third sector or and developing countries: some possibilities andrew dobson [[email protected]]

Third sector OR and developing countries:

some possibilities

Andrew Dobson[[email protected]]

Presentation to cover

• 3rd sector organisations working with or in developing countries: an overview– Who, where, what?– Where might OR help?

• 2 examples – Bwindi Community Hospital– Rwanda Men’s Resource Centre

3rd sector & developing countries: The variety


UK


UK Developing country

Total income & expenditure of UK voluntary organisations, by area of activity (£millions)

0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,000

Culture & recreation - 22,600 orgs

Education - 7,775 orgs

Parent teacher associations - 13.143 orgs

Playgroups & nurseries - 7,908 orgs

Research - 3,625 orgs

Health - 6,505 orgs

Social services - 31,091 orgs

Scout groups & youth clubs - 6,578 orgs

Environment - 5,443 orgs

Development - 11,504 orgs

Village halls - 5,995 orgs

Housing - 3,838 orgs

Employment & training - 1,826 orgs

Law & advocacy - 3,907 orgs

Grant-making foundations - 12,004 orgs

Umbrella bodies - 1,267 orgs

International - 5,099 orgs

Religion - 13,551 orgs

Income (£millions) Expenditure (£millions)

3rd sector & developing countries: How many 3rd sector organisations?



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Government

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Government Government

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International governmental agencies (eg UN, EU, WHO)

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3rd sector & developing countries: Where might OR help?


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3rd sector & developing countries: 2 questions


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1) Where within this complex picture might OR work have most impact?

2) If there are/were OR people working in different parts of the ‘picture’, could there be scope for collaboration to significantly improve the impacts?

Bwindi Community Hospital:Basic facts

Bwindi Community Hospital:Basic facts

Started in 2003 as an outdoor clinic ‘under a tree’ by an American doctor after visiting the area

Now a Ugandan charity-run provider of the ‘full’ range of health services to its catchment area population of 100,000 with staffing of 120+

Funded by individual donors & private grants, mostly still, but has also introduced a community insurance scheme

Located in a remote rural corner of Uganda

Activities are: 3 primary health care units, child & maternal health care, hospital inpatient services, surgery, HIV/AIDS services, and community/public health ‘outreach’ to villages throughout the area

‘Part’ of an organisationally disparate Ugandan health system

Developing still currently constructing a nursing school

Bwindi Community Hospital:Different types of challenge

1) Of designing ‘outputs’ (products, services, etc) to meet purpose:

3) Of internal operations:

4) Of external ‘environment’:

2) Of inputs:



•Local health problems are severe

•Some require joining up with other providers to tackle effectively



2) Of inputs:







2) Of inputs:

•Both finance & staff are hard to get

•A long away off self-sustainability






•Complex operation to manage efficiently


2) Of inputs:








•Complex operation to manage efficiently


•Uneasy relationships with gov’t health services & traditional medical practitioners

•Demands of large donors & grant-makers

•Geographical remoteness

2) Of inputs:



Bwindi Community Hospital: My involvement as an ‘OR intervention’

Initial arrangement

was for a 3 month volunteer placement, but with longer-term aim

From a distance

a relatively large operational organisation (for a local NGO), wanting help particularly with challenge of moving towards greater financial sustainability

On arrival open to advice on where my skills could be used best, but clear that (whilst overall an impressive organisation) they could benefit from help with trying to move further away from a ‘hope things turn out’ form of financial planning

Initial conclusion

to split time between work on a) supporting comm’ns mgr to develop an approach to achieve a more systematic & regular fundraising performance, and b) working with finance mgr to increase focus within organisation on efficiency & value for money

Work done on each of these, but really still ‘work in progress’

Currently, from a distance

supporting monitoring of fundraising performance and development of a new hospital IT system

Planning a further 3 month visit from April, primarily for a project to ‘capacity build’ mgrs in relation to cost awareness, efficiency & value for money, and to help development of supporting systems (eg MI, budgeting, PIs, targets, audits/reviews, … )

Bwindi Community Hospital: Future possibilities for OR?

A variety of future possibilities could flow from improved MI and increased organisational capacity to manage value for money

More substantial internal reviews of systems & priorities, eg: work flows within hospital, managing capacity, balance between preventative & curative work?

Involvement of organisation in broader OR studies with other organisations, eg of health care approaches of the sort that others may describe in this session?

With technological developments, there should be increasing scope for work from a distance

[For more on the organisation, see: www.bwindihospital.com]

Rwanda Men’s Resource Centre:Basic facts

Rwanda Men’s Resource Centre:Basic facts

Started in 2008 by a group of 9 Rwandan men who were concerned that the set of national policies & other efforts to improve the situation of Rwandan women were not working because they lacked the crucial ingredient of involvement of men

Now a small NGO with staffing of 9, and budget in 2012/13 of about $½m, running a set of relatively complex projects

Funded by a variety of local & international agencies, including UN

Based in Kigali, but currently carrying out work in about half the 30 districts of Rwanda

Activities are a combination of a variety of educational & community ‘mobilisation’ activities, often with a focus on reducing gender-based violence, plus advocacy with government & other officials

‘Part’ of an international ‘network’ of organisations carrying out similar work

Ambitions for work to become much more widespread, and to bring about a national shift in traditional masculine cultural norms

Rwanda Men’s Resource Centre:Different types of challenge

1) Of designing ‘outputs’ to meet purpose:

•Trying to tackle difficult problems, eg high levels of gender-based violence, and bringing about change in cultural norms not a quick job

•Approaches tried elsewhere still need local adaptation

•Country where people are not necessarily very open & particular sensitivity is needed in relation to violence


•Relatively complex projects to manage, and even harder to assess whether they are working

•Director has difficulty of finding time for strategic work


•Small organisation operating in a field with many different players with different interests

2) Of inputs:

•Some parts of the work seem much harder to get funds for than others

•So, problem of being driven by donors’ interests

Rwanda Men’s Resource Centre:My involvement as an ‘OR intervention’

Initial arrangement

again, short (12 week) volunteer placement, with longer-term aim

From a distance

an organisation doing extremely interesting & important work, and facing the difficult but interesting problem that I’d seen before of how to ‘value’ advocacy work

On arrival immediately clear that it was an organisation with the familiar difficulty of finding any time to think beyond the challenges of the current work

Initial conclusion

was that the director needed help in: a) clarifying the projects they really wanted to run, and how to make the case for them; and b) getting in place some more effective organisational-level monitoring & evaluation (but director also needed help in being helped)

Work done on each of these, but again really still ‘work in progress’

Planning to return in April and July, to: review progress with M&E; support staff to produce the next year’s Annual Report; give further advice, guidance & training on M&E; and, probably, have other discussions with director about strategic work, eg making the case for ‘scale-up’ and his problems of ‘overload’

Rwanda Men’s Resource Centre:Future possibilities for OR?

A variety of possibilities could flow from improved monitoring & evaluation, eg use of outputs to support operational management, programme planning, and funding bids

Other modelling support to programme planning, eg in theory, epidemiology-type modelling of how cultural change might spread, for planning and business cases?

Possibly helping join up thinking across the broader international ‘network’?

[For more on the organisation, see: www.rwamrec.org]

3rd sector & developing countries: 2 questions


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1) Where within this complex picture might OR work have most impact?

2) If there are/were OR people working in different parts of the ‘picture’, could there be scope for collaboration to significantly improve the impacts?

third sector or and developing countries: some possibilities andrew dobson [[email protected]]

Documents

variety slide

self sustainability

nursing school slide

developing countries

hospital inpatient services

range of health services

new hospital

local health problems