the nigeria civil society and communities ccm … · one focus group discussion of not less than...

The Anglophone Africa Civil Society and Communities CCM Shadow Report and Scorecard Initiative

THE NIGERIA CIVIL SOCIETYAND COMMUNITIES

CCM SHADOW REPORT

Authors:

Ifeanyi Orazulike, International Center for Advocacy on Right to Health (ICARH)

Martin Mary Falana, Kids & Teens Resource Centre

Olayide Akanni, Journalists Against AIDS ( JAAIDS) Nigeria

2

Every one of the Country Reports were done using Participatory Action Research: The research was developed, conducted, analysed and written by in-country national

civil society activists.

The Nigeria Civil Society and Communities CCM Shadow Report

3

Table of Contents

Abbreviations .....................................................................................................................................................................4

Problem Statement ...........................................................................................................................................................5

About the research ............................................................................................................................................................7

Expected Outcomes ...........................................................................................................................................................7

Methodology ......................................................................................................................................................................8

Analysis .............................................................................................................................................................................10

CCM Performance ............................................................................................................................................................10

EPA Tool & Process ..........................................................................................................................................................16

PIP Tool and Process .......................................................................................................................................................16

Finding 1: CCM members ignorant of EPA and PIP process .......................................................................................17

Finding 2: Need to engage people affected and not just technical experts .............................................................17

Finding 3: Grant proposal and implementation process flawed ...............................................................................17

Recommendations ...........................................................................................................................................................19

Priority Area 1: Training required on CCMs, EPAS and PIPs .......................................................................................18

Priority Area 2: Greater involvement of CSOs in CCM spaces ....................................................................................18

Priority Area 3: Need for CSO watchdogs, especially KP CSOs, on fund implementation ......................................18

Notes .................................................................................................................................................................................18

Contact Details .................................................................................................................................................................22

4

AAI AIDS Accountability InternationalCCM Country Co-ordinating MechanismCoI/CI ConflictofInterestCG Community groupCSO Civil Society OrganisationCS Civil SocietyEANNASO EasternAfricaNationalNetworksofAIDSServiceOrganisationsEPA EligibilityPerformanceAssessmentFBO Faith-Based OrganisationFGD Focus Group DiscussionWSW WomenwhohaveSexwithWomenGF/GFATM GlobalFundforAIDS,TuberculosisandMalariaHIV HumanImmunodeficiencyVirusIDU Injecting drug usersINGO InternationalNon-GovernmentalOrganisationKAP KeyAffectedPopulationsKP Key PopulationsMDR TB Multi-Drug-ResistantTuberculosisMSM MenwhohavesexwithmenNFM NewfundingmodelNCM NationalCoordinatingMechanismNGO Non-GovernmentalOrganisationNPO Non-ProfitOrganisationOIG OfficeoftheInspector-GeneralPAM PeopleAffectedbyMalariaPATB PeopleAffectedbyTuberculosisPIP PerformanceImprovementPlanPLWD PeopleLivingwiththeDiseasesofHIV,TBandmalariaPLWHIV PeopleLivingwithHIVPR Primary RecipientRFA RequestforApplicationSR Subsidiary RecipientSSR Sub-Subsidiary RecipientSW SexWorkersTB Tuberculosis

Abbreviations


5

EffectiveCountryCoordinatingMechanisms(CCMs)areavitalpartoftheGlobalFundarchitectureatcountrylevel.

CCMsareresponsible forsubmittingrequests for fundingandforprovidingoversiteduring implementation.With

theintroductionoftheGlobalFund’sNewFundingModel(NFM)inMarch2014,CCMsplayanevenmoreimportant

centralrole,convenestakeholderstoengagemeaningfullyininclusivecountrydialogue,agreeonfundingsplit,and

participateinthedevelopmentofNationalStrategicPlan(NSP)discussionsforthethreediseasesatcountrylevel.

Withtheenhancedresponsibility,theNFMalsointroducedmorerigorousCCMassessmentprocesses.Previously,

CCMssubmittedaself-assessmentattachedtotheirproposal.Now,CCMself-assessmentsarefacilitatedbyconducted

byanexternalconsultant–either the InternationalHIV/AIDSAllianceorGrantManagementSolutions forandon

behalfoftheCCMHub.Further,CCMsarealsomandatedtohaveaperformanceimprovementplantoaccompany

theirassessment,ensuringthatareasofweaknessareaddressedinanopenandtransparentmanner.

