FANIKISHA Project Strengthens Kenyan Civil Society Organizations, Country Ownership: A Conversation with Dr. Bukenya

Dr. Daraus Bukenya. {Photo credit: MSH.}Photo credit: MSH.

USAID’s FANIKISHA Institutional Strengthening Project (2011–2016) aims to strengthen the institutional capacity of Kenyan civil society organizations (CSOs) so they can have greater impact in implementing community health interventions and strengthen the Kenyan health system as a whole. FANIKISHA is funded by USAID and represents a partnership between MSH, Pact Inc., Danya International, and the Regional AIDS Training Network.

MSH spoke with Dr. Daraus Bukenya, FANIKISHA’s project director and MSH’s country representative for Kenya, about CSOs, country ownership and governance in Kenya.

FANIKISHA’s mission is to strengthen the leadership and management capacity of civil society organizations (CSOs) so they can improve the health of communities. Why are CSOs so important?

CSOs are key actors in a comprehensive health system. In Kenya, they are on the frontline of health service delivery at the community level. At least 50 percent of healthcare services to communities in Kenya are provided through the nongovernmental sector, which is made up primarily of civil society organizations. In recent years the number of CSOs in Kenya has increased exponentially. The NGO Coordination Board, one of several government entities that register NGOs, registered at least 7,500 NGOs in 2011. The average number of new NGOs registering with the board has tripled since the early 1990s, from 200 to nearly 600 new NGOs last year. Similarly, the amount of funding from the government and development partners channeled through local Kenyan CSOs to support community interventions has nearly quadrupled, from about Kenya shillings 27 billion in 2004/05 to about Kenya shillings 104 billion in 2009/10, a four-fold increase in less than a decade ($1 USD equals about 80 Kenya shillings).

CSOs are also increasingly engaging in health policy advocacy at the national level, influencing policy decisions that impact the health of communities.

Part of your work with CSOs is building their capacity to directly acquire donor funding. Why is this important?

The potential for local CSOs to rapidly expand high-quality services in communities is immense. Through CSOs, access to health care in Kenya stands to improve dramatically. And yet, local CSOs have faced a huge challenge: accessing adequate funding. A recent study by Devex shows that of the top 25 NGOs in Kenya that receive funding to implement large-scale community health interventions, only two could be characterized as local. The majority of grant recipients by far are international organizations. The low capacity of local organizations to receive, manage, and use large-scale funding is the most significant limiting factor. While the number of CSOs is increasing, capacity to manage funds in a manner that meets donor requirements has not increased at the same rate. This has compromised country-led, country-driven health development in Kenya.

How else does FANIKISHA’s work foster country ownership of health sector development in Kenya?

FANIKISHA has adopted the strategy of engaging stakeholders to strengthen the capacity of CSOs. Multiple stakeholders – including the government, civil society networks, the private sector, and implementers of community health interventions – form the FANIKISHA Committee of Advisors (FCA), which provides oversight of our projects. The FCA also oversees the selection of CSOs that will partner with the project and the identification of local opportunities for CSO capacity-building.

FANIKISHA has also established multiple technical working groups and consultative groups with wide stakeholder representation to design, develop, review, and roll out important project resources such as database systems for CSO decision-making, an institutional-strengthening marketplace for CSOs, and the CSO Institutional Strengthening Standards and Indicators for Kenya. These resources are hosted by a government entity and FANIKISHA is strengthening that entity’s ability to own, manage, and promote the resources. FANIKISHA is also partnering with stakeholders to design national-level advocacy for community health.

MSH’s work is based on the principles of humility, partnership, and empowerment of others. We believe these principles make strong leaders. How does FANIKISHA strengthen Kenyan leaders?

The FANIKISHA approach to institutional strengthening is primarily mentorship of key CSO personnel. At the very start, this approach was discussed with the CSOs that expressed willingness to work with FANIKISHA. Before we began working with these CSOs, we agreed upon the level of effort and commitment that the CSOs would have to demonstrate. This was followed by an assessment of the CSOs’ capacity, in which the CSOs participated fully at every stage. Indeed some of the CSOs found the assessment process so informative that they started taking action to improve their systems even before they signed an agreement with FANIKISHA. The CSOs will follow a similar approach when they support the capacity of their affiliates in turn. In this regard, FANIKISHA is helping CSOs adopt the principles of humility, partnership, and empowerment.

What are some of the biggest overall governance challenges within Kenya’s health sector?

A major constraint to good governance in Kenya is a lack of adequate data systems to monitor action and inform strategic decisions. Without good data, it is difficult for the government and other organizations to be accountable to their beneficiaries. Lack of data also makes it difficult to allocate resources in a responsive and equitable manner or determine the effect of those resources on the health and wellbeing of Kenyans. Another challenge is limited knowledge and understanding of best practices in good governance. For example, it is common to encounter governance arrangements that do not take into account conflict of interest, do not clearly define roles and responsibilities, and do not demand shared responsibility. Worse still, many health care institutions do not have governance bodies. These need to be established from scratch.

Although much more must be done, we believe FANIKISHA’s work with CSO will substantially strengthen the overall health system, contributing to the alleviation of these problems.

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