Cornerstone country initiatives: duration and phases, selection criteria

Duration and phases

A Cornerstone Initiative country project of the World Federation of Hemophilia (WFH) is implemented for a period of two to four years, depending upon the needs of the country, the goals of the program, the level of success reached, and the amount of WFH program funding. It is carried out in three phases:


During the assessment phase, WFH program staff gather information and establish communications, and an ongoing working relationship, with patient organizations from underserved countries and/or countries with associate NMO status (new or prospective), and/or from certain regions (mainly in sub-Saharan Africa & Asia). The WFH develops closer ties with the country as it initiates the development of basic standards of care. Country visits allow the WFH to observe first-hand the needs and realities of the country and to determine appropriate program objectives.


In this phase, using a step-by-step approach defined in its comprehensive development model, the WFH implements planned activities that address the specific areas that need to be supported and strengthened. Progress is monitored and evaluated, on an annual basis, by program staff and expert volunteers. 


When the country initiatives’ objectives are reached, and the results are considered to be sustainable, the WFH begins a gradual phase-out. The Cornerstone initiative will allow countries to move at an appropriate pace and intensity. Participating countries that have demonstrated the motivation and the potential to improve bleeding disorders care may be considered for the country programs.

Selection criteria

To become a Cornerstone Initiative country, the following criteria must be met:

Target countries and/or regions

  • Country with associate NMO status (new or prospective)
  • Underserved regions & countries (mainly Sub-Saharan Africa and Asia)


  • Low Gross National Income (GNI) ─ less than US$1,500
  • Inaccurate diagnosis or no diagnosis at all
  • Limited or low level of clotting factor concentrate (CFC) supply (0 – 0.1 IU per capita)
  • Limited or unsafe blood products

Though many underserved countries and/or regions meet the above criteria, it is ultimately WFH resources that determine which are selected.

Updated March 2013