Larry Casazza, MD MPH

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NGO Involvement in Global Health Initiatives or
(Confessions of a Global Initiative Meeting
Groupie)

• Larry Casazza, MD MPH
• Director, ACAM African Communities Against
  Malaria
• November 29, 2005
• Save the Children Headquarters, Washington, DC

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Global Initiative Partnership Experience

• IMCI, especially HH/C-IMCI
• Still on-going interaction, but limited impact
• PEI
• Alive and well with adequate funding offers
  lessons learned for other collaborative efforts
  at national levels
• RBM
• New emerging importance for NGO engagement with
  GFATM and PMI resources through National NGO
  Secretariats in sub-Sahara Africa

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History related to HH/C-IMCI

• As a CORE Representative and WV partner
  attended
• Multiple UNICEF and WHOsponsored IMCI Partners
  sessions starting in 1997 in Santa Domingo, DR
  and at UNICEF/NYC, and in Washington, DC.
• Also several USAID meetings urging scaling-up of
  what NGOs learned from their CSPs drawn from more
  than 15 years experience

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HH/C-IMCI sessions Contd

• CORE launched Reaching Communities for Child
  Health Partnering with PVOs in Integrated
  Management of Child Illness at PAHO in 1999
  inviting WB, UNICEF, WHO and USAID this was a
  major shift in PVO dialogue with UN agencies
• As CORE member, presentation at International
  Workshop on Improving Childrens Health and
  Nutrition in Communities Durban, South Africa,
  2000-little recognition in the final Official
  Report

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Outcome of Durban Meeting

• The Durban meeting concluded with a call upon
  all partners
• to support families and communities
• through the development and expansion of the
  community component of IMCI and other community
  based health and nutrition initiatives
• that contribute to reducing mortality and
  promoting childrens health, growth and
  development.
• But where is the collaborative Action for Next
  Steps?

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HH/C-IMCI sessions Contd

• January 2001, CORE members with BASICS and CSTS
  input finalized the HH/C-IMCI Framework WHO
  response delayed
• Later in the same month, JHU hosted meeting to
  address research opportunities related to
  HH/C-IMCI little follow-up results to date

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PEI and CORE

• Opportunity presented by USAID for NGOs to get
  involved in surveillance activities in 2002
• Lessons learned for other collaborative efforts
  at national levels, namely RBM Secretariats
• Developed innovative mapping techniques and ME
  data collection and reporting

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Main Lessons - Opportunities

• Facilitate CORE PVOs as full partners in other
  national level health initiatives (e.g., malaria)
• Increase recognition appreciation of PVOs
• Secretariats can help us scale up. NGO/CBO
  partners have tripled the number of partners
  engaged in community level services
• Ease entry into new activity areas (e.g.,
  surveillance)
• Attract resources from new sources

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CORE Malaria Working Group Next Steps adopted
in 2002

• Strengthening networking of NGOs at Global,
  national and district levels
• Involvement in planning and revision of treatment
  protocols that address ARI and malaria
  appropriately
• Involvement in OR opportunities
• Provide leadership in creative marketing and
  distribution strategies for ITMs such as links
  with microfinance and market research with
  private sector to expand net access

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Effective Networks for Collaboration Are Critical
To Achieving Abuja Targets

• Current Condition of NGO Networks
• Strong implementation expertise
• Provide focal point for technical input
• Minimal leadership, management, or administrative
  capabilities
• Governments have no clear model of how to work
  with NGOs (and vise versa)
• Four secretariats now under formation

• Future Condition
• Scalable, sustainable programs
• Pro-active secretariats who plan three moves
  down the chessboard
• Local ownership and voice
• Coordinated distribution models
• Enhanced government partnership
• Enhanced NGO collaboration
• Heightened community coordination

• What Weve Learned
• Effective distribution of aid requires a coupling
  of technical expertise with management
  capabilities
• Secretariats have the potential to be the
  mechanism for this coupling
• Ownership and self-management from local
  organization is critical to scaled, sustainable
  results
• Collaboration between NGOs, CBOs, and
  governments is imperative
• Business best practices exist which can be easily
  applied to our efforts
• LQAS measurement methodology
• Value chain assessment and design
• Transformational leadership
• Success stories and models (NicaSalud)

• What We Need
• Shared governance framework that creates a clear
  path for NGO collaboration and coordination
• Development and implementation of simple business
  practices to ensure the effective distribution of
  aid and technical expertise
• Shared long-term vision that addresses the
  evolution and maturity of secretariats
• Working plan that allows secretariats to generate
  their voice and ownership of vision and
  objectives
• Models for network building

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Ongoing RBM Activities

• National level coordination strengthened in 5
  countries using CORE-supported training and
  organizational opportunities
• Established representation of NGOs at RBM Global
  Secretariat
• Careful documentation of process steps in
  development of national level coordination bodies
  and the resulting activities achieved by them.

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Recommendations for Partnerships

• Key questions for Global Initiative planners
• Whose agenda is it?
• For whom is it intended?
• What is the shared vision?
• How to share it with the key stakeholders?

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Enhancing Capacity to Implement Partnerships

• Understanding the operating context- not
  operating in a vacuum, but with linkages down to
  community/household level
• Enhancing Human Resources - all partners require
  management strengthening with sufficient
  resources to do the work
• Supporting Organizational Development for
  sustainable engagement of all partners to be
  capable of playing their role - (often in a
  heavily bureaucratic environment in need of major
  attitudinal change)

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Activity Domains of the actual work for
Partnerships

• Program delivery
• Human resource development
• Resource mobilization
• Research and innovation
• Public information, education and advocacy

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Essential process factors for successful
partnerships

• These describe how partners relate to one another
• The most successful partnerships DO NOT have
  formal hierarchical structures or are they bound
  by legal contracts (except in those instances
  where funds are to be jointly managed)
• Rather, they are built on strong trust that
  ensures accountability among participants
• Openness allows for flexibility to draw on
  complementary skills

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Valueadded mechanisms for successful
partnerships (why the partnership can accomplish
more than the individual actors)

• Continuity needed to maintain or expand on
  skills and competencies of the poor
• Comprehensiveness - the greater the number of
  causal factors it addresses, the better
• Coordination- awareness and collaboration with
  other actors allows for better coverage ,
  economies of scale and builds social capital for
  future challenges
• Risk mitigation- Partnerships hedge or reduce
  risk through diversification of skill sets,
  contacts, spheres of influence, and prior
  experience

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Types of Partnerships

• Potential Actors are aware of each other
• Nascent partnering started ,but not yet
  maximized
• Complementary limited to a fixed set of
  activities
• Synergistic address a complex set of activities
  through the addition of new activity domains, for
  example, advocacy and research

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Suggested reading

• CORE publication reference
• A Partnership Model for Public Health Five
  Variables for Productive Collaboration
• Beryl Levinger, Ph. D. and Jean Mulroy

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