By: Rebecca Furth, Senior Technical Advisor, Initiatives Inc.
Initiatives Inc. provides organizational development assistance to non-governmental organizations (NGOs) in the Democratic Republic of the Congo (DRC). We initiated this work in 2011 under the USAID-funded TB TO 2015 project, led by PATH. The follow-on project, Challenge TB, launched in DRC in 2014 under the leadership of The International Union Against TB and Lung Disease (The Union). The Union asked Initiatives to continue its support to two NGOs and expand support to two additional organizations. All four organizations are involved in community-based TB control activities. Returning to work with the organizations after an 18 month hiatus provided Initiatives an opportunity to learn what developments “stuck,” whether organizations were able to advance further without assistance, and what challenges still needed to be addressed. Initiatives conducted organizational capacity assessments with three of the four organizations in May 2015. We learned a lot in this process, but here we present just a few key takeaways from our organizational development work in DRC.
1. Organizations with strong leadership sustain good management practices. In 2013, the two organizations we worked with had similar scores on their final OCAs, but the picture was quite different in 2015. One organization sustained its performance and even improved a bit; the other saw its performance decline. Both organizations experienced a significant decrease in funding at the end of the TB TO 2015 project, so what made the difference? Leadership. The organization with strong and consistent leadership was able to sustain its performance, despite funding challenges.
2. The development community giveth and taketh away. There is a large and well-justified push among the international development community to expand funding to local organizations, but the approach may set local NGOs up for failure. One organization saw a rapid influx of millions of dollars between 2006 and 2009. Today, its budget is less than $100,000. The organization didn’t do anything wrong, but donor priorities shifted faster than it could adjust. Over the next year, we will work with this organization to develop a new strategic plan that will hopefully help it better navigate the ebbs and flows of donor funding and prepare to mobilize resources from more diverse sources in an effort to nurture sustainability.
3. Participatory approaches to organizational development build demand. One of the more remarkable aspects of our work in DRC with the Challenge TB project is that the organizations requested Initiatives’ services. Having worked through our participatory approach under TB TO 2015, they knew how far they had come, but also what more they wanted to achieve and they wanted more support to help them obtain their goals. The participatory approach we use did what it was supposed to: empowered our partners to take charge of their development.
By: Sarah Murungi, Senior Organizational Capacity Development Specialist, ABH Project
How can we help civil society organizations (CSOs) in Uganda to more effectively advocate for improved community health services? The USAID Advocacy for Better Health (ABH) project (2014-2019) is designed to do just that – empower communities, advocate for better services, and strengthen civil society capacity to provide quality services. Twenty-one civil society organizations, four national and seventeen district level, have received grants from ABH to implement the project.
As a partner to PATH, Initiatives is responsible for capacity development. Initiatives designed its first Organizational Capacity Assessment in 2006 and has, over time, tailored it to the needs of new projects. For ABH, Initiatives worked with PATH to create the Organizational Advocacy and Capacity Assessment (OACA). Supporting the two main themes of the project, the OACA helps CSOs identify and address gaps in management systems and advocacy strategies. The combination strengthens CSOs’ overall ability to meet community health and social service needs.
Initial assessments were facilitated by a team of staff and consultants trained on the OACA process and tools. Each assessment lasted four days; to date, 18 assessments have been conducted. The assessments resulted in action plans to guide CSOs to prioritize actions toward improvement, with clear timelines and assigned responsibility. To review progress and new challenges, OACAs are conducted annually over the life of the five-year project.
The OACA was a great experience for facilitators, CSO staff, and board members. It was the first time many were exposed to the participatory process and tools, and able to discuss in a multi-disciplinary setting their current strengths and areas of weakness. Their own rankings helped CSOs develop strategies for improvement. “Loved how thorough and transparent the process was. The OACA really helped us reflect on our strengths and weaknesses as an entire organization.” – ACODEV
Many CSOs found the process very detailed and appreciated its participatory nature, including the ability to facilitate objective scoring. “Enables open discussion sessions where each member’s ideas were considered.” – JIACOFE
Others found it to be a helpful team-building exercise. “I appreciated the willingness of staff to participate and build consensus during the assessment.” – CEHURD
The project is currently supporting CSOs to address their prioritized areas identified in their action plans.
Under the majestic shadow of Mount Kilimanjaro lies Kibong’oto Infectious Disease Hospital (KIDH), the leading multi-drug resistant tuberculosis hospital in Tanzania. In 2012, KIDH was called the Kibong’oto National Tuberculosis Hospital; but the Ministry of Health and Social Welfare (MOHSW) and hospital leaders wanted to turn the TB specialty hospital into a parastatal institution to lead training and to help KIDH provide regional services for infectious diseases. USAID was also interested in funding the hospital directly for its TB diagnostic and treatment services, but wanted to KIDH to have systems strong enough to manage United States Government funds.
Through the TB TO 2015 Project, led by PATH, USAID supported KIDH to strengthen its service delivery, diagnostic and training systems. As a partner to PATH, Initiatives Inc. helped to build KIDH’s organizational capacity to help the hospital in its transition and strengthen its systems to meet the requirements for receiving direct funding from USAID.
KIDH’s capacity building process began with a participatory assessment. Together, Initiatives and KIDH personnel applied Initiatives’ organizational capacity assessment (OCA) and action planning process to assess the hospital’s capacity development needs and document a road map for strengthening systems. Following the initial OCA, Initiatives provided technical support to address the identified gaps including a guiding the development of a new strategic plan; documentation of KIDH finance, administration, and human resources policies and procedures; training KIDH leaders in resource mobilization; orienting staff on establishing ualityuality improvement; and training senior KIDH staff in leadership and management.
The involvement of KIDH staff in the hospital’s capacity assessment increased their commitment to make improvements. Follow-up OCAs showed growth, but it is KIDH’s successes in the last year that speak loudest to how far it has come. The KIDH strategic plan was approved by the MOHSW. The KIDH resource mobilization team is in place and successfully obtained additional resources to establish new training programs. Despite a major leadership change, KIDH was able to stay on track with its mission and strategic objectives. The hospital staff and leadership also established quality improvement (QI) teams and began instituting QI processes. The hospital also established nursing process standards and is now rolling out training on the standards to all nurses in all departments. Finally, a strong impact was made on leadership and decision making. A new organogram and relevant job descriptions were developed, training on supervision provided, improved communication systems put in place and strategies for improving the working environment for all staff established.