DespitetheimportanceofCCMsinGlobalFunddecision-makingatcountry level,studieshaveflaggedissueswith

CCMmembershipbalance,poorrepresentationandlimitedconstituencyfeedback.1,2Further,therecentauditreport

fromtheOfficeoftheInspectorGeneral(OIG)foundseveralpersistentshortcomingswithCCMperformance:

• 10%ofthe50countriesrevieweddidnothavetherequiredoversightcommittee;

• Morethanhalfofthecountriesdidnothavespecificinformationonroles,timelines,andbudgetsintheiroversight

plans,ortheyhadoversightplansthatwereoutdated;

• 62%oftheCCMswerenon-compliantwiththerequirementofseekingfeedbackfromnonCCMmembersand

frompeoplelivingwithand/oraffectedwiththedisease;

• Morethanhalfofthe45CCMsthathaveoversightbodiesdidnotadequatelydiscusschallengeswiththePRsto

identifyproblemsandexploresolutions;

• 58%oftheCCMshadnotsharedoversightreportswithcountrystakeholdersandtheGlobalFundSecretariatin

theprevioussixmonths;and

• 26%didnotsharetheoversightreportswithrelevantstakeholdersinatimelymannerthatcouldhaveensured

well-timedremedialaction.

InlightoftheOIGCCMAudit,andtheenhancedroleofCCMsincountryleveldiseasegovernanceintheFunding

Model,thereisaneedforawiderangeofstakeholderstobeempoweredtodemandimprovedCCMperformance.

WhilethemovetohaveanexternalconsultanttofacilitatetheCCMEligibility&PerformanceAssessments(EPA)and

thedevelopmentofPerformanceImprovementPlans(PIPs)toguidethesubsequentstrengtheningoftheCCMisan

improvement,thefactthattheseEPAsandPIPsarenotpublicisanobstacletoaccountability.

Problem Statement

1 Oberth,G. (2012).Who isReallyAffecting theGlobalFundDecisionMakingProcess?:ACommunityConsultationReport.AIDSAccountabilityInternational.CapeTown,SouthAfrica.Onlineathttp://aidsaccountability.org/?page_id=80942 Tucker,P.(2012).WhoisreallyaffectingtheGlobalFunddecisionmakingprocesses?AQuantitativeAnalysisofCountryCoordinatingMechanisms(CCMs).AIDSAccountabilityInternational.CapeTown,SouthAfrica.Onlineathttp://aidsaccountability.org/?page_id=8094

6

VestedstakeholdersandcommunitiesmustbeabletouseCCMassessmentsandimprovementplansasaccountability

mechanismstodemandbetterperformance.

AddedtothisisthatfactthatcurrentlyCCMAssessment&PerformanceImprovementPlanslackquestionsthatspeak

toqualityofperformancesuchasmeaningfulengagement,useofdocumentationandinformation,etc.

CivilsocietyneedstobefurtherengagedwiththeCCMAssessment&PerformanceImprovementPlansinorderto

holdstakeholdersaccountable.Similarly, thesesamecivilsocietywatchdogsandaffectedcommunitiesmusthave

thetools,knowledgeandinformationtheyneedtobeabletomeasuretheperformanceoftheCCMmembersthat

representthemandtoholdCCMsaccountable.

Problem Statement


7

About the research

Long term goalMoreaccountableCCMs.

Medium term objectiveIncreased transparency around

CCMperformanceandimprovementplans.

Theprojectcomprisesoftwotypesofresearch:

The Country CCM Shadow Reports

ThesereportsdrilldownintoissuesatcountrylevelandassessCCMperformancefromtheperspectivesofbothCCM

membersaswellastheperspectiveofotherstakeholderssuchasprincipalrecipientsandsubrecipients.Thereport

isbasedontheGFATMCCMAuditProgressAssessmentToolbutalsoincludevariousotherquestionsthatareseen

tobelackingintheexistingauditsbyGeneva.Thereasonwhytheresearchisconsideredashadowreportingexercise

isthatmethodologicallyandintermsofcontentwearehopingtobuildandimproveonthemethodsbeingusedby

Genevaatthistime.Shadowreportsareusedtosupplementand/orprovidealternativeinformationtothatwhich

wassubmittedintheoriginalreports. Inthiswork,ouraimisthesame:tosupplementand/orprovidealternative

informationtothatfoundintheoriginalCCMaudits.

TheCivilSocietyCCMScorecardandCountryCCMShadowReportswillnotduplicate theGlobalFundsupported

EligibilityandPerformanceAssessments(EPAs).ThisisbecausewhilstEPAsareconsultantfacilitatedself-assessments

ofCCMsthatarelargelydrivenbytheGlobalFundtofacilitateaccountabilityusingatopdownapproach;theCivil

SocietyCCMScorecardandCountryCCMShadowReportswillbeundertakenbycivilsocietyincountry,usingabottom

upapproach.Inaddition,theCivilSocietyCCMScorecardandCountryCCMShadowReportssoughttointerviewboth

CCMmembersaswellas implementingpartners (principal recipients (PRs)andsub-recipients (SRs))who interact

withCCMs.TheresearchfortheCivilSocietyScorecardandtheCountryCCMShadowReportswasfacilitatedbycivil

societyresidentincountrysotheexercisecouldbothempowercivilsocietyandsustainthecultureofdemanding

accountabilityfromCCMsincountryandbereplicatedacrossothergrantimplementers.

