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STRENGTHENING THE LONG-TERM CAPACITY OF COMMUNITY-BASED

ORGANIZATIONS TO MANAGE GRANTS AND DELIVER QUALITY

HIV/AIDS AND TUBERCULOSIS SERVICES

THE BUILDING SUCCESS SERIES: VOLUME 2

Production of this manual is made possible by the generous support of the American people through the United States Agency for International Development (USAID), and by the President’s Emergency Plan For AIDS Relief (PEPFAR). The contents are the responsibility of the Nigeria Pro-ACT and PLAN-Health projects, and do not necessarily reflect the views of USAID, PEPFAR, or the United States Government.

ACRONYMS:

AIDS Acquired immune deficiency syndromeCBO Community-based organizationCCT Comprehensive care and treatmentCEPAT Citizen Empowerment Project and AdvocacyCESDYO Centre for Sustainable Development and Youth OrganizationCHEDA Centre for Health and Development In AfricaCUBS Community-Based Support for Orphans and Vulnerable ChildrenFLHE Family, Life and Health EducationGLOHWOC Global Hope for Women and Children FoundationHIV Human immunodeficiency virusINGRA The Initiative for Grassroot AdvancementIPC Interpersonal communicationLGA Local government authorityM&E Monitoring and evaluationMSH Management Sciences for HealthNGO Nongovernmental organizationPEPFAR U.S. President’s Emergency Fund for AIDS ReliefPLAN-Health Program to Build Leadership and Accountability in Nigeria’s Health SystemProACT Prevention and Organizational Systems—AIDS Care and TreatmentQRT QuarterRFA Request for applicationsRFP Request for proposalsSMOH State Ministry of HealthSOP Standard Operating ProcedureTB TuberculosisUSAID United States Agency for International Development

Cover Photo: Maryamu and Tijanu Audu (both HIV positive and in treatment) being counseled by community volunteer, Rejoice, outside their Garkida, Adamawa home. Their baby, Audu, was born HIV negative.

Copies of this and other manuals in the Building Success series may be obtained by writing to:

Management Sciences for HealthPlot 564/565

Independence AvenueBlock B, Former RCC Building

A.U.J. Complex, CBD, Abuja, Nigeria

email: [email protected]

AUTHORS:

Toyin Afachung Emmanuel Atuma

CONTRIBUTORS:

Nwokedi Ndulue Philomena Orji

Christopher Aruku Wande Okediran Amaechi Okafor

Callista Ike

© May 2012 by Management Sciences for Health

STRENGTHENING THE LONG-TERM CAPACITY OF COMMUNITY-BASED

ORGANIZATIONS TO MANAGE GRANTS AND DELIVER QUALITY

HIV/AIDS AND TUBERCULOSIS SERVICES

THE BUILDING SUCCESS SERIES VOL 2

iv ■ Volume 2: Building Success Series Strengthening the Long-Term Capacity of Community-Based Organizations

ACKNOWLEDGEMENTS

BUILDING SUCCESS reflects the hard work and contributions of all those involved in ProACT, PLAN-Health, and the other Management Sciences for Health (MSH) projects as well as project-supported State Ministries of Health (SMOH) and Health Manage-ment Boards, State Local Government Area Councils, project-supported treatment facilities, community-based organizations (CBOs), community leaders and members, and project staff. Some of the effective approaches and practices described in these manuals are based on lessons learned while networking with other implementing partners (IPs). We gratefully acknowledge those organizations for their contributions to the program.

MSH thanks the following people:

■ Toyin Afachung, Emmanuel Atuma, and Paul Waibale for conceptualizing the idea and providing the framework, and contributing content, for the series.

■ The authors and contributors Dr. Sam Abiem, Dr. Inedu Abutu, Dr. Richie Adewusi, Dr. Murphy Akpu, Dr. Wada Aminu, Christopher Aruku, James Yisa Dantala, Dr. Amana Effiong, Atuma Emmanuel, Patrick Igbana, Callista Ike, Amina Jafun, Dr. Mustapha Jamda, Dr. Ndulue Nwokedi, Chioma Ogbozor, Foluke Ojelabi, Amaechi Okafor, Wande Okediran, Patrick Okoh, Comfort Okpe, Olukunle Omotoso, Dr. Onyebuchi Oparah, Philomena Orji, Ochanya Iyayi Paul, Dr. Barry Smith, Charles Uwakwe, and Abdullahi Wokili for enriching the series with critical inputs based on their field experiences and work.

■ The former ProACT Chief of Party Paul Waibale, for his innovation, motivation, and technical inputs into this series.

■ All ProACT and PLAN-Health central staff whose great work and support ensured the completion of this series: Mariah Boyd-Boffa for editing and Marilyn Nelson for copyediting, Philippe Heckly and Erin Dowling for design and layout, Amber Jamanka for managing the process toward the successful completion of the series, and finally Kathleen Alvarez for inputs on framing the series to support the emergence of leadership and management at the SMOH, State Action Committee on AIDS (SACA), health facility, community, and individual levels.

■ We would also like to thank the USAID health team for their ongoing support of programs that improve health services in Nigeria. Also, many thanks to the USG technical team led by Emeka Okechukwu and McPaul Okoye for technical inputs to the writing.

MSH pays special tribute to Ann Buxbaum for the initial brainstorming, sequencing, editing, and review of the series.

