Using Rwandan traditions to strengthen programme and policy implementation

Implementing change is far harder than making policy pronouncements that call for change. Rwanda, in the 20 years since the 1994 genocide, has made substantial progress in turning around its economy and in meeting key Millennium Development Goals (MDGs). Real GDP in Rwanda grew at a rate of over 8% per year in the past years, the percentage of the people living in poverty has dropped by 14%, and UNDP reports that Rwanda is on track to meeting many but not all MDGs by 2015. Rwanda's progress in economic and social spheres stands out in Africa, where many countries, despite commitments to the MDGs, lag behind on performance. The difference in Rwanda is the leadership's attention to implementation, and the incorporation of endogenous practices, particularly into planning and accountability. This article is based on observations of practice at national and community levels and of policy design and implementation. It is a by-product of a study of the impact of different approaches to community health delivery systems in Rwanda, completed as part of the author's doctoral dissertation, and also of the author's experience working within the government in Rwanda.     

Reconciling cultural practices and progress: childbirth in Dove,Ghana

Women are forbidden from giving birth within the community in Dove, Ghana because it is against their culture. Such cultural practice is scarce in contemporary societies so studies on the impact of the practice are currently limited in development literature. This article uses key informant interviews and focus group discussion guides to gather data. Findings reveal that the Chief, the Queenmother, and other community members maintain that the practice is not negatively affecting the socio-economic development of Dove as they have strategies to mitigate the practice.     

Pledges not kept: JICA's project challenges in Ghana

Japan's project aid initiatives for capacity development still occupy a large part of the aid discourse of the country's development cooperation programme. Over the years, Japan's development rhetoric has been significantly adapted to the wider policy shifts of Western donor countries and has introduced in its programme and project documents such terms as ‘ownership’, ‘needs-based approach’, and ‘participatory’ initiatives in order to achieve more ‘sustainable’ results. Furthermore, the importance of ‘institutional memory’ has been repeatedly highlighted by Japan as an important element for greater project effectiveness. This article investigates how this development rhetoric translates in Japan International Cooperation Agency's (JICA) project practice in a three-year community-based initiative in rural Ghana. The results illustrate that despite the short-term benefits the project has brought to the targeted communities, the development practice of JICA falls short of its discursive representation and more effort is needed by JICA toward a more committed and inclusive project practice.     

Meeting the challenges of the handicraft industry in Africa: Evidence from Nairobi

This article presents findings on observed productivity constraints of handicraft firms in Nairobi, Kenya. The goal is to help NGOs, intergovernmental organisations, and national governments in their efforts to foster local handicraft industries in Africa and beyond. One-hundred and two respondents were interviewed about their business, cost structure, hiring practices, and other intra-industry relationships. This article points out a number of practical problems hindering productivity and limiting livelihoods, including problematic labour practices, conditions of adverse selection, the context of proprietary information in small scale manufacturing, and the tendency of the industry toward hypercompetition.     

Centring African culture in water,sanitation, and hygiene development praxis in Ghana: a case for endogenous development

International development aid is driven by actors steeped in Western neo-liberal theory and practice. Africa has largely received failed Western aid, administered mainly through international NGOs in neo-comprador relationships. This article calls for African-centred and -led development, revitalised through endogenous development (ED) praxis. Using a water, sanitation, and hygiene (WASH) sector case study from Ghana, the article theorises Africa's WASH development within the context of globalisation and the politics of knowledge production on Africa. It shows how ED provides African people with self-determining and culturally relevant development necessary for WASH justice and improved health and livelihoods.     

Assessment of the Livelihood Empowerment Against Poverty programme in Karaga district,Ghana

This article assesses the contribution of the Livelihood Empowerment Against Poverty (LEAP) programme in reducing rural poverty in the Karaga district of Northern Ghana, using a mixed research design to compare the livelihoods of beneficiaries and non-beneficiaries. It concludes that the programme is contributing to poverty reduction among the poor and vulnerable, and recommends that school children benefiting from LEAP should be exempted from paying extra expenses such as examination and PTA fees. There should also be a system to provide subsidies for agriculture inputs to enable beneficiaries to engage in agriculture to promote longer term poverty alleviation.     

“Yes we are here,living, but malaria is surrounding us”: sustainable livelihoods and malaria in Tanzania

This paper examines connections between sustainable livelihoods and the ability to deal with health risks, in the Kilombero Valley in Tanzania where rates of mortality and morbidity from malaria remain high. Application of the Sustainable Livelihoods Approach (SLA) to a narrative of daily lives demonstrates that villagers have experienced a reduction in assets, income, and capital, which limits their ability to follow health promotion advice. The focus on livelihoods highlights possible local developmental interventions that could have a significant impact on improving the health and well-being of the villagers, with potential relevance to other places in the Global South.     

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.     