The Civil Society CCM Scorecard

Acomparativeanalysisthatrankstheparticipatingcountriesagainsteachotherintermsoftheirperformance.Using

theAAIScorecardmethodology,datafromtheCountryCCMShadowReportsisanalyzedandcountriesaregraded

ontheirperformance,asameanstouncoverbestandworstpractice,whoisahead,whoisfallingbehind,andother

similaritiesanddifferencesthatmightmakeforgoodentrypointsforadvocacy.

Focus Countries

Ninecountriesparticipatedintheresearch:Ghana,Kenya,Malawi,Nigeria,Rwanda,Swaziland,Tanzania,Ugandaand

Zambia.

Expected Outcomes

Short term aimEmpoweredcivilsocietyand

communitygroupswhocandoeffectiveshadowreporting.

8

Thetechnicalteam(AAIandEANNASO)developedaquestionnairebasedontheGlobalFundEligibilityandPerformance

Assessments(EPAs)questionnaire(calledtheProgressAssessmentTool).AAIalmostexclusivelyusesParticipatory

Actionresearch(PAR) forfieldresearch,abestpractice inwhichcommunityandcountrycivilsocietypartnersco-

developedthemethodology,researchtools,conductedtheresearchandwrotethefinalreportsandanalysis.

Localcivilsociety,whodonotsitontheCCManddonotreceiveGlobalFundmoney,wereidentifiedtodoconduct

theresearchatcountrylevel,includingdatacollectionandanalysis.Weselected3localwatchdogsineachofthe9

countriesforatotalof27localwatchdogstobetrained,mentoredandsupportedtodotheresearch.Thetraining

alsoequippedcivilsocietywithskillstoenablethemtoengagewiththeCCMSecretariattoplanandschedulethe

interviewsandFGDs.Civilsocietyconductedinterviewstocollectdatausingamixofquestionnaireinterviewsand

focusedgroupdiscussions(FGD).ComprehensivequestionnaireswithopenendedquestionsandFGDguideswere

providedtocivilsociety;theseallowedforprobinganddiscussionswhilstcollectingdata.

First,thecoregroupofrespondentsfromtheCCMfortheinterviewandfocusgroupdiscussionsweredrawnfroma

crosssectionofCCMmembersrepresentingtherespectivegovernments,faithbased,civilsociety,privatesector,key

populations,peopleaffectedbythediseases,thebilateralandmulti-lateralpartnersandtheCCMsecretariat.Civil

societyconductingtheresearchwereexpectedtoundertakeaminimumofeightfacetofaceinterviewsandconduct

onefocusgroupdiscussionofnotlessthansixCCMmembers.

These interviewsandaFGDcollectively includedallofthefollowingsectors:government, faithbased,civilsociety,

privatesector,keypopulations,peopleaffectedbythediseases,thebilateralandmulti-lateralpartnersandtheCCM

secretariat.

Secondly,civilsocietyalsoconductedaFGDof10-12nonCCMmembersmainlydrawnfromimplementinggovernment

andcivilsocietyPRsandSRs.ThesecondFGDenabledtheresearchtogettheperspectivesofnonCCMmembers

whohaveinteractedwiththeCCM.Keyareasofdiscussionincluded:

• HowtheyhavebenefittedfromtheoversightfunctionoftheCCM;

• How,whenandtheoutcomesoftheoversightfieldvisit;

• IftheoversightreportsandoutcomesareformallysharedandpublishedthroughtheCCMwebsite

• WhetherwomenandKPsareadequatelyrepresentedontheCCM;

• Ifcivilsocietymemberswereelected/selectedinanopenandtransparentmanner;

• AnunderstandingofthelevelofmeaningfulparticipationofKPsinCCMleadership;

• AnunderstandingofthelevelofmeaningfulparticipationofKPsinformalandadhoccommittees;

• ThemethodsofsolicitingKPinputandthenthisfeedbacktothelargerconstituency;

• Conflictof Interest (COI)e.g.howgrant implementers (SRs)whoarealsoCCMmembersmanageCOI inCCM

meetingsetc.