CONTENTS

ACKNOWLEDGEMENTS . . . . . . . . . . . . . . . . . . . . .iv

FOREWORD . . . . . . . . . . . . . . . . . . . . . . . . .vi

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . 1

A STEP-BY-STEP PROCESS FOR ESTABLISHING AND MANAGING CCT SERVICES . . . . . . . . . . . . . . . . . 2 Step 1. Building a Credible Organization . . . . . . . . . . . . . . 2 1.1. Knowing What Donors Are Looking For . . . . . . . . . . . 2 1.2. Meeting the Credibility Criteria . . . . . . . . . . . . . . 2 Step 2. Managing a Grant . . . . . . . . . . . . . . . . . . . . 9 2.1. Studying the Contract Before Signing It . . . . . . . . . . . 9 2.2. Referring to the Contract during Implementation. . . . . . . . 9 2.3. Assuring Effective Technical Implementation . . . . . . . . . .11 2.4. Assuring Effective Financial Management . . . . . . . . . . .11 2.5. Assuring Effective Monitoring and Evaluation . . . . . . . . .12 2.6. Communicating Results . . . . . . . . . . . . . . . . .14 Step 3. Looking Ahead . . . . . . . . . . . . . . . . . . . . .15 3.1. Scanning Your Environment for Opportunities and Threats . . . .17 3.2. Strategically Positioning Your Organization . . . . . . . . . .17 3.3. Building Partnerships, Alliances, and Networks . . . . . . . . .17

THE LAST WORD… . . . . . . . . . . . . . . . . . . . . . . 17

ANNEX A. . . . . . . . . . . . . . . . . . . . . . . . . . . 18

ANNEX B. . . . . . . . . . . . . . . . . . . . . . . . . . . 19

vi ■ Volume 2: Building Success Series Strengthening the Long-Term Capacity of Community-Based Organizations

FOREWORD This manual is one component in BUILDING SUCCESS, a series of guides offering practical, concrete, and innovative approaches that have proven effective in strengthening the response to HIV/AIDS and tuberculosis (HIV/AIDS/TB) in Nigeria. Each manual can stand alone, but the manuals will be most effective if you view them as components of an integrated package.

Each manual contains references to relevant information in other components of the series. The series synthesizes and expands the learning gained from MSH’s Nigerian projects, supported by the United States Agency for International Development (USAID) through the U.S. President’s Emergency Fund for AIDS Relief (PEPFAR):

■ Prevention and Organizational Systems—AIDS Care and Treatment (ProACT)

■ Community-Based Support for Orphans and Vulnerable Children (CUBS) Project

■ Program to Build Leadership and Accountability in Nigeria’s Health System (PLAN-Health)

In 18 states, these three projects are striv-ing to achieve USAID’s strategic objec-tive for the country: “Increased Nigerian capacity for a sustainable HIV/AIDS and TB response.”

They are equally committed to MSH’s mis-sion: “To save lives and improve the health of the world’s poorest and most vulner-able people by closing the gap between knowledge and action in public health.”

Project staff members work with state and local governments, CBOs, and targeted health facilities and communities to bring high-quality services to people living with HIV/AIDS and TB, and to their families.

OUR GUIDING PRINCIPLESThis manual, with the others in the series, embodies the principles that guide the day-to-day activities of everyone who works for MSH Nigeria projects. We are grounded in the recognition that people—both the users and providers of health services—are at the core of our work. We believe that—

■ Success depends on empowering all the players: community leaders and members—including people living with HIV/AIDS—as well as health providers at all levels, government officials, and employees of civil society organizations.

■ The solutions to people’s problems lie within themselves.

■ We can celebrate our successes and use each failure as a learning opportunity.

■ Small successes add up to big changes.

■ Freely shared information and insights are essential to achieving common goals.

Strengthening the Long-Term Capacity of Community-Based Organizations Volume 2: Building Success Series ■ vii

Who Created This Series?The staff of the ProACT Project has written BUILDING SUCCESS with input from the other MSH Nigeria projects. Most of the approaches, lessons learned, and success stories come from clients and colleagues in the six states where ProACT is working to improve systems for service delivery: Adamawa, Kebbi, Kogi, Kwara, Niger, and Taraba.

ProACT’s clients have used the approaches described here to successfully implement a quality program despite many challenges. The series is based on the belief that successes in any project can be replicated in other settings, bringing high-quality, sustainable, gender-responsive HIV/AIDS/TB services to the people who need them.

How Can You Use the Building Success Series? The reason this project, or any development project, exists is to empower people to save lives and improve the quality of life for themselves and their fellow citizens. You, like all of our readers, can make a significant contribution to this challenge. To support you in this effort, BUILDING SUCCESS will enable you to do the following:

■ Use the “software”—the approaches, concepts, processes, and examples in these manuals—to put into action the “hardware”— the systems, structures, standards, and guidelines that already exist in your professional and geographic area

■ Apply proven approaches to strengthen your organization and its HIV/AIDS/TB programs

■ Translate guidelines into action and apply them for the greatest possible effect

■ Benefit from the examples of health professionals at all levels who have overcome challenges to bring better health to the people they serve

■ Enthusiastically carry out your responsibilities for providing or supporting the quality care that will prolong and improve the lives of people living with HIV/AIDS and their families

The manuals provide real-life examples of these successes, drawn from experience in the six project states. The manuals also refer to some documents—tools, government guidelines, standards of practice, forms—that you and your colleagues can use in carrying out these approaches and that are readily available to those working with HIV/AIDS/TB programs. You will find a few other important documents, newly developed and not yet widely distributed, in the annexes.

