The percentage of HIV treatment and prevention services in Kenya provided by faith-based health providers

ABSTRACT

Although the percentage of health services provided by the faith-based sector in sub-Saharan Africa is often cited along a range from 30% to 70%, depending on the country, such citations tend to be anecdotal and without reference to actual analysis of health service data. This article reports on a secondary analysis of health service data in Kenya to determine the percentage of HIV services provided by faith-based health providers. It then discusses the contributions of faith-based providers in light of these data, identifying opportunities and challenges involved in efforts to ensure that the resources of the faith-based sector are maximised.     

The unhealthy divide: how the secular-faith binary potentially limits GBV prevention and response

ABSTRACT

While progress has been made in creating conversations between the secular and faith actors involved in developmental issues, a distinct binary still exists. This could potentially be limiting a holistic response to gender-based violence, a global public health, development, humanitarian, and human rights issue. This article explores how perceptions of this binary – faith versus secular – are understood to impact GBV prevention and response efforts. Drawing on interviews conducted during a scoping study, the opinions and experiences of actors from faith-based organisations and academic institutions are used to shed light on how the faith-secular binary is being upheld and challenged, and how it is perceived to be impacting holistic GBV prevention and response.     

Water tariff conflict resolution through indigenous participation in tri-water sector partnerships: Dalun cluster communities in northern Ghana

The paper examines how the perceived ownership of a water resource negatively influenced local people's attitudes towards payment of potable water tariffs and exacerbated conflicts between water users and service providers in the Dalun community of the northern region of Ghana. The paper presents a case study of how community participation and endogenous approaches to conflict resolution contributed to payment of water tariffs. The findings show that the establishment of a tri-water sector partnership (TWSP), consisting of the Ghana Water Company Ltd (GWCL), private sector development practitioners, and community water boards, led to positive mediation of water tariff conflicts using the institution of chieftaincy. Alternative, endogenous conflict resolution methods combined with modern methods in a tripartite partnership showed promise as an approach to managing conflicts in water projects and in broader poverty reduction efforts.     

Mobilising faith-based and lay leaders to address antenatal care outcomes in northern Ghana

ABSTRACT

Despite the benefits of antenatal care, evidence from sub-Saharan Africa suggests that women often initiate these services after the first trimester of pregnancy and do not complete the recommended number of visits. This study examines the impact of mobilising faith-based and lay leaders to address the socio-cultural barriers to antenatal care uptake in northern Ghana in the context of a broader child survival project. A quasi-experimental design was used, and data were analysed using a difference-in-differences approach. The results presented in this article indicate the potential for faith-based and lay leaders to promote uptake of maternal and child health behaviours.     

Domains of faith impact: how “faith” is perceived to shape faith-based international development organisations

Increasing interest in faith-based international development organisations (FBOs) recently has improved understanding of these agencies. One reason for complex, often contradictory findings is the lack of frameworks analysing the interactions of worldviews on organisational structures, processes, and behaviours of agencies, and development outcomes. We utilise Lincoln's (2003. Holy Terrors: Thinking about Religion after September 11. Chicago: University of Chicago Press) four “domains of religion” to explore how the literature reports faith impacting the shape of development FBOs’ structures, behaviours, and outcomes. Literature suggests faith has a significant impact upon these agencies. We outline very specific similarities and differences, highlighting the importance of nuanced analysis of faith's role in FBOs. Further research is needed to build more evidence around these impacts of faith on FBOs.     

Productive power in the Papua New Guinea church partnership programme

This article analyses the strategy of partnership governing the Papua New Guinea Church Partnership Program (CPP). Using a governmentality lens that sees power as having a productive aspect, it focuses on how the technologies of financial management and planning, monitoring, and evaluation (PME) are taken up by the churches. Fieldwork research reveals how, in conforming to the discipline of these technologies to fulfil the partnership requirements, skilful and pragmatic individuals utilise the same technologies to empower their churches to enact their theology on development. For partnerships to work, the space must be created for such productive power to flourish.     

Network development for non-state health providers: African Christian health associations

ABSTRACT

Substantial effort has been put into forming and strengthening national networks of non-state, non-profit health providers in lower- to middle-income contexts. Christian health associations (national umbrella networks of faith-inspired health providers) were first established in the 1950s, and are currently present in an estimated 23 of the 54 countries in Africa. The establishment of CHAs was equally encouraged by faith-based health providers, governments, and external stakeholders. CHAs look different in each context, but perform similar roles: networking diverse institutions and facilities together into a loose system; and establishing a more cohesive sector to simplify and strengthen advocacy and engagement with the government.     