Methodology


9

Oneaimwastobuildthecapacityofthelocalcivilsocietywatchdogstoengagewithavarietyofdifferentresearch

techniquesanddatagatheringmodalities,sothefollowingwillcontributetothisobjective:

• CivilsocietyreceivedtrainingonFGDsattheworkshop;

• Civilsocietycompletedhardcopiesofthequestionnairesatcountrylevelandthenalsocapturedthedataonline

intoasurveymonkey.

• Civilsocietydevelopedtheirown2-3pageanalysisofeachofthe2FGDs,talkingaboutkeyfindings(estimate5-8

findings)andrecommendingstrategicentrypointsforadvocacy(estimate3-5)

• In addition to this, civil societywrote their own 5-8 page analysis of all of the data as they understood and

interpreteditandsubmittedthistothetechnicalteam.Thisanalysisformedthebasisofalloftheresearchthey

conducted,andinformedthetechnicalteam’sanalysisofthedata.

Sub-grantsweremadetoeachofthelocalwatchdogstosupporttheirimplementationoftheshadowreporting.The

contentfromthecountrydatacollectors,onceenteredintothesurveymonkeytool,wasanalysedbyAAI,presented

toEANNASOandcountryteamsatameetinginKigali,RwandainFebruary2017,andfeedbackfromthismeetingand

fromemailcorrespondencefromcountryteamswasincludedtodevelopthefinalreports.

MethodologicallyitisimportanttonotethedatesofwhentheshadowEPAsandtheGenevaEPAswereconductedas

differencescouldbearesultofchangesovertime.AlltheshadowEPAresearchwasconductedbetweenNovember

2016andFebruary2017.Nigeria’sGenevaEPAsweresubmittedonthe2017-02-01.

10

Note: This research exercise was conducted in Nigeria between November and December 2016 and does not necessarily reflect or capture changes in the CCM leadership that occurred in Feb 2017.

CCM PerformanceAllCCMsarerequiredtomeetthefollowingsixrequirementstobeeligibleforGlobalFundfinancing:

1. Atransparentandinclusiveconceptnotedevelopmentprocess;

2. AnopenandtransparentPrincipalRecipientselectionprocess;

3. Oversightplanningandimplementation;

4. MembershipofaffectedcommunitiesontheCCM;

5. Processesfornon-governmentCCMmemberselection;and

6. ManagementofconflictofinterestonCCMs.

Belowisahighlightoftheresearchfindingsaspertheaboveeligibilityrequirements:

1. A transparent and inclusive concept note development process

InNigeria,priortotheadventoftheNewFundingModel(NFM),thecountryhadengagedthesupportoftechnical

stafffromtherelevantgovernmentparastatalsandagencies,developmentpartnersandconsultantswithlittleinput

ofcivilsocietyinthedevelopmentoftheconceptnoteforthecountry.Limitedcommunityengagementgaveroom

forgapsduringimplementationofprojectsbecausecivilsocietygroupsthatweresaddledwiththeresponsibilityof

implementingthesegrantsinthecommunitieswerenotnecessarilypartofthedevelopmentoftheconceptnote.

TheintroductionoftheNewFundingModelhoweverhasfosteredchangesintheconceptnotedevelopmentprocess.

Throughthecountrydialogues, theCCMhasbeenabletoengageadiversityofpartnersandstakeholdersat the

country level, includingKeyAffectedPopulations (KAPs)andPeopleLivingwith theDiseases (PLWD). Thecountry

dialogueshavehelpedtodefineinaparticipatorymanner,strategiestocombatthemaindriversofthediseasesas

wellasthemostappropriateinterventionstoaddressthem.

Feedbackfromthisassessment indicatedthattheCCMNigeriahasdemonstratedtransparencyandinclusiveness

through broader community engagement in the development of concept notes .. According to the civil society

representativesinterviewed,theopportunityprovidedforbroaderengagementwithcommunitygroupsandwasa

welcomedevelopment,asmanycommunitystakeholdersgotabetterunderstandingoftheGlobalFundprocesses

throughtheconstituencyconsultations.Respondentsfromthefocusgroupdiscussionsandtheface-to-faceinterviews

conductedhadarelativelybalancedimpressiononthetransparencyofthewholeprocessofthedevelopmentofthe

countryconceptnotes.

Analysis


11

2. An open and transparent Principal Recipient selection process

TheviewsonthePrincipleRecipient(PR)selectionprocessvariedbetweentheCCMandtheNon-CCMrespondents.

OnthepartoftheNon-CCMrespondentsduringtheFGDs,therewaslimitedclarityonhowthePRswereselected,but

CCMmemberswereoftheopinionthattheyhaddoneagoodjobwiththeselectionprocess,addingthat:

‘’The whole process of engaging the Principal Recipients has always been very transparent

and open and due processes were followed.”