The manuals in this series are yours to read, re-read, discuss, adapt, and apply. But they are not all you need—no document by itself can enable you provide all the information neces-sary to carry out a successful program. We strongly recommend that you and your col-leagues supplement the information in each manual with other useful documents, including guidelines, standards of practice, checklists, reports, and success stories.

viii ■ Volume 2: Building Success Series Strengthening the Long-Term Capacity of Community-Based Organizations

You can seek assistance from a variety of sources: government agencies, IPs, civil society organizations, and other groups that have successfully implemented initiatives like the one you are undertaking. With the support of these entities, you can use the manuals as a starting place and an ongoing point of reference.

We welcome you, our readers, as partners in the effort to provide the HIV/AIDS/TB ser-vices that will contribute to a long and meaningful life for all our fellow citizens.

—The MSH Nigeria Team

Kanadi Ayuba of Gombe State

Strengthening the Long-Term Capacity of Community-Based Organizations Volume 2: Building Success Series ■ 1

INTRODUCTION

Who Can Use This Manual?If you have a management or technical position with a community-based organization (CBO) that is a past, current, or potential recipient of a grant, this manual is intended for you. A granting agency may also want to review it with grantees to be sure that the con-tents are generally consistent with the agency’s requirements and to address any discrep-ancies.

Strengthening CBO Capacity: What Does It Mean? To strengthen the capacity of your CBO is to build the competence and confidence that will make the organization more effective. Your strong CBO will be able to meet the requirements of granting agencies and donors, take responsibility for implementing grants, use the grants to improve service delivery, and win future grants that will enable you to grow and become a more potent force for change in your community.

In the following pages, you will find guidance for making your organization a credible contender for grants and then, when you win a grant, for managing a new project success-fully. The manual also offers approaches that you can use to assist smaller CBOs to access resources for HIV/AIDS/TB and other health services.

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A STEP-BY-STEP PROCESS FOR ESTABLISHING AND MANAGING CCT SERVICES

STEP 1. BUILDING A CREDIBLE ORGANIZATION

1.1. Knowing What Donors Are Looking For

Take a moment to reflect on four critical questions:

■ Are you a member of a group of people, an association, or an organization?

■ Do you have a cause (an issue that is no longer tolerable in your community) that calls for action to be taken?

■ Do you think there may be funding somewhere that you could tap into to support your cause?

■ Is there something about your organization that would make anyone attracted to supporting, funding, or partnering with you?

If you answered “yes” to these questions, you may be in a good position to find support for your cause. All donors are looking for credible organizations whose cause matches their priorities. Having a credible organization means having the following:

■ A clear mission and vision

■ Legal registration

■ Basic human resources

■ Functional management and financial systems

■ Designated office space and clear contact information

Now reflect on one last question: Is your group, association, or organization credible?

Many organizations have started and failed because they were established mainly to respond to a call for a proposal or to address one pressing social problem and failed to meet the criteria for credibility. You and your colleagues will want to do everything pos-sible to be sure that your CBO avoids this disappointing situation.

1.2. Meeting the Credibility CriteriaThese criteria are important not only because of donor requirements, but because they help to establish your organization as credible with the public and key stakeholders. They are also essential for your organization’s effective functioning. They contribute to the effective functioning of both people and systems, the core elements of any organization. Let us look at the criteria one by one.

1.2.1. Establishing a Clear Mission and Vision

The mission and vision offer two powerful guiding forces for your organization or a project.


The mission is the purpose, the reason the organization exists. It answers the question, why do we do what we’re doing? See the box at left for examples of good mission state-

ments.

The vision is a picture of a desired situ-ation—an image of success that you can visualize in your mind. It answers the question, what will we see in this commu-nity if our organization succeeds in carrying out its mission? See the second box for examples of good vision statements.

If your organization doesn’t yet have a mission and vision, your management team need to sit together, ask yourselves these questions, discuss your responses, come to agreement, and write up the results. If you already have a mission statement or a vision, reviewing them is worthwhile to see if they really answer those two important questions. You may want to seek outside assistance in this process from someone who has relevant experience with other organizations. You might also look around to find organiza-tions with missions and visions that you find compelling and ask one of their staff to help you refine yours.

Many organizations post their mission and vision in public places, to remind their clients—and themselves—why they exist and where they hope to be.

1.2.2. Registering Your Organization

Your nearest local government authority (LGA), relevant state ministry, or Corporate Affairs Commission will provide you with a list of requirements for registration. When you have met the requirements, you can register your organization with the appropri-ate authority. As part of the registration, you will be required to have a constitution and a governance structure that spells out the power of the board of trustees/patrons and the secretariat. Here again, you may find it useful to seek outside help from a registered organization that is similar to your own.

EXAMPLES OF MISSION STATEMENTS

■ CEPAT, Kogi State To empower citizens to mitigate the impact of poverty, ignorance, and diseases

■ CHEDA, Taraba State To improve community involvement and participation on health and development issues especially HIV, TB, malaria, potable drinking water, and sanitation

■ INGRA, Kogi State To help develop grassroots communities through information dissemination and economic and social empowerment

EXAMPLES OF VISION STATEMENTS

■ CESDYO, Kogi State A society free of poverty, disease, and injustice where people live a life of dignity

■ GLOHWOC, Kogi State A society where less privileged women, children, and people living with HIV have access to the basic needs of life

■ NETWORK FORUM, Taraba State To create an enabling environment for sustainable development in the community


1.2.3. Assuring Basic Human Resources

Here are some suggestions that many young organizations have found helpful in recruit-ing, hiring, and retaining motivated employees:

■ Establish a human resource management system that ensures recruitment, alignment, and deployment of staff by merit to meet organizational and programmatic goals.

