Quite often, in terms of mental health issues, the focus of attention is on specific groups of people (eg those living with HIV-AIDS) who suffer from conditions such as depression and alcohol abuse. What tends to receive slightly less attention is the prevalence (usually only anecdotally reported as there is a distinct lack of research into the key issues) of drug and alcohol abuse among young people in rural communities. Gede’s work in Cross River State is starting to shine some light onto a range of important issues in this regard, almost all of which revolve around, (i) easy availability of substances, and, (ii) their relative affordability. This is a potent combination which could, in some cases, lead to addiction and all of the social costs which come with this. Gede, in partnership with UNICEM and the National Drugs Law Enforcement Agency (NDLEA) will soon be taking the lead in raising awareness of these key issues through activities which will form part of the International Day Against Drug Abuse and Illicit Trafficking. Activities will be aimed at schools in Akpabuyo and Akampa local government areas. Watch this space for coverage of these important activities
HIV-AIDS Prevention and awareness Raising in Ibadan
Gede’s zonal office in Ibadan has been particularly busy in 2015 implementing a State HIV Agency project (funded by the World Bank) which focuses on prevention and awareness raising re HIV-AIDS in ‘local’ communities, with a particular focus on the engagement of key stakeholders, including ‘gatekeepers’. Most recently, programme staff joined a training exercise which raised awareness about the need for all data generated in the project to ‘fit’ into the District Health Information System (DHIS) – ie avoiding the generation of ‘parallel’ information which does not engage with official structures. This important initiative is aimed at ensuring that key information generated by a range of partners (including Gede) can be collected and analysed in ways which are routine and regular – and which are then used to enhance programme delivery, as well as being the basis for the design of new interventions in future. Watch this space for regular Ibadan updates
Are we just good at something or do we have genuine core competencies?
During my time working with major international NGOs, it was not unusual to hear very senior managers state with great confidence that, ‘we have many core competencies’, or, ‘yes, that’s one of our core competencies’. As too often with NGOs, highly specific language was bandied around in a cavalier fashion so that ‘core competencies’ has come to mean anything the NGO is ‘good at’. This is deeply misleading and is, in my opinion, one of the reasons why many NGOs end up (often through donor assessments) realising that they are not quite as good as they thought they were in addressing their core activities. Why? Mainly because core competencies need to be defined very carefully indeed – and also need to be nurtured in the same way. As Hamel and Prahalad noted some years ago, for any skill, product, knowledge or approach to be defined as a genuine core competency, it needs to demonstrate/deliver three results at the same time – (i) provide potential access to a wide variety of markets/beneficiaries/opportunities, (ii) make a significant contribution to the perceived customer benefit of the end product, and, (iii) be difficult to imitate by other agencies. Stating ‘Coca Cola’s secret recipe’ is a good example from the business world, but NGOs struggle because too many of them have approaches which are easily replicated or do not, in fact, add as much value added to ‘beneficiaries’ as the NGO might like to believe. Should NGOs evolve in ways which genuinely develop core competencies, then this situation might very well change. Look at your favourite NGO – what do they do which could not be imitated by another civil society organisation?
Sectoral Programmes – Where’s The ‘Power’?
One of the key limitations of NGO planning processes lies in their over reliance on tools such as SWOT. I have talked before about the self-indulgent limitations of this tool (especially Strengths and Weaknesses which encourages an unusual degree of self congratulation), but it also holds within it a lack of rigour which often produces a superficial so-called external analysis. Such an analysis is often limited to a review of potential institutional donors (the ‘Opportunities), as well as the potential of said donors withdrawing their support if they are currently supporting programmes (the ‘Threats’). It is all aimed at largely supporting the status quo, with few NGOs daring to step into the realm (for example) of assessing private sector initiatives to alleviate poverty through the provision of employment, no matter how temporary or even badly paid. NGOs tend to stick to what they know best – the civil society ‘sector’. While there is nothing wrong with this as a starting point, it results in external analysis approaches being based on what is already known rather than exploring what is not. The engagement of a sectoral analysis tool such as Porter’s Five Forces (http://www.mindtools.com/pages/article/newTMC_08.htm) can easily be adapted by NGOs to dig ever deeper into any issue – digging and digging until the real drivers of poverty are identified and addressed
NGO Strategic Planning – Time For A Re-Think?
When one considers how dynamic the forces are which keep far too many people (in lower and middle income countries as they are now called) in conditions of absolute poverty, it remains something of a mystery why so many NGOs base their approach to ‘strategy’ on activities which are calendar driven (punctually, every 3-5 years), complete with exercises which do little other than to support the status quo (Vision and Mission are rarely open to debate in any meaningful sense of the word) and ring fence favoured projects. There is a growing body of literature which suggests that the organisation-wide strategic planning exercises achieve little apart from vast waste as regards to workshops and per diems. Instead, an increasing number of agencies are starting to engage with more rigorous strategic planning tools, such as the approach of leading strategist, Richard Rumelt who states that the ‘hard work’ of strategy is always the same – ‘despite the roar of voices equating strategy with ambition, leadership, vision, mission, or long term planning, strategy is none of these. Rather, it is coherent action backed by an argument. And the core of the strategist’s work is always the same: discover the crucial factors in a situation and design a way to coordinate and focus actions to deal with them’. How many NGOs (and their so-called beneficiaries) would be better off following Rumelt’s approach?