Someindividualmembersintheface-to-faceinterviewshoweverexpressedconcernsabouttheundueinfluenceof

theGlobalFundSecretariat,evenintheselectionofPRs:

“Sometimes the Global Fund contributes to the failures being experienced by the country in the

implementation of the grants, by for instance insisting that the initial 5 selected PRs be reduced to 3.”

AnotherrespondentcitedtheinvocationofthesafeguardpolicywithrespecttotheHIV/AIDSandMalariagrantsin

NigeriawherebytheGlobalFundhasselectedPRsandadvertisedtheirnamesinthenewspaperswithoutconsulting

withtheCCM:

“They (The Global Fund Secretariat) take decisions without recourse to the CCM. For instance, in replacing

the PRs (NACA and NMEP), the Global Fund just advertised in the newspapers that they had selected Family

Health International (FHI). The Nigerian Government is angry about this kind of selection process. The

CCM has no role in the selection of the new PRs. The selection was just handed over to us. There was no

justification for this and the CCM is being made to look like a lame duck on these issues.”

3. Oversight planning and implementation

FeedbackindicatedthattheCCMisperformingitsroles inplanningandimplementationbut itscapacitycouldbe

enhancedtodomore.“Iwouldqualifyourprogressastwostepsforward,onestepbackwards,”oneCCMmember

noted.

MostmembersoftheCCMhowevercommendedtheCSOrepresentativesforbeingvocalandraisingalarmswhen

thingsaregoingawry.TheOversightCommitteewasidentifiedastakingtheleadinensuringthatoversightvisitsto

implementationsitesareconductedasandwhendueetc.andhavebeenusefulinprovidingguidancetoPRs/SRsin

grantimplementationandaddressingsystemic,structuralandprogrammaticgapsinthefield.Itwashowevernoted

thatoftentimes,follow-upactionsfromtheOversightSub-Committeedonotoccurinatimelymanner:

“we need to be able to differentiate between grant monitoring and our oversight roles. Sometimes we get

bogged down with un-actionable actions which we cannot follow up on”.

100%

90%

90%

86%

100%

73%

100%

100%

88%

0%

10%

10%

14%

27%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

1.AFendmeeGngs?

Yes No Idon'tknow

88%

100%

70%

75%

50%

45%

67%

100%

50%

13%

30%

13%

38%

55%

33%

50%

13%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

2.Speak&beheard?

Yes No Idon'tknow

AnotherrespondentnotedthatthisslowresponseonthepartoftheCCMsmayaccountforwhythePRsoftenside

steptheCCMsandcommunicatedirectlywiththeGlobalFundSecretariat in instanceswherepromptandurgent

responses to requests areneeded. Inorder to enhanceeffectiveness, the capacity and skills ofmembersof the

OversightCommitteewasalsocalledintoquestionassomeoftherespondentsnotedthattherearekeyrequired

skillswhichtheCCMcurrentlylacks:

“The committee is made up of members with different expertise that may not correlate with the expertise

that is needed. The Government is not supporting the CCM. I would love to bring in other experts (e.g.

supply-chain etc. and this will need extra funds. If Government takes ownership of the CCM that may be

possible.”

Analysis

ATTENDANCE DOES NOT EQUAL BEING12

18%

25%

9%

13%

64%

40%

50%

13%

27%

14%

17%

38%

88%

36%

60%

50%

38%

27%

71%

67%

50%

9%

14%

17%

13%

25%

9%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

QuesGon:Oversight:Howwouldyouratetheperformanceoftheoversightbody?

Totallyunacceptablequality Unacceptablequality Acceptablequality Goodquality Perfectquality Idon'tknow

Question: Oversight: How would you rate the performance of the oversight body?

TheGhanaCivilSocietyandCommunitiesCCMShadowReport

88%

100%

60%

67%

50%

27%

86%

100%

88%

13%

40%

17%

38%

73%

14%

13%

17%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

3.ParFcipatemeaningfully?

Yes No Idon'tknow

63%

100

50%

57%

50%

18%

50%

92%

25%

13%

40%

14%

38%

73%

50%

75%

25%

10%

29%

13%

9%

8%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

4.Influencedecisions?

Yes No Idon'tknow

TheCCM‘soversightroleoverthePRsalsoraisedseveralconcerns.CCMmembersbothintheFGDsandface-to-face

interviewsexpressedtheirfrustrationswithPRs,notingthatthey(theCCM)felttheyhadnoreal“powers”overthePRs

astheGlobalFundSecretariatcommunicatesdirectlywiththePRwithoutkeepingtheCCMintheloopandthePRs

tendtobemoreresponsivetotheGlobalFundSecretariatthantothem.