■ If, like most CBOs, your organization began with the founders as staff, plan to recruit future staff through a competitive process based on merit.

■ If you are initiating a new project, seek creative ways to tap the talents of your current staff to fill the new positions before you begin recruiting from outside the organization.

■ Produce a simple organizational chart or organigram (see figure 1) that shows the relationships among all staff members.

Figure 1. Organizational chart of a small CBO in Taraba State

Executive Director

Program Officer

M&E Officer

Program Manager

Account Officer


■ Pick your staff as much for their character, commitment, and team spirit as for their professional qualifications.

■ Provide regular supportive supervision, with periodic sessions for performance planning and review.

■ Consider supplementing full-time staff with part-time employees; draw on carefully selected, well-trained, closely supervised volunteers to carry out specific tasks.

■ Plan ahead for the workforce you will need, both short- and long-term.

■ Recruit new staff and consider promotions of high performers or task-shifting to fill vacancies.

■ Prepare a job description for each staff member.

■ Deploy staff on jobs appropriate to their skills.

■ Make a conscious effort to develop your staff.

Once you have selected, recruited, and deployed your basic staff, you will want to retain them, maintain their motivation, and build their skills. Supportive supervision should be geared to their level of achievement and the complexity of their assignments.

A small organization may not have a formal supervisory system, but it should provide every staff member with ongoing support and guidance. In particular, if you are fortunate enough to have volunteers taking on tasks, they will be far more motivated and produc-tive with a staff member overseeing their work. As your CBO grows, you will want to establish more systematic supervisory procedures at all levels. Even the executive direc-tor should report to the board and benefit from its members’ counsel and advice.

Offering your staff opportunities for growth through coaching, mentoring, training work-shops, exchange visits, conferences, access to organizational libraries and, where available, Internet resources is equally important.

CHOOSING THE RIGHT PEOPLE: WISE WORDS FROM TWO AMERICAN STATESMEN

“We can have people with the best skills in the world, but without character, nothing much can happen or, worse, the wrong things can happen.”

— General Eric Shinseki, Former U.S. Army Chief of Staff

“Endeavors succeed or fail because of the people involved. Only by attracting the best people will you accomplish great deeds.”

— General Colin Powell, Former U.S. Secretary of State


MSH has developed a program to build leadership and management skills with staff at all organizational levels. ProACT, like other MSH projects throughout the world, has applied the Leading and Managing for Results model (left) with its own staff and with ProACT-supported organizations. The model has yielded im-pressive results in developing the skills of individuals and teams. It can be applied by any organization with even a very small staff and board.

Annexes A and B summarize the core elements of the model. Annex A shows how management and leadership link to positive public health results. Annex B details the practices that distinguish good

management and strong leadership.

1.2.4. Establishing Functional Management and Financial Systems

A good management system requires an operational plan with objectives, activities, mea-surable indicators, responsible parties, and time lines. Members of the senior manage-ment team should monitor the plan at agreed-upon intervals to track success or failure against the indicators and to revise the plan accordingly. You will want to hold senior team meetings regularly, following an agenda to which all team members can contrib-ute. The minutes of each meeting should feature the actionable points and the person assigned responsibility for the follow-up actions. Each meeting can then begin with a review of these actions and the results.

Another feature of good management is the allocation of ultimate responsibility. Some-body in your organization must provide direction, make final decisions, and be held accountable for results. This person’s role must be well defined and made clear to the entire staff and board. But all other staff must also have clear roles and responsibilities, which should be spelled out in a detailed job description and which the staff member reviews and agrees to, with the understanding that the job description may well be revised as the staff member’s responsibilities change.

A sound financial system is critical for the success of your organization. You will find de-tails on internal financial controls in this manual under “Managing a Grant,” step 2 below. At this point, it is enough to touch on the basic processes. Ideally a staff member with thorough knowledge and considerable experience should manage your organization’s

LEADING AND MANAGING FOR RESULTS: A CBO SUCCESS STORYAccording to Mr. Iliyasu Krim, Principal of Government Day Secondary School, Nukkai, Jalingo LGA, Taraba state, “Prior to MSH intervention, our teachers found it very difficult to discuss issues of HIV and AIDS and other adolescent reproductive health issues with the students as our culture, tradition, and even religion does not encourage this. It is regarded improper for parents to discuss sex education and other reproductive health issues with their children and wards. But since the commencement of this FLHE program in our school, our teachers have been trained and this has tremendously improved their capability to reach out to the students with information on HIV prevention and other adolescent reproductive health issues. Communication between the students and their parents on HIV and other health issues has improved because we actively involve the PTA [parent teacher association] in our Program Management Committee.”


finances; such knowledge and experience includes accounting procedures such as set-ting up and maintaining an organizational bank account, cash book, ledger, and the other aspects of a simple accounting system.

