Sustainability through Country Ownership
On beginning my fellowship in Nairobi some of the initial weeks were heavily dedicated to research and reading into the project structures and operations for areas I would be involved in. While undertaking this orientation exercise however, I did sometimes wonder how local organizations in Kenya could manage some of these projects in the absence leadership from international organizations and ensure sustainability of initiatives.
As I approach the end of my second month based at the Christian Health Association of Kenya (CHAK) Secretariat office, I have been gaining a more in depth understanding into one of my focus areas, investigating possible efficiencies in the reporting process for a HIV/AIDS project. Kenya is one of over 30 countries that receive funding through ‘The United States President’s Emergency Plan for AIDS Relief ‘(PEPFAR). PEPFAR came into existence in 2003 to help combat the HIV/AIDS pandemic as despite the availability of antiretroviral therapy, very few people with HIV/AIDS were receiving treatment for HIV in the poorer parts of the world. It supports training and salaries for personnel (including clinicians, pharmacists, counselors, medical records staff, outreach workers, peer educators, etc.), renovation and refurbishment of health care facilities, updated laboratory equipment and distribution systems, logistics and management for drugs and other commodities. This is intended to ensure the sustainability of PEPFAR services in host countries, enabling long-term management of HIV/AIDS. Prior to October 2011, AIDSRelief, an international consortium, was supporting all 29 care and treatment facilities supported though PEPFAR funding in Kenya. In November 2011, 13 of these facilities were formally handed over to two local partners, CHAK and the Kenyan Episcopal Conference (KEC) with funding being centrally managed by the Center for Disease Control and Prevention (CDC) in Kenya. As part of the hand-over, facilities are divided into two geographical regions with CHAK and KEC taking ownership for a region each. A two-year capacity building period ending in February2013 was established with each partner to ensure adequate organizational structures and processes were in place to operate the program. Within CHAK, one aspect of the project involves receiving a variety of monthly reports from facilities outlining how funding was dispersed. This information is then fully validated to ensure accountability and CHAK in turn then reports to CDC on a quarterly basis. Given the fact that Kenya has received over $1,912 million in funding since 20041 tracking funds is quite a sizeable activity, so any efficiencies to be gained on this process are welcome. By 2013 all facilities will move to the new local partners marking a key milestone and a clear demonstration that in-country ownership is both possible and successfully taking place. Additionally, the full transition ties in with PEPFAR objectives and ensures closer links to country strategic goals. References 1 http://www.pepfar.gov/countries/kenya/index.htm