On theotherhandhowever, oneof thePR respondentsnoted thatwhile theCCMhas statutorily performed its

oversightvisitsatstatelevels,itsneedstoextendthesamefunctionstothePRs:

“The CCM has a follow-up opportunity with the PRs. The quarterly dashboard presentations made by the

PRs only presents the achievements. The CCM needs to probe more in order to call the PRs into account.”

ThispositionisfurthercorroboratedbyanotherCCMmemberwhonotesasfollows:

“It’s difficult to glean Information from the PRs. For instance, the financial information that they provide

doesn’t give you enough information as the PRs tend to give you whatever they want.”

RespondentsnotedthatconflictsofinterestswerealsounderminingtheeffectivenessoftheCCMassomemembers

alsoworkwithorganisationswhoarealsoGlobalFundgrantimplementers.Theyrecommendedthatstrengthening

themembers’capacitytobetterunderstandtheiroversightrolesandeffectivemanagementofconflictof interest

issueswouldgoalongwaytoaddressthesechallenges.

4. Membership of affected communities on the CCM

WhereasgovernmentrepresentativesusuallyhavealargerrepresentationonCCMs,theGlobalFundrecommends

that aminimum of 40% of CCMmembers (and sub-CCM, or Regional CoordinatingMechanism) represent non-

government sectors, including: academia, educational NGOs, community-based organisations, the private sector,

ABLE TO INFLUENCE DECISION MAKING 13

14

keyaffectedpopulations,includingpersonslivingwithHIV/AIDS,TBand/ormalaria,faith-basedorganisations,and

multi-lateralandbi-lateraldevelopmentpartnersincountry.Presently,theNigerianCCMNon-Governmentalsector

representation iswellabove theminimumrequirementwithabout51%ofCSOson theBoard.Asat the timeof

conductingthisresearch,theCCMChairandvicewerebothfromtheCSOconstituency.

Althoughthecommunitieswiththediseases,(HIV,TBandmalaria)arewellrepresented,keyaffectedpopulationssuch

assexworkersandmenwhohavesexwithmen(MSM)donotdirectlysitontheCCMandareinsteadrepresentedby

proxies.Asonerespondentnoted,

“Generally, many CCM members don’t want the KAPs on board. Many times, the KAPs don’t seem t

justify their inclusion in these meetings, judging by the quality of contributions and

representations in the meetings.”

5. Processes for non-government CCM member selection

Before2014,theCCMmemberswerenominatedbasedontheguidelinesoftheGlobalFundwhenitwasinaugurated,

aswell as the selection / nomination ofmembers based on criteria identified by the groups/constituencies they

represent.However,theselectionoftheNon-GovernmentCCMmembershasalsocomeunderscrutinybytheCCM

Secretariat. Respondentsnoted that effective from2014, theCCMSecretariat /membershavebeen involved as

Observersintheelectionprocesseswhichsomeoftheconstituencies(particularlytheCommunitiesofPersonsLiving

withHIV,TBandMalaria)undertookinnominatingtheirrepresentativestotheCCM.

Analysis

18%

13%

43%

18%

14,29

38%

36%

100%

14%

14%

9%

17%

50%

50%

27%

86%

43%

55%

57%

50%

38%

36%

14%

33%

13%

14%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

CSOQuality:WhatisthequalityofcivilsocietysectorrepresentaSon?

Totallyunacceptablequality Unacceptablequality Acceptablequality Goodquality Perfectquality Idon'tknow


15

6. Management of conflict of interest on CCMs

Manyoftherespondentsnotedthatthereareissuesorcasesofconflictofinterest.Whilesomenotedthatthere

areadequatemeasuresputinplacetomanageit,someotherswereoftheopinionthatthemanagementcouldbe

improvedupon.

FromtheNon-CCMmembers’perspectives,noCCMmembershouldbeinvolvedwithimplementinganyGlobalFund

projectseitherasPRs,SRsorSSRs.Theynotedthatthiswillenablethemtohaveaclearandunbiasedassessmentas

theyprovidefeedbackongrantimplementationandastheycarryouttheiroversightfunctions.

Ontheotherhand,CCMmembersintheirfeedbacknotedthatconflictsofinterestcouldexist,butcouldbedelicately

balancedifthepersonsinvolveddeclaretheconflictofinterestandmechanismsareputinplacetoeffectivelymanage

theCOI.BoththeCCMandNon-CCMmemberswereunanimousintheiropinionsthatPRsshouldnotbeontheCCM.

However,exceptionsweremadetotheruleininstanceswhereagovernmentagencysuchastheMinistryofHealth

isconcerned.

Asonerespondentnoted:

“Dropping the MOH from being PR for the Global Fund is not a good thing as it will affect the relationship

of the Government with the Global Fund, as is happening now.”