If no one on the staff is fully qualified, you will want to provide coaching for the most appropriate person, helping him or her to grow into the role. You may find a quali-fied financial management coach working with another civil society organization, with the finance department of a government body, or with a bank or local business. Some organizations have found coaches who volunteered their services because they believed firmly in the mission and vision of the CBO.

1.2.5. Setting aside Designated Office Space with Clear Contact Information

Office space need not be elaborate as long as it is set aside for organizational activities and has space for at least one staff member to carry out those activities. The organiza-tion must have clear contact information—an accessible address and active telephone number. It should have a simple filing system, including a locked drawer or box for per-sonnel and financial records. As your organization grows, you will need enough space to accommodate more staff and to hold meetings.

1.3. Mobilizing Resources: Is Your CBO Ready to Write a Winning Proposal?

Resources can be mobilized in innumerable ways—use your imagination and your knowledge of your environment to be open to every possibility. Is it best to advocate with powerful local leaders? Should you initiate income-generating activities? Can you supplement your funding and increase public awareness with local fund-raising events? Do you have commodities or services you could sell? Can you offer consulting services to other organizations? Are you in a position to establish an endowment?

You and your colleagues can brainstorm possibilities and greatly expand this list. Then you can shape your ideas into a resource mobilization plan that states your resource needs and identifies potential resources within and outside your community to meet those needs.

Your local area may have many potential sources of support for innovative programs, but to sustain and grow your CBO and take on new challenges will require a significant level of funding and technical assistance. Most CBOs begin by writing a proposal—applying for a grant from a larger nongovernmental organization (NGO) which, in turn, is a grantee of one or more donors. In that instance, the NGO transmits the donor’s requirements and priorities and can be viewed as the CBO’s donor.

You are likely to seek assistance in writing the proposal for your grant—perhaps from the NGO itself or from other organizations or consultants the NGO recommends. Even if you have had some success in writing proposals before, each situation is different, and

outside help is always useful.


Here are some tips—based on the experience of other CBOs—for writing that winning proposal.

■ Read (and re-read!) the request for applications (RFA) or request for proposals (RFP) very carefully—this step is critical.

■ Request clarification of any ambiguous or confusing wording or items.

■ Adhere strictly to donor’s guidelines. Pay close attention to evaluation criteria if they’re given.

■ Use the donor’s language wherever possible, but don’t just repeat what’s in the RFA/RFP—summarize, confirm, or expand on it if you can, using examples from your organization’s experience.

■ Show your CBO’s achievements in its focus areas, and provide examples of success.

■ Provide convincing evidence of financial management—capacity to manage a grant.

■ Outline the technical strategy for using the new grant. Create a logical flow, such as a results framework. State the end point: goals, anticipated results, or deliverables (use the donor’s language), then objectives (or intermediate results), and then detailed activities to meet those objectives.

■ Provide a work plan with a time line, monitoring and evaluation (M&E) indicators, and milestones even if the donor may not have asked for them.

■ If you are not experienced in grant writing, seek outside help from bigger NGOs.


STEP 2. MANAGING A GRANT

If your organization has proven itself credible, establishing all the necessary systems and procedures, and you have written a successful proposal, you will now have the privilege and challenge of carrying out the activities and meeting the objectives for which you have been funded.

2.1. Studying the Contract Before Signing ItA word of caution: This requirement is one of the most critical—and most often ig-nored—for good grant management. In the excitement of winning a grant, many organi-zational leaders look through the contract only briefly, thinking that they are thoroughly familiar with all aspects of the project. They later find themselves held to requirements they never noticed.

To avoid unpleasant surprises, you and the members of your management team should read the document carefully more than once, and then review it together line by line before signing. Be sure that all of you understand the nature of the work being proposed and the implications of all aspects of the contract and that you are satisfied that you will able to meet them. If no one on your staff has experience with the financial aspects of grant management, you may want to bring in an experienced colleague from another organization to clarify the financial requirements.

After the internal review, you will want to clarify any gray areas and concerns with your donor before signing. Once you have signed, you will be held responsible for adhering to every provision in the contractual agreement.

2.2. Referring to the Contract during ImplementationAfter signing the contract and receiving the first installment of funds, you may be tempted to put the contract away in a safe place and get on with the work. Don’t give in to that temptation. Your contract guides every activity throughout the project, and you will want to refer to it often. Every staff member with a project role is responsible for adhering to some provision or requirement of the contract. For this reason, you should share the document freely with your staff and help them to be aware of their responsi-bilities in meeting contractual requirements.

The contract forms the basis for your project work plan; the work plan should be shaped to meet the donor’s expected results and deliverables. (See figure 2 for a sample.) Everyone with a significant role to play on the project should participate in work planning. The project work plan is similar to your organization’s operational plan but is more detailed. Although there are several possible formats, certain elements are generally included in any work plan: objectives, general activities and more specific tasks, measurable indicators and/or milestones or benchmarks, responsible parties, and time lines. Be sure to include reporting among the activities and to allow the time and resources needed to meet the donor’s reporting requirements.


Some work plans also specify the level of effort and resources required for activities and tasks. Whether or not these items appear on the work plan itself, you and your project management team must allocate realistic costs to every work plan activity and task and track these costs to guarantee that you are working within the approved and available budget.

