Behind the Scenes of Programme Management at Amref
By Aneesa Ahmed and George Gikunda
Amref UK’s Programmes Manager, Aneesa Ahmed, and her Kenyan colleague at our HQs Institute of Capacity and Development (ICD), George Gikunda, share their honest insights into how Amref decides which projects we fund, how we manage them and crucially, how we learn from them.
How do we decide which projects to fund?
Amref implements a broad range of healthcare projects, so we are not limited in what types of projects we can fund. However, with so many competing priorities between and even within the countries Amref works, it can be challenging when assessing where the greatest need is.
Choosing a project to fund
We base our decisions both on specific country needs and the restrictions that our key partners place on the funding they support Amref with. Often partners have a certain country or thematic area of our work (e.g., training health workers) which they are particularly interested in funding. Our programmes team works with the partner to fully understand their funding criteria, any limits there will be and whether we have any flexibility around it. It is not a linear process and often involves some back and forth and co-creation.
Leading with Community Voices
The UK team then reach out to colleagues in Africa country teams to discuss where the greatest need is and where the funding is going to have the greatest reach and impact. Community voice is always at the heