How can we make our work more relevant and effective?
Earlier this summer, FHI 360 held its first summit on integrated development, Greater Than the Sum of its Parts. Ben Ramalingam, a researcher and the Leader of the Digital & Technology Cluster at the Institute of Development Studies, delivered our keynote address. While Ben was in town, we talked about how to maximize the effectiveness of international development and how we need a paradigm shift to generate real change.
How do we measure nonprofit organizational effectiveness?
I was delighted to have a conversation with Jeri Eckhart Queenan, Partner & Global Development Practice Head at the Bridgespan Group, about the challenges in financing development. This was a great opportunity to discuss emerging trends in how organizations manage their programs in order to deliver the most effective results while maximizing value for their stakeholders, especially the beneficiaries of their work.
Tamimah grew up in Nakuru, a community in Kenya’s Rift Valley where the rate of HIV infection is high and where many young people don’t graduate high school. Tamimah’s early home life was precarious: Her mother left her and her three younger siblings, and her father provided limited support. The children were raised primarily by their grandmother.
Before Tamimah turned 13, her grandmother died, leaving the children without primary support. Tamimah and her two sisters and brother struggled to take care of themselves, stay in school and be healthy. It was “very hard to grow up in this place,” Tamimah said.
Things began to shift, however, when they were recruited to take part in APHIAplus, an FHI 360 project focused on improving health care delivery and multisector services to vulnerable populations in the Rift Valley. Through APHIAplus, which is funded by the U.S. Agency for International Development, Tamimah gained access to health education and services. She also received support to cover the costs of her school fees and supplies.
From these multipronged activities, there was a ripple effect: She was able to stay in school. Upon graduation, Tamimah studied tailoring through a vocational program also offered through APHIAplus and was able to provide for her siblings. After a year, she saved enough to open Al Hamis Café, named after her brother.
How can an adolescent girl succeed in school if she is not protected from sexual violence inside the classroom? How does a child thrive when his mother must choose between buying medication or nutritious food? We know that poverty, lack of access to education, poor health and violence are intimately linked, and how we tackle these problems is a global issue with important implications for the way the United States funds international development programs for women and girls. At the moment, we tend to compartmentalize our efforts in top-down, single-issue solutions, not because that is the most effective way to meet the needs of women and girls, but because it meets the needs of funders and their implementing partners. As we enter the new era of the Sustainable Development Goals (SDGs), we need to do better.
There is an obvious starting point.
We need to be a lot more deliberate and get a lot better at integrating efforts to improve the well-being of women and girls. Given the siloed nature of how we organize development work, especially in terms of funding and specialized expertise, we tend to think and act with narrowly predetermined notions of cause and effect. As a result, we miss vital connections and opportunities for action and impact. For example, I recently asked an African Minister of Health what was the biggest obstacle to women’s and girls’ health, and he immediately responded, “access to transport” to get to health facilities and obtain medicines. And yet, how often does transport come up as a priority when funders and development agencies plan health programs?
What will it take to eradicate extreme poverty?
I sat down with Carla Koppell, Vice President for the Center for Applied Conflict Transformation at the United States Institute of Peace to discuss the U.S. Agency for International Development’s (USAID) ambitious Vision to End Extreme Poverty. A former Chief Strategy Officer at USAID, Koppell shares her insight on how the international development community can turn vision into reality.
Why focus on extreme poverty? How do strategies for addressing extreme poverty differ in states with weak institutions? How do we balance getting rapid results with strengthening local capacity? These are just a few of the topics we dive into as we search for ways to turn ideas into action.
Dr. Timothy Mastro
Photo: Leanne Gray/FHI 360
World TB Day 2016 comes at a watershed time in the history of the tuberculosis (TB) epidemic and the broader global response to health and development. In recent years, we have expanded access to more sensitive TB diagnostic services, increased awareness about the important role of infection control within health care settings and have new treatment options for individuals with multidrug-resistant (MDR) TB. But, there is much work still to be done.
TB now rivals HIV as the top global infectious disease, yet we have not applied the same vigor to controlling TB as we have to controlling the HIV epidemic. That time is no longer. We have the opportunity to mirror the advances gained toward ending the HIV epidemic, largely based on evidence, driven by ambitious targets and linked to well-designed guidance.
In many parts of the world, HIV poses a particular challenge to TB control, which we cannot ignore. We have developed HIV prevention and treatment tools that will allow us to end the HIV epidemic, and we must add urgency to align these with TB control efforts. Doing so will assure successful outcomes in the fight against HIV and TB coinfection. The urgency comes from World Health Organization reporting that indicates mortality from TB eclipses mortality from HIV. The tremendous research and program advances from unprecedented investments in the HIV response must be leveraged to take control of TB morbidity and mortality.
Dr. Carol Dukes Hamilton
Photo: Leanne Gray/FHI 360
This moment in time is particularly important as we transition to the Sustainable Development Goals (SDGs) that will guide policy and funding over the next 15 years and are linked to a pledge to end poverty, everywhere, permanently. While health is now only one of 17 goals, the shift in focus may bode well for control of TB, which is a disease of poverty exacerbated by malnutrition, overcrowding and poor hygiene.
FHI 360’s TB initiatives strategically align with the SDGs. Our projects provide technical assistance to governments to yield evidence-based solutions to their local TB situations. We assist governments with improved disease surveillance so they can invest in ways that will yield the greatest impact by providing curative treatment and limiting new infections. We promote an approach that focuses on those most vulnerable in society because TB concentrates in the most marginalized populations of any given society. A human rights-based approach that engages affected communities is the basis for a sound, effective response.
In a statement declaring the clusters of birth defects that appear to be linked to Zika virus infection in Brazil “a public health emergency of international concern,” the World Health Organization recommends important measures for tackling this emerging infectious disease threat: improving surveillance, developing better diagnostic tests, intensifying vector control efforts and carrying out other prevention and treatment measures.
More remarkable were calls from public health officials in Colombia, Ecuador, El Salvador and Jamaica for women to postpone pregnancy until more is known about the association between the Zika virus and microcephaly, a severe birth defect affecting the brains of newborns. Salvadoran health officials have even advised women to delay pregnancy until 2018, when the risk of being infected with Zika may be lower.
The spread of Zika in the Americas adds urgency to the need to help all women — and their male partners — avoid unintended pregnancies. But, women and couples in countries affected by Zika face formidable barriers to achieving their fertility intentions, including lack of access to contraceptives and other reproductive health services, some of the world’s most restrictive abortion laws and high rates of sexual violence.
Placing the burden of protecting unborn children from the virus’ effects solely on women who have limited reproductive rights and contraceptive options is discriminatory and unsustainable. Expanding access to reproductive health services must be part of a comprehensive response to the Zika virus, and these services should be supported in ways that protect and strengthen the reproductive rights of women and girls.
The Sustainable Development Goals adopted by the United Nations in September provide an expansive vision of what we can accomplish over the next 15 years. Unlike the previous global development agenda, they include goals for all countries, not just poor ones, and more consideration for protecting our planet. The language also emphasizes that the new goals are integrated and indivisible, something the authors explain as win-win cooperation among the social, economic and environmental domains.
Now that the new global agenda is officially launched with slick logos and celebrity endorsements, and as the cheers (and some boos) start to die down, it’s time to talk about the hard stuff: How do we actually operationalize an integrated development agenda?