Successful grantees track activities against work plans and keep their donor informed of progress, both through required written reports and, if appropriate, through more frequent informal communication. Note: It is absolutely critical to warn the donor in

Figure 2. An illustrative work plan format for a new grant

Objective 1: To provide high-quality comprehensive care and treatment (CCT) to people living with HIV/AIDS

Activities/Tasks Persons Responsible

Indicator Dates

QTR 1 QTR 2 QTR 3 QTR 4

1. Incorporate updated standards of practice (SOPs) into CCT

Project Technical Director

SOPs in use at all CCT sites in District A

a. Revise SOPs ■ CCT advisor X

b. Distribute SOPs to CCT sites

■ Supervisors X X

c. Train caregivers in use of revised SOPs

■ Supervisors X X X

2. Submit quarterly reports to donor

Project Director Quarterly reports submitted on time, meeting donor’s specifications

a. Collect and synthesize data from CCT sites (monthly reports)

■ Supervisors X X X X

b. Prepare financial report vis-à-vis budget

■ Finance/Operations Director

X X X X

c. Write up activities and results vis-à-vis work plan milestones

■ Technical advisors X X X X

3. Continue as above


advance if you anticipate departures from the work plan and to obtain documented ap-proval of any changes before carrying them out.

2.3. Assuring Effective Technical ImplementationThe orientation of your project staff should clarify the roles and responsibilities of every staff member in implementing the activities in the work plan. There may be aspects of the work that your organization cannot provide on its own. If so, the orientation stage provides an excellent opportunity to network with other organizations in the same geographical area that have relevant expertise. These linkages will not only enable your organization to meet its contractual obligations; they will also bring together various resources and services for increased efficiency. They may even lead to effective advocacy on issues of mutual concern.

Like many grantees, you may find it useful to create a project management team that meets regularly to monitor the work plan, discuss programmatic and technical topics, share lessons, and resolve issues. Members of this team can also be alert to best prac-tices from other projects and localities that could enhance the work of your project.

2.4. Assuring Effective Financial ManagementWhy is financial management important?

■ It helps your organization to gain the respect of donors, partners, and beneficiaries.

■ It helps your organization to be more accountable to donors and other stakeholders.

■ It is the basis for the satisfactory use of resources to achieve objectives and fulfill your commitment to stakeholders.

■ It gives your organization an advantage over others when competing for scarce funding.

■ It helps your organization prepare for long-term financial sustainability.

Effective financial management depends on a functional financial system. To this effect, CBOs are strongly encouraged to develop a financial manual that spells out the key elements of the system. Even if you lack a manual, the basic requirements remain, and your organization must have all the elements in place for effective financial management. Once again, an external coach can work with the person designated to manage your organization’s finances. Together, they can be sure that you have the following in place.

■ A simple accounting system: a method of entering transactions of amounts received and paid out by the organization in a cash book; can be done manually or by using an Excel® spreadsheet or accounting package such as QuickBooks®

■ Books for record-keeping: a cash book, payment vouchers, bank statements, receipts, bank reconciliations


■ A procurement system: procedures to ensure that no officer is single-handedly responsible for initiating, paying, and executing procurements. All procurements must use competitive procedures that will produce value for money and be fair to all parties.

■ A clearly defined process for disbursements: requesting, approving, and making payments

■ Procedures for prompt retirement of advances with receipts or signed acknowledgments of receipt of money. Lists of participants in trainings and meetings should be stapled to the receipts.

■ A system for verification of payment requests before approval including checking the requests against the work plan and budget

■ A separate bank account for each funded project

■ A listing of allowable expenses under the contract and a system for ensuring compliance

■ Understanding of and compliance with the donor’s reporting requirements

■ Safe-keeping of all project assets, including cash and records

2.5. Assuring Effective Monitoring and Evaluation An M&E system enables your organization to learn from your work and use what you learn to inform future programs. An M&E plan should be developed in conjunction with the project work plan; it spells out how you will measure the indicators in the work plan. It is critical to managing the grant; it enables you to honestly assess progress, to avert crises, and to report accurately on the results that you have been funded to deliver. M&E is not only about figures; the information that your organization and donor require could be both quantitative (numeric) and qualitative (descriptive text).

2.5.1. Developing a Useful Monitoring and Evaluation Plan

The best M&E plans are developed in a participatory manner. They bring together all members of the project management team to clearly define the desired results of a project and discuss how they will track progress (monitoring) and assess the ultimate re-sults (evaluation). The project management team confirms or adapts the indicators from the work plan and identifies the tools they will use and activities they will undertake to measure results. They agree on who will be responsible for each M&E activity. They determine the frequency of data collection and reporting. They then cost out the plan to be sure the project budget will accommodate all the required M&E activities. Figure 3 is a sample M&E plan.

2.5.2. Carrying out the M&E Functions

All staff members should be able to monitor and evaluate the activities and results for which they are responsible. A competent M&E focal person should be responsible, how-ever, for coordinating the collection, management, and use of data.


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Anyone with M&E responsibilities will need to know how to do the following:

■ Develop and adapt data and information-gathering tools

■ Collect and compile data

■ Analyze and interpret data

■ Use the findings for project and program management

■ Give regular feedback to those who provide the data, enabling them to use their own data to recognize achievements and identify areas for improvement

The M&E focal person will be responsible for the following:

■ Keeping service delivery data collected at the point where services are provided, in a locked drawer or cupboard

■ Maintaining both paper-based and electronic data storage systems if possible

■ Checking from time to time to be sure that the data collected are of good quality

■ Using simple methods to analyze and present the data or information collected

■ Ensuring that data are kept after expiration of the project as stipulated by the contract or, if a term is not defined, for at least five years

A few guidelines will go far in making your M&E system work for this and other grants. First, and most important, make your M&E system and tools as simple as possible, col-lecting only the data that you absolutely need to measure project results. Make M&E reviews part of regular project management team meetings, to be sure you are on track with these reviews as with other project activities.