10%

70%

20%

13%

64%

27%

13%

20%

20%

63%

9%

20%

60%

60%

27%

40%

45%

75%

25%

20%

13%

10%

10%

25%

18%

75%

40%

9%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

QuesGon:ArethereanyconflictsofinterestintheCCM?

AlltheGme VeryoRen SomeGmes/Occasionally Seldom Never Idon'tknow

16

EPA Tool & ProcessTheEligibilityandPerformanceAssessment(EPA)toolwasratedwellbytherespondents.However,themajoritywere

oftheopinionthatforqualitativefeedback,thereshouldbeafewopen-endedquestionsthatwouldprovidemore

detailsbeyondthechecklistsusedintheEPA.

OneoftherespondentsrecommendedthatinimprovingtheEPAs:

“The assessments should focus on quality, based on the following indices and on how well the CCM has

been able to achieve them: the CCM Mandate; Capacity Strengthening of PRs; Risk Management; Efficient

Communication to Partners; Resource Allocation for Country; and Quality of Staff Engaged.”

RespondentsalsonotedthatalthoughtheEPAprocesswasgood,itneededtobemoreparticipatory.Thatway,the

peoplecouldunderstandwheretheproblemswereanddesignanimprovementplantogethertoaddressissues.

PIP Tool and Process90%ofrespondentsconfirmedtheavailabilityofaperformanceimprovementplan(thoughthiswasnotcited,acopy

wasgiventothecountryassessmentteamatthestartuptraining).However,theCCMcomplainedaboutinadequate

fundstoimplementtheplan.WhileCCMmemberscommendedtheGlobalFund,theyexpectadditionalresources

fromthecountrytocomplimenttheavailableresourcesfortheimplementationofthePIP.Asonerespondentnoted:

“PIP addresses the gaps but the implementation and the need for the

Government to take ownership is crucial.”

Analysis

43%

63%

90%

100%

100%

90%

50%

83%

100%

57%

38%

10%

10%

50%

17%

13%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

CantheexisHngEPAbeimprovedon?

Yes No

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Ghana

Kenya

Malawi

Nigeria

Rwanda

Swaziland

Tanzania

Uganda

Zambia

DoesyourcountryPerformanceImprovementPlan(PIP)addresstheCCM'sperformancegaps?

Yes No Idon'tknow


17

Findings

Finding 1: Negative perceptions about the Global Fund Secretariat / Relegation of CCM to the background ThereisastrongperceptionamongrespondentsthatthereisundueinterferencefromtheGlobalFundSecretariat

withregardstothemanagementandimplementationofgrants.Severalcomplaintsaboutside-liningCCMmembersin

communicationandinteractingdirectlywiththePRs,selectingnewPRsandadvertisingonthepagesofnewspapers

withoutnotifyingtheCCMandmicromanaginggrantimplementationprocessthroughfrequentvisitsetc.emerged

fromtheconversationswithmanyofthekeystakeholders.Asonerespondentnoted:

“The CCM should be given a hand in decision-making without getting approval from the Global Fund

Secretariat. The current situation relegates them to the background. The Global Fund should trust us and

give us the opportunity to use initiatives that will not create risk, give time and space to implement, provide

support to perform – rather than look for faults to nail us.”

Finding 2: Staffing and other Challenges at the CCM SecretariatTheCCMSecretariat isunderstaffedand the fewstaffengagedareoverwhelmedandcurrentlyworkunderpoor

conditions(severalvisitsweremadetotheSecretariatinthecourseofthisresearchandtheyhadnothadelectricity

supplyforover2weeksduetosomeelectricalfaults).TheCCMSecretariatispresentlyhousedwithintheMinistryof

Healthandthecurrentlocationdoesnotallowfortheuseofalternativepowersourcessuchasgenerators.

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KeyrolessuchasthatoftheCommunicationsFocalPersonnolongerexistandsuchdutiesarebeingcarriedout

byotherstaff,which isalso impactingontheCCM’scommunicationwith itsstakeholders.Asnotedbyoneofthe

respondents:

“The CCM in Nigeria is grossly understaffed. The Administrative staff backstops for

everyone (planning, communication, oversight etc.).”

Finding 3: Concerns about Leadership Manyrespondentsnotedthatleadershipisakeychallenge.WhileinterviewswereheldwiththetwoViceChairs,the

CountryteamwasunabletointerviewtheCCMChairthoughseveralattemptsweremadetoscheduleappointments

ashewasinandoutofAbuja.Anelectronicversionofthequestionnairewasalsosenttohimbuthelatersentin

apologiesthathewasunabletocompleteitwithinthegivendeadline.