Faith-based HIV response in post-Soviet Eastern Europe: the case of Channels of Hope in Russia,Romania, and Armenia

ABSTRACT

Most of the data available on faith-based HIV response focus on Africa, which is the heart of the pandemic. This article investigates faith-based community-level HIV responses within Eastern Europe, by studying the implementation of World Vision International’s “Channels of Hope” faith-based HIV intervention. The intervention approach was developed in a high HIV-prevalence setting (South Africa) and then implemented across sub-Saharan Africa and elsewhere – including three low HIV-prevalence Eastern European settings (Armenia, Romania, and Russia). Drawing from implementation and evaluation research, this article explores the nature, challenges, and potential of faith-based HIV response within low-prevalence, post-Soviet contexts.     

Strengthening public health supply chains in Ethiopia: PEPFAR-supported expansion of access and availability

When the US President's Emergency Plan for AIDS Relief (PEPFAR)-supported Supply Chain Management System (SCMS) programme began working in Ethiopia in 2006, the estimated population of people living with HIV exceeded one million, while only 24,000 were on treatment and only 50 treatment sites were in operation. SCMS and other key partners entered into this context to support the Ethiopian government in significantly strengthening the public health supply chain system, with the aim of increasing the availability and accessibility of pharmaceutical products. The country now has 1,047 treatment sites and is nearing complete treatment coverage. This article discusses how priorities were set among many competing challenges from 2006 until 2014, and how the four-step strategy of build, operate, transfer, and optimise has resulted in a successful partnership.     

A comprehensive approach to providing services to survivors of sexual and gender-based violence in Democratic Republic of Congo: addressing more than physical trauma

ABSTRACT

The eastern Democratic Republic of Congo (DRC) is impacted by a prolonged conflict and humanitarian crisis. Sexual and gender-based violence (SGBV) affects an estimated 39.7% of women and 23.6% of men in the region, and is associated with serious medical, psychological, and socio-economic outcomes for survivors and communities. IMA World Health, a faith-based non-profit organisation, implements a USAID-funded project, Ushindi, which is a collaborative effort with three national NGOs and one technical partner in response to SGBV in eastern DRC. The consortium provides a comprehensive package of services to SGBV survivors, focusing on medical, emotional, psychological, legal, and socio-economic needs.     

Peacebuilding for faith-based development organisations: informing theory and practice

Faith leaders and their congregations have been recognised as holding the potential to engage positively in peacebuilding activities in a post-conflict context. Alongside this, faith-based development organisations (FBDOs) have the ability to engage with these constituencies to increase the peacebuilding impact of their activities. This paper presents a framework of faith engagement for FBDOs to work with local faith leaders and people of faith to develop the peacebuilding impact of development activities. A reworking of Anderson's “Do No Harm”, it encompasses the areas that FBDOs need to address in order to be effective peacebuilding actors in a faith context.     

Women’s NGOs as intermediaries in development cooperation: findings from research in Tanzania

This article employs research conducted with the Kivulini Women’s Rights Organization in Tanzania to discuss opportunities, constraints, and broader lessons about the role of women’s NGOs as intermediaries in development projects. Findings reveal that women’s NGOs often have insecure positions in development projects and are undervalued by executing agencies because advocating for gender equality is perceived as a “natural” extension of women’s roles in patriarchal societies. Women’s NGOs are “feminised” and consequently trivialised in their role as intermediaries, putting gender equality objectives at risk of attrition or abandonment. Under certain circumstances, women’s NGOs can be pushed out of partnership projects altogether.     

Addressing avoidable vision impairment in Mozambique and the Africa region

The Mozambique Eyecare Project was an international partnership to implement and research eye health education in Mozambique and the Africa region. An optometry degree was developed at Universidade Lúrio, Mozambique. In addition, existing eye health workers were upskilled with training. Researchers from various disciplines evaluated the project and its potential for impact on eye health in the region. The body of evidence generated from the research provides useful lessons for development programmes in general, as well as specific lessons for delivering eye health education and service delivery models for low-income settings.     

