Cool Aid Society is a great example of the perspectives
and objectives of a service organization, whose mission is to operate as a steward for humanity
in providing shelter and community health services to adults in need. Notice from this sampling
the emphasis on becoming known and trusted in the community both in the eyes of clients and
potential donors.
1. Financial Perspective
• Seek actively funding to deliver new or expanded services or programs.
• Diversify funding mix.
• Maintain break even budget and ensure adequate reserves.
2. Customer Perspective (Expectations)
• “Provide support, guidance, and leadership in your fields of expertise.”
• “Provide us with opportunities to contribute.”
• “Listen to my needs and be there when and where I need you.”
3. Internal Processes
• Learn from our clients in order to advocate solutions within our community.

• Engage stakeholders proactively to communicate who we are and our capabilities.
• Minimize negative workplace environmental factors (number of violent incidents).
4. People Development Perspective
• Hire, retain, and train to align resources and competencies.
• Nurture a culture that supports and advocates the importance of work/life balance.
• Foster a culture that embraces innovation, teamwork, leadership, and knowledge sharing.
Required Resources
Balanced Scorecard
• Balanced Scorecard Resources [DOC].
Suggested Resources
Services to Address Global Health Issues
This page discusses global health initiatives and how the CDC is addressing specific global
health challenges.
• Centers for Disease Control and Prevention. (2017). Global health: What CDC is doing.
Retrieved from https://www.cdc.gov/globalhealth/what/default.htm
This discusses WHO events to address specific global health challenges.
• Anonymous. (2015). WHO events addressing public health priorities. Eastern Mediterranean
Health Journal, 21(10), 770–772.
Non-Profit Organizations and Financial Resources
This page provides an exhaustive list of nonprofit organizations and links to their services.

• National Institutes of Health Fogarty International Center. (n.d.). Nongovernmental
organizations (NGOs) working on global health research. Retrieved from
https://www.fic.nih.gov/Global/Pages/NGOs.aspx
Website for this organization which delivers medicines and supplies, volunteers and medical
training to prevent disease, promote wellness, respond to disaster and save lives around the
globe.
• Project Hope. (n.d.). About us. Retrieved from http://www.projecthope.org/about/
Website for an international, independent, medical humanitarian organization that delivers
emergency aid throughout the world.
• Medecins Sans Frontiers. (n.d.). Medical issues. Retrieved from http://www.msf.org/en/medicalissues
Cost-Benefit Analysis
Provides a step-by-step guide to cost-benefit-analysis with real-world examples.
• Mind Tools. (2018). Cost-benefit analysis: Deciding, quantitatively, whether to go ahead.
Retrieved from https://www.mindtools.com/pages/article/newTED_08.htm
Performance Measures for Improvement
• McLees, A. W., Nawaz, S., Thomas, C., & Young, A. (2015). Defining and assessing quality
improvement outcomes: A framework for public health. American Journal of Public Health,
105(Supplement 2), S167–S173.
• Scott, K. W., & Jha, A. K. (2014). Putting quality on the global health agenda. The New England
Journal of Medicine, 371(1), 3–5.
• Dilley, J. A., Bekemeier, B., & Harris, J. R. (2012). Quality improvement interventions in public health systems: A systematic review. American Journal of Preventive Medicine, 42(5), S58–S71.
• Ruelas, E., Gómez-Dantés, O., Leatherman, S., Fortune, T., & Gay-Molina, J. B. (2012).
Strengthening the quality agenda in health care in low- and middle-income countries: Questions
to consider. International Journal for Quality in Health Care, 24(6), 553–557.
Suggested Resources for Further Exploration
• Muenning, P., & Su, C. (2013). Introducing global health: Practice, policy, and solutions. San
Francisco, CA: Jossey-Bass.
o Chapter 2, “Case Studies in Development and Health,” pages 31–56.
o Chapter 3, “The Global Burden of Disease,” pages 63–85.
• American College of Healthcare Executives. (2018). Retrieved from http://www.ache.org/
o Website for international society of 40,000 health care executives leading hospitals, health care
systems, and other health care organizations.