You are in a position to turn M&E data into visible improvements in health services. When you have collated, analyzed, and compared the statistics from health facilities, you can feed information back to the providers who gathered and reported the statistics. If you help them to understand the meaning of their own data, they can use the information to identify gaps in service delivery and improve the quality of their services.

A solid M&E system will also enable you to gather facts to use in advocacy, to plan new organizational initiatives, and to increase your CBO’s credibility by providing evidence of your successes.

Many organizations seek outside assistance to develop comprehensive M&E systems and build basic M&E skills among the staff. You can do a lot on your own, however, with guid-ance from such resources as MSH.

2.6. Communicating ResultsYou and your colleagues will surely want to communicate your results to a broader audi-ence at the end of your project and even earlier if you have exciting results to report or events to describe.


2.6.1. Why Communicate?

Compelling communication will increase your organizational visibility and reputation—and that of your donor. It will enable your CBO to influence the broader society by promoting policies, practices, and funding for the causes you care about. You will be bet-ter able to create alliances of people with common interests and help them to advance their causes. Ultimately, your experience will contribute to the global body of knowledge about meeting important health challenges.

To communicate effectively, you will need to think ahead about the different audiences you hope to reach. The audiences for communications from your CBO are likely to include all your stakeholders: donors, state and LGA officials you work with, clients and potential clients, health care providers at all levels, community leaders and members, and representatives of other NGOs. Knowing your audience will help you determine what information and messages you want to convey and what communication products and platforms will be most effective. These products and platforms will form the elements of a simple costed communication plan.

2.6.2. What and How to Communicate

There are dozens of ways to communicate; with a little research and some conversa-tions with your colleagues, you can choose the products and channels that best fit each audience. A few guidelines will make your communications memorable:

■ Document your processes carefully as you go along; turn them into results and lessons learned.

■ Seek communication channels and devices that will appeal to varied audiences. Some CBOs have told their stories through before-and-after photographs, quotes from clients, radio and TV broadcasts, news nuggets, abstracts for presentations at conferences, drama, songs, and dances. (See box 6 for a sample.)

■ Define what attitudes, behaviors, or actions you want your message to bring about in each target audience.

■ Present the message in clear, simple, but powerful language that your audience can easily understand and respond to.

■ Use varied venues to convey your messages, ranging from town hall meetings to international conferences to community theaters.

STEP 3. LOOKING AHEAD

Every organization needs to understand that sustainability will not happen automatically. The first grant your organization gets is just the beginning of your journey. Sustainability needs to be integrated and mainstreamed into your project from the start by empha-sizing community participation, building partnerships and networks, and being cost-conscious.


MANY WAYS TO COMMUNICATE: A SUCCESS STORY EXAMPLEHOPE CAN LIE WITHIN YOU….THE RABI SULEIMAN STORY— by Favour Odunze, Communication Assistant, ProACT, Kebbi

BEFORE

Forty-year-old Rabi Suleiman lives in Koko Besse local government area, Kebbi State, Nigeria. She is married without children. Rabi, who now lives with her third husband, recalls that her ordeal with illness and social ostracism began in 2009. Rabi’s three marriages were the result of her inability to conceive and a continuous search for a partner with whom she could successfully bear children. In the course of her multiple marriages she contracted HIV and tested positive on April 16, 2009. Rabi believes she got the HIV infection from her second husband.

Weakened by continuous infections and emaciated beyond recognition, Rabi recalls that she was abandoned, equated to animal status, and locked up in a hut meant for cattle in her family home. Her meals were pushed to her through a door-opening by relatives who refused to look her in the face.

AFTER

Today, Rabi has a new story to tell. With the assistance of a Prevention Organizational Systems—AIDS Care and Treatment (ProACT) project outreach team, Rabi was enrolled with the USAID-supported ProACT antiretroviral program in the General Hospital, Koko, late in 2009. She says her traumatic experience with sickness, stigma and ostracism is now history, “I am happy; I am confident of who I am now. Now I can speak publicly about my status.” Transcending her initial status of rejection and abandonment, Rabi is once more a respected member of her community. With her support, two individuals were recently counseled, tested, and enrolled at the Koko General Hospital facility, Kebbi State, where she now works as a peer counselor.

Rabi urges, “Know your status because if you don’t, you could be at risk. HIV is never the end. Your attitude toward your medication determines your attitude toward your health. A lot can be said about you and to you, but it’s in your best interest not to worry about it. I am happy and can do everything any other human beings can do. I have a shop at home, I go to the market, and I have a lot of friends. I always advise HIV-infected individuals to take their medication regularly, and to try to free their minds of worry.”

Rabi is blooming and happy these days. In laughter when asked for her words of advice to USAID and Management Sciences for Health, she responds, “I have nothing to say but I know you are blessed for bringing help to people like me. It is challenging but you shall not miss your reward at the end.”

Management Sciences for Health’s ProACT project is a USAID-PEPFAR funded intervention being implemented in six Nigerian States: Adamawa, Kebbi, Kogi, Kwara, Niger, and Taraba.


To assist your organization in looking ahead to long-term survival and growth, you can carry out some proven approaches even while you are implementing your project.