WhilethereweremixedfeelingsaboutthequalityoftheCCMLeadership,severalrespondentsnotedthattheleadership

needstolistenandbemorereceptivetotheviewsfrommemberswhileothersevenrequestedaleadershipoverhaul.

Ontheflip-side,however,onerespondentnoted:

“the current CCM Chair is technical and quite available, listens to challenges from various communities, but

he is sometimes incapacitated to respond. His response is also conditioned to the Global Fund Secretariat

and his level of independence is tied to the Global Fund.”

Other CommentsAnother critical issue raisedby thecivil society representativeson theCCM is the limited fundsavailable tohold

constituencyconsultations.TheynotedthatthefundingprovidedviatheCCMSecretariatwasinsufficienttotransport

/accommodateconstituencyrepresentativesfromoutsideAbuja(wheretheCCMSecretariatislocated),thusitplaces

alimitationonhowbroad-basedtheConstituencyconsultationcanbe.Severalrespondentswereconcernedabout

this,notingthatthefundingprovideddoesnottakecognisanceofthesizeofacountrylikeNigeriaandthisneedsto

bereviewed.

VeryfewrespondentsaddressedthequestionsraisedabouthowCSOrepresentativesengagewithruralcommunities.

Clearly, themechanisms for getting feedback from the communities are weak and need to be strengthened by

partneringwithCommunityBasedOrganisationswhomaybeimplementingprojectsinthesecommunities.

Findings


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Recommendations

Priority Area 1: Negative Perceptions about Global Fund Secretariat / Relegation of the CCM to the BackgroundWhat:NegativePerceptionsaboutGlobalFundSecretariat/RelegationoftheCCMtotheBackground.Thefeedback

indicatesthattherelationshipbetweentheGlobalFundSecretariatandCCMNigeriaisshakyanddoesnotaugurwell

forgrantimplementation.ManyCCMmembersareclearlyfrustratedwiththeactionsoftheGlobalFundSecretariat

andthePRsseemtobecaughtinbetween(respondingtotheGlobalFundandtheCCM).

Who:GlobalFundSecretariatandCCMSecretariat.

What should be changed?:Fosteringamoremutuallyrespectfulrelationship.

Who can do it?:FindingsfromthisexerciseshouldbesharedthroughtheGlobalFundCCMHubandmeetings/

avenuesfacilitatedbytheHubforhonestandfrankdialoguebetweentheGlobalFundCountryTeamsandtheCCM

members inordertoaddresstheseperceptionsandchartawayforwardwithclearmilestonesformanagingthe

relationship.TheCCMHubshouldalsofacilitatediscussionswiththemembersandleadershipoftheCCMsothey

canbetterarticulatetheirconcernsandchartawayforwardforstrengtheningleadership.CountryTeamscanalso

attendandprovideObserverfeedback

When:2017.

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Priority Area 2: Addressing Staffing and related challenges with the CCM Secretariat What:AddressingtheStaffingandotherrelatedchallengeswithintheCCMSecretariat.

Who:CCMSecretariat,CCMMembersandCountryTeams.

What should be changed:StaffingoftheCCMwithindividualswiththerelevanttechnicalcapacityandstrengthening

countryownershipbyGovernmentsupportingadditionalCCMstaff.

Who can do it:TheHonourableMinisterofHealth,andtheSecretarytotheStateGovernment.(TheCCMLeadership,

Secretariat,andCountryTeamscouldtargettheiradvocacyeffortsattheGovernmentrepresentativestodeploy/

hireadditionalstafffortheSecretariataswellastoprovidethenecessarysupporttocreateaconduciveworking

environmentfortheCCMSecretariatstaff).

When:2017

Priority Area 3: Managing Conflict of Interest within the CCMWhat:ManagingConflictofInterestwithintheCCM.

Who:CCMSecretariat,CCMMembersandCCMHub.

What should be changed:Continuousorientation/implementationoftheexistingCOIguidelinesandassessment

oncomplianceaswellasstrengtheningmembers’capacitytobetterunderstandtheiroversightroles.

Who can do it:CCMMembers/CCMHub(Reviews/UpdatetheCOIpolicyifrequired).

When:2017-2018.

Recommendations


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Notes

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Contact Details

Ifeanyi Orazulike, InternationalCenterforAdvocacyonRighttoHealth(ICARH): [email protected]

Martin Mary Falana, Kids&TeensResourceCentre: [email protected]

Olayide Akanni, JournalistsAgainstAIDS(JAAIDS)Nigeria: [email protected]

Olive Mumba (EANNASO):[email protected]

Phillipa Tucker(AIDSAccountabilityInternational):[email protected]


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the nigeria civil society and communities ccm … · one focus group discussion of not less than...

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