Understanding the needs and challenges of a Black community in South Africa

This article reports on a study conducted with an unemployed group of community members residing in the Gugulethu Township in South Africa. The study aimed to gain an in-depth understanding of their needs and challenges, and what they thought could be done to assist and empower them so that they could improve their lives. Their basic human needs were violated during apartheid and as a consequence, they are still battling poverty today. We offer suggestions on how Black communities in South Africa could be supported and empowered in order to become employable and self-reliant.     

Donor-induced depoliticisation of development implementation: the case of Ghana’s Compact I

Based on empirical evidence from a donor-funded project in Ghana, this article demonstrates that when development implementation is depoliticised, targets will likely be achieved within budget and on time. Funded and supervised by the Millennium Challenge Corporation of the United States, Ghana Compact I has been recommended as a model for future development implementation. This article is an attempt to explain this success, compared to select social programmes. It argues that Compact I was implemented successfully because it was insulated from political interference, and suggests that donor-induced depoliticisation offers a route to successful development implementation in recipient countries.     

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.     

Capacity building at mid-programme: an international education development programme in Malawi

This article reports on a case study of a mid-programme capacity building evaluation within a large education aid programme collaboration between non-governmental educational organisations in Malawi and US university literacy faculty. The article outlines the programme context and its formal and informal capacity building inputs. Analyses of data collected on capacity building at the midpoint of the programme are offered. The authors argue that capacity is built along the life of large programmes, and evaluating capacity building development (and understanding its challenges) before the end of the programme can help cross-national teams of administrators and implementers in modifying programme operations.     

Towards universal health coverage in Zambia: impediments and opportunities

Universal health coverage has been given a prominent place in the post-2015 global development agenda, but there are concerns over its feasibility in low- and middle-income countries. This article assesses successive Zambian governments’ efforts to achieve this agenda. We discuss the recent restructuring of health governance to support policies that re-emphasise the social determinants of health and health equity. This includes a new Ministry of Community Development and Mother and Child Health alongside the Ministry of Health. We argue that recent innovations in policy and practice need to be extended to include ministries which focus on economic development.     

Utilisation of maternal health services in Ethiopia: a key informant research project

This article explores the application of key informant research to examine barriers and facilitators to maternal health services in rural and pastoralist Ethiopia. The key informants were health extension workers (HEWs) who assist women with birth preparedness and facilitate timely referral to health centres for birth. While women encounter many barriers to giving birth in health facilities, where HEWs are supported by their communities and health centre staff, they can effectively encourage women to travel to health centres to give birth with skilled birth attendants rather than at home with unskilled relatives or traditional birth attendants.     

Using birthing kits to promote clean birth practices in Ethiopia

This article explores three NGO projects that assemble and distribute clean birthing kits in Ethiopia. It contrasts the government's health strategy that aims to increase skilled birth attendance, with local realities as most women in rural and remote settings give birth at home, often in unhygienic conditions, and without skilled assistance. Many health facilities are also unable to provide hygienic conditions for birthing women. The findings indicate that clean birth kits have assisted the NGOs to effectively promote clean delivery at home or in health facilities, and to encourage antenatal care, and early referral to emergency obstetric and new-born care.     

African philanthropy,pan-Africanism,and Africa's development

Reflective and theoretical, this article explores the foundations and principles of African philanthropy and juxtaposes them with pan-African-led development. It pays particular attention to new continental initiatives, such as Agenda 2063. It points out that African philanthropy, by its definition and practice, is the foundation for development. This is because the identity of an African is premised on philanthropic notions of solidarity, interconnectedness, interdependencies, reciprocity, mutuality, and a continuum of relationships. No one embodies these better than Nelson Mandela in his demonstration of the link that exists between pan-Africanism and African philanthropy in the development process.     

The persisting challenge of age-for-grade non-compliance in post-free primary education in Kenya

This article examines the prevalence of non-compliance on the age-for-grade policy in the post-free primary education system in Kenya. We utilised data from the 2009 cohort of enrolled primary schoolchildren. The analysis revealed non-compliance to be a persisting concern in the school system, characterised by both under-age and over-age enrolment at the age-for-grade level of analysis in spite of the introduction of free primary education in 2003. Irrespective of the nature of non-compliance, overcrowding in the lower grades is more prevalent, with potential for adverse compromises in quality of learning and the attendant added dimension of the mismatched grade-for-age curricula.     

Roles of religious actors in the West African Ebola response

ABSTRACT

More than 11,000 people died during the 2014–15 Ebola epidemic. It devastated the communities concerned and set back progress in building health systems and socio-economic development more broadly. Concentrated in three poor West African countries, Guinea, Liberia, and Sierra Leone, the tremors reverberated worldwide, spurring mobilisation of vast human and financial resources. The epidemic highlighted contemporary challenges for public health, particularly in fragile states, with lessons extending far beyond health sectors. Religious actors played distinctive roles at various points and across different sectors. This article focuses on religious responses to the 2014 Ebola epidemic and implications for public health practitioners.