Informing the future of capacity building: lessons from an NGO partnership

Despite a recent surge in popularity, critical gaps remain in effectively building the capacity of organisations through global development projects. Two non-governmental organisations, FHI 360 and Conservation Through Public Health (CTPH), established a partnership focused on strengthening CTPH's organisational capacity to conduct high quality monitoring and evaluation and to effectively advocate for integrated population, health, and environment work. To help inform the design and implementation of future capacity building programmes, the partners describe their lessons learnt as illustrated through the five key capacity building steps: stakeholder engagement and partnership formation; capacity needs assessment; capacity plan design; plan implementation; and evaluation.     

Promoting NGO–academic partnerships for population,health, and environment learning

Population, health, and environment (PHE) projects integrate family planning, community health, conservation, and livelihoods activities into a single effort. Despite growing calls for integrated services, relatively little academic research on PHE has been published, which has hampered the development of the approach. This article argues that additional partnerships between academics and NGOs are necessary to further advance learning around PHE. However, such partnerships need not be approached in the same way. The article discusses barriers that currently impede the development of stronger partnerships and adapts (Roper, L. 2002. “Achieving Successful Academic-Practitioner Research Collaborations.” Development in Practice 12 (3–4): 338–345) typology of NGO–academic partnership models to describe how different relationship types are currently leveraged within the PHE community.     

Using subsidised seed to catalyse demand-driven bean seed systems in Malawi

Through an innovative public-private partnership, Demeter Agricultural Limited, along with the Malawi National Bean Programme and the International Center for Tropical Agriculture, supplied 2,559 tons of certified bean seed between 2009 and 2012 through the government's Targeted Farm Input Programme. Farmers were satisfied with the variety supplied, timeliness of the operation, pack size, and information provided. Growing numbers also accessed new improved varieties, from 264,661 households in 2009 to 344,200 in 2012. These emerging farmers’ demands and the subsequent DAL responses suggest a base for building sustainable delivery systems. However, decentralised seed-based systems will be needed for promoting varieties suited to micro-ecological niches.     

Building civil society through partnership: lessons from a case study of the Christian Reformed World Relief Committee

Civil society is seen increasingly as a necessary element of sustainable human development. Some Northern NGOs hope to contribute to the development of civil society by partnering with Southern NGOs. However, recent scholarship shows that such partnerships are frequently dominated by the Northern NGO, thus inhibiting the establishment of vibrant, locally owned and locally managed civil society organisations. This paper explores some of the practical reasons for this imbalance and suggests strategies for working within what Alan Fowler calls ‘authentic partnerships’. Such partnerships prevent the domination of Northern NGOs and thus help foster a climate more amenable to the growth of civil society. Suggested strategies for promoting authentic partnerships address funding, working relationships, phase-out, advocacy, and evaluation of the partnership itself. The paper draws on a case study of the partnership work of the Christian Reformed World Relief Committee (CRWRC), a North American faith-based NGO.     

Shaping participation: an international NGO implementing a government participation policy

This article reports on a case study of how one NGO utilised a government participation policy to establish ostensibly participatory spaces in the Cambodian health sector. The ethnographic field study revealed how the NGO exerted influence in establishing and facilitating participative committees by controlling membership, resources, and meeting agendas. This resulted in limited citizen participation, with committees used to educate, lobby, and mobilise community leaders to work towards the NGO’s priorities rather than community identified needs. This case contributes to our understanding of insisted spaces and the role of third parties implementing government participation policies.     

Farmers,peanuts, and aflatoxins in Uganda: A gendered approach

This article describes a collaborative research for development project that used participatory methods to engage smallholder farmers in Uganda in post-harvest aflatoxin management. It is based primarily on qualitative research with peanut growers tracing ‘the path of the peanut’ through their hand-drawn maps and journal writing. By focusing on everyday life and including recipes and drawings, this research encouraged women's participation and emphasised women's roles. A unique partnership among universities, women's organisations, and farmers created an environment of mutual learning and produced a book documenting food preparation and other post-harvest practices as part of a study and capacity-building effort on peanuts and aflatoxins.     

Climate resilient planning in Bangladesh: a review of progress and early experiences of moving from planning to implementation

Bangladesh is one of the first least developed countries (LDCs) to develop a long-term climate change strategy, the Bangladesh Climate Change Strategy and Action Plan (BCCSAP). Two funds were set up after developing the BCCSAP, one using government resources (BCCTF) and the other using donor resources (BCCRF). This paper uses the “building blocks” framework to analyse changes that occur when progressing from planning to finance and implementation by comparing the BCCRF and BCCTF. This analysis reveals how governance enablers are influenced by political economy dynamics that steer funding decisions and implementation outcomes, and provides lessons for countries pursuing climate resilience.