See below for a guest blog from Rosemarie Muganda-Onyando, deputy country director for PATH Kenya, and Aaron Emmel, senior policy advisor at PATH. This is the sixth post in our field feedback series and the second in Save’s “Aid Reform Stories from the Field” series. Click here to read a post from Save the Children in Guatemala and Malawi, Women Thrive in Ghana, Oxfam America in Uganda, and Management Sciences for Health in Bolivia.
When Janerose Temko was five months pregnant with her third child, a PATH-supported community health worker in her village in western Kenya dropped by to talk about the importance of prenatal care. Janerose knew the woman—she was a member of her church and a trusted neighbor—so for the first time, Janerose went for checkups during her pregnancy. And when her labor started, she made her way to a community health clinic, where she delivered a healthy baby girl.
Janerose’s decision to depart from the tradition of an at-home birth and therefore improve her—and her baby’s—chance of a healthy future demonstrates the gains that can be achieved when development organizations and agencies approach global health and development in partnership with local civil society organizations and governments. By combining the personal relationships and community networks built by local organizations with the global networks and resources of international aid organizations, we are able to effectively reach individuals to help them access health services and make the best decisions for themselves and their families.
In recent years, foreign aid agencies and nongovernmental organizations have begun taking steps to more strategically engage the people who they are meant to serve as collaborators—rather than as simply beneficiaries—by giving them the opportunity to plan and execute development programs. Through these efforts, they are increasingly implementing programs based on what is commonly referred to as “country ownership” and they are having an impact.
At PATH, we integrate the country ownership approach in three ways. First, we ensure that key local and national stakeholders are involved in the planning, implementation, and execution of health programs. Second, we help donors to coordinate their aid around current national strategies. And finally, we help ensure that local and national policymakers have the information they need to make the best decisions for their country’s future.
In western Kenya, for example, PATH works closely with the US Agency for International Development (USAID) and other partners to actively engage the ministry of health at all levels through the USAID-supported program AIDS, Population and Health Integrated Assistance Plus project, known as APHIAplus. The program involves the government of Kenya, civil society, and community level structures. One of the greatest contributions is the increased support from international donors for the government of Kenya’s Community Health Strategy, through which millions of people like Janerose are reached with information, mobilized, and linked with essential health services.
By supporting capacity-building at the local and national levels, donors not only promote sustainable programs, but they also put greater responsibility on local communities and governments for their own country’s health. This approach seems to be paying off. The results of a 2012 survey by InterAction, the largest alliance of US-based international nongovernmental organizations, suggest that the US government’s activities are increasingly felt on the ground: local organizations and local staff of international nongovernmental organizations are at the forefront of program planning and implementation, and they see their own governments taking more ownership of national health plans. Our PATH colleagues in Kenya also say that they have seen their government become more deeply involved in development efforts, especially through APHIAplus.
Country ownership remains a guiding principle of USAID’s Global Health Strategic Framework FY2012–FY2016, and has been incorporated into both country programs and the new Office of Country Support that USAID announced as part of its Global Health Bureau reorganization in September. PATH commends USAID for making country ownership a priority, and helping to lead the field into a future built on greater partnership through foreign assistance.
When country stakeholders are heavily involved in the planning and implementation processes, projects are more likely to be sustainable—because they are built to fit within the local cultures and infrastructure—and have a greater impact. Through these efforts, we hope more community health workers and other local practitioners are able to reach more people like Janerose, who said that if she has another child, she will go to a health facility again.