3.1. Scanning Your Environment for Opportunities and ThreatsGet to know the donor community—their different areas of focus and their shared concerns. Scan your own community for emerging needs, resources, and obstacles; en-courage other members of your organization to actively scan their environment as well. You can seek information on funding opportunities from local authorities, the Internet, and the organizations with which you are building links and networks. Finally, participate in local and international conferences, meetings, and workshops where you can not only present your organization to new audiences but also gather useful information from formal presentations and informal contacts.

3.2. Strategically Positioning Your OrganizationThe right kind of board can help to give your CBO the status it deserves and position it for growth. It is important to pick board members who are well respected and who have connections with people of influence, but who are also passionately committed to your cause. You can draw on the board to identify opportunities and resources for your organization.

3.3. Building Partnerships, Alliances, and NetworksFor increased efficiency and maximum impact, make links with relevant organizations. Map all of the stakeholders in your area, find out what resources and services they pro-vide, and determine how you might collaborate with them to serve a common purpose. CBOs are agents of change, with the potential to influence policies, practices, and direc-tion of resources. Your CBO can be a powerful force if you form alliances to advocate for common causes.

THE LAST WORD…To become a leader or a leading organization is not a one-off event but, rather, a lifelong process that begins with making the right choices and then working through them to practice and learn. Perseverance and discipline to remain focused on your mission, vision, and plans will begin to allow small results to happen. Because they grow to become visible changes, we have observed that small results are powerful motivators of internal and external energy. By reading this manual and practicing what is herein, you have taken the first step to making meaningful impacts in your society. To keep rising, let us remain networked with others of like mind. As civil society organizations, we have a great con-tribution to make to society, and governments and donors have resources for us if we demonstrate internal capacity to be credible and coordinated and to produce results. Let us take up the challenge.


ANNEX A.Leading and Managing for Results ModelHow do management and leadership contribute to improved service delivery?

MANAGING

improvedwork

climate

improvedmanagement

systems

improvedservices

improvedhealthoutcomes

scan

focus

align/mobilize

inspire

plan

organize

implement

monitor andevaluate

Results

Leading and managing practices

LEADING

improvedcapacity

to respondto change


ANNEX B.Leading and Managing FrameworkPractices that enable work groups and organizations to face challenges and achieve results

LEADING MANAGING

scanning

focusing

■ identify client and stakeholder needs and priorities■ recognize trends, opportunities, and risks that affect the

organization■ identify staff capacities and constraints■ know yourself, your staff, and your organization —

values, strengths, and weaknesses

organizational outcomeManagers have up-to-date, valid knowledge of their clients, the organization, and its context; they know how their behavior affects others

■ articulate the organization’s mission and stategy■ identify critical challenges■ link goals with the overall organizational strategy■ determine key priorities for action■ create a common picture of desired results

organizational outcomeOrganization’s work is directed by well-de�ned mission, strategy, and priorities

aligning/mobilizing■ ensure congruence of values, mission, strategy, structure,

systems, and daily actions■ facilitate teamwork■ unite key stakeholders around an inspiring vision■ link goals with rewards and recognition■ enlist stakeholders to commit resources

organizational outcomeInternal and external stakeholders understand and support the organization’ goals and have mobilized resources to reach these goals

inspiring■ match deeds to words■ demonstrate honesty in interactions■ show trust and con�dence in staff, acknowledge the

contributions of others■ provide staff with challenges, feedback, and support■ be a model of creativity, innovation, and learning

organizational outcomeOrganization displays a climate of continuous learning and staff show commitment, even when setbacks occur

planning

organizing

implementing

monitoring and evaluating

■ set short-term organizational goals and performance objectives

■ develop multi-year and annual plans■ allocate adequate resources (money, people, and

materials)■ anticipate and reduce risks

organizational outcomeOrganization has de�ned results, assigned resources, and an operational plan

■ ensure a structure that provides accountability and delineates authority

■ ensure that systems for human resource management, �nance, logistics, quality assurance, operations, information, and marketing effectively support the plan

■ strengthen work processes to implement the plan■ align staff capacities with planned activities

organizational outcomeOrganization has functional structures, systems, and processes for ef�cient operations; staff are organized and aware of job responsibilities and expectations

■ integrate systems and coordinate work �ow■ balance competing demands■ routinely use data for decision-making■ coordinate activities with other programs and sectors■ adjust plans and resources as circumstances change

organizational outcomeActivities are carried out ef�ciently, effectively, and responsively

■ monitor and re�ect on progress against plans■ provide feedback■ identify needed changes■ improve work processes, procedures, and tools

organizational outcomeOrganization continuously updates information about the status of achievements and results, and applies ongoing learning and knowledge

VOL 1: COMPREHENSIVE HIV/AIDS CARE AND TREATMENT: SITE START-UP AND MANAGEMENT

VOL 2: STRENGTHENING THE LONG-TERM CAPACITY OF COMMUNITY-BASED ORGANIZATIONS

VOL 3: HEALTH PROFESSIONAL FELLOWSHIP PROGRAM: BUILDING THE CAPACITY OF HEALTH PROFESSIONALS TO DELIVER HIGHER QUALITY HIV/AIDS, TB, AND OTHER HEALTH SERVICES

VOL 4: HIV/AIDS CARE AND SUPPORT: A COMMUNITY RESPONSE

THE BUILDING SUCCESS SERIES

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