Sustainable Development Targets – Old Wine in New Bottles?
As most people are aware, the Millennium Development Goals are soon to be ‘replaced’ (evolved into?) by Sustainable Development Targets (http://unsdsn.org/resources/goals-and-targets/). While ‘targets’ are often to be applauded and, indeed, MDGs seem to have been effective on a number of levels, many development agencies, such as Gede, are currently engaged in the debate which is aimed at ensuring that SDTs avoid some of the more obvious pitfalls which MDGs fell into. Perhaps the biggest issue which agencies agree on is the objective that SDTs should not encourage a ‘silo’ mentality towards health issues and the subsequent funding of such. Certainly, if one considers the MDGs, it’s easy to see how funding streams in particular became fixated on ‘X’ or ‘Y’ (HIV seemed to be an understandable donor focus, although this now seems to be on the wane), often at the exclusion of the very factors which made them so devastating to the lives of so many. The sad fact is that for many people living in poverty, the challenges they face cut across absolutely everything they do – and to select one or two only to address misses the point in terms of what puts them – and keeps them – in conditions of great poverty.
OVCs and Mental Health
One of the great strengths of many programmes aimed at delivering care and support to orphans and vulnerable children (OVC) is the way in which they package ‘physical’ with psychosocial support. One of the great weaknesses, however, is the way in which they package ‘physical’ with psychosocial support. By this, I mean that it is admirable that programmes at least recognise that the mental health of OVCs is important, but recent research in Ghana (http://theses.gla.ac.uk/3629/) suggests that rather generic psychosocial support (provided by most programmes) might very well ‘miss the point’ as far as the complex mental health challenges facing orphans is concerned. There is clearly a great deal to do if OVCs are to be provided with the mental health care and support they need (which, research suggests, should also include some attention on how they interact with peers) and deserve. Gede is currently reaching out to leading OVC agencies to discuss this cutting edge research and to see what can be done to support, in greater depth, the mental health needs of OVC
No Shame Day
Late last week, Gede met with renowned Nigerian Poet and media celebrity, Bassey Ikpi, to discuss plans related to the holding of a ‘No Shame Day’ in Nigeria. Bassey’s USA-based ‘No Shame Day’ (http://www.thesiweproject.org/no-shame-day/) has already been a great success and resulted in an avalanche of attention being paid not only to mental illness but also, equally important, ‘mental health’. Our initial meetings with Bassey have suggested that a possibility exists to raise awareness, across Nigeria, of the importance of a healthy mental ‘life’ which would engage a variety of people – from community based activists to celebrities from the ‘media world’ – as well as those who are perhaps yet to be convinced that ‘mental health’ is an important ‘issue’. It is always important, when addressing underserved and stigmatised health burdens to engage not only those who are ‘converted’, but also those who doubt both prevalence and impact. Watch this space as our plans develop in time for World Mental Health Day on October 10 2015
NGOs and Strategic Planning – The Groan Factor
In an era increasingly characterised by intense competition for donors funds, experienced and qualified Team members and cutting edge partnerships, it remains something of a surprise that many NGOs remain lethargic about the way in which they address and formulate ‘strategy’. In response to dynamic environments, far too many NGOs focus on calendar driven ‘strategy exercises’ which ‘tick the box’ in terms of – (i) a reaffirmation of Vision and Mission (tick), (ii) the regulation SWOT exercise (tick), and, (iii) budgeting based on spend rather than income (tick). The five year plan is then written, reaffirms the status quo (although will often pay lip service to ‘change management’ across an entire organisation) and is then filed away to be brought out of the bottom drawer in another five years. The relative marginalisation within ‘development’ which NGOs have undoubtedly experienced over the last decade is, I feel, in part due to the fact that their approach to strategy is so very poor – usually undertaken with no engagement of rigorous strategy tools such as Porter’s Five Forces, Hamel and Prahalad’s approach to core competencies, as well as Rumelt’s era defining strategy tool. Why NGOs have been so slow to evolve their approaches to strategy is something of a mystery - but their failure to do so, while retaining their faith in outdated, calendar-driven tools, will continue to result in their marginalisation within ‘development’ circles?
EXPERIENCES OF A PREVALENCE SURVEY INTERVIEWER
When we started, l was nervous because I was going to be face to face with HIV patients and was worried about their reaction but after the two weeks of training, I got to understand that they are people like us as everyone on earth. Gede Foundation /IHVN have come together as a team to strengthen the well being of people living with HIV into a further study on their alcohol use, depression and suicidality.
Quite interesting to know that most HIV patients are depressed as a result of their status and having to think that the world and everything around them is not worth living for,some tend to drink too much of alcohol to save them some mind torture while others think that killing themselves is the best way out but not withstanding, others have come in terms with it but majority needs care and attention which is part of what this Team is for.
The progress on the study is been quite interesting having to work as a team where quality training have been giving to the interviewers because they are the ones faced with administering the open ended questionnaire and also the site visit was interesting because all the sites coordinators are ready to start but few things will have to be in place before the study kicks up proper.
It's a great privilege to be part of this, first of its kind in Africa, with great tenacity from all the wonderful supervisors and my co-interviewers (the team) set to deliver and improve the quality of health for people living with HIV.