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Third sector OR and developing countries: some possibilities Andrew Dobson

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Presentation on theme: "Third sector OR and developing countries: some possibilities Andrew Dobson"— Presentation transcript:

1 Third sector OR and developing countries: some possibilities Andrew Dobson [AndrewEDobson@aol.com]

2 Presentation to cover 3 rd sector organisations working with or in developing countries: an overview –Who, where, what? –Where might OR help? 2 examples –Bwindi Community Hospital –Rwanda Mens Resource Centre

3 3 rd sector & developing countries: The variety

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7 3 rd sector & developing countries: How many 3 rd sector organisations?

8 3 rd sector & developing countries: The variety

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22 3 rd sector & developing countries: Where might OR help?

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28 3 rd sector & developing countries: 2 questions 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?

29 Bwindi Community Hospital: Basic facts

30 Started in2003 as an outdoor clinic under a tree by an American doctor after visiting the area Nowa Ugandan charity-run provider of the full range of health services to its catchment area population of 100,000 with staffing of 120+ Funded byindividual donors & private grants, mostly still, but has also introduced a community insurance scheme Located ina remote rural corner of Uganda Activitiesare: 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 ofan organisationally disparate Ugandan health system Developing stillcurrently constructing a nursing school

31 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:

32 Bwindi Community Hospital: Different types of challenge 1) Of designing outputs (products, services, etc) to meet purpose: Local health problems are severe Some require joining up with other providers to tackle effectively 3) Of internal operations: 4) Of external environment: 2) Of inputs:

33 Bwindi Community Hospital: Different types of challenge 1) Of designing outputs (products, services, etc) to meet purpose: Local health problems are severe Some require joining up with other providers to tackle effectively 3) Of internal operations: 4) Of external environment: 2) Of inputs: Both finance & staff are hard to get A long away off self- sustainability

34 Bwindi Community Hospital: Different types of challenge 1) Of designing outputs (products, services, etc) to meet purpose: Local health problems are severe Some require joining up with other providers to tackle effectively 3) Of internal operations: Complex operation to manage efficiently 4) Of external environment: 2) Of inputs: Both finance & staff are hard to get A long away off self- sustainability

35 Bwindi Community Hospital: Different types of challenge 1) Of designing outputs (products, services, etc) to meet purpose: Local health problems are severe Some require joining up with other providers to tackle effectively 3) Of internal operations: Complex operation to manage efficiently 4) Of external environment: Uneasy relationships with govt health services & traditional medical practitioners Demands of large donors & grant-makers Geographical remoteness 2) Of inputs: Both finance & staff are hard to get A long away off self- sustainability

36 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 arrivalopen 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 commns 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 doneon 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 Planninga 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, … )

37 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]

38 Rwanda Mens Resource Centre: Basic facts

39 Started in2008 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 Nowa small NGO with staffing of 9, and budget in 2012/13 of about $½m, running a set of relatively complex projects Fundedby a variety of local & international agencies, including UN Based inKigali, but currently carrying out work in about half the 30 districts of Rwanda Activitiesare 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 ofan international network of organisations carrying out similar work Ambitionsfor work to become much more widespread, and to bring about a national shift in traditional masculine cultural norms

40 Rwanda Mens 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 3) Of internal operations: Relatively complex projects to manage, and even harder to assess whether they are working Director has difficulty of finding time for strategic work 4) Of external environment: 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

41 Rwanda Mens 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 Id seen before of how to value advocacy work On arrivalimmediately 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 doneon each of these, but again really still work in progress Planningto return in April and July, to: review progress with M&E; support staff to produce the next years 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

42 Rwanda Mens 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]

43 3 rd sector & developing countries: 2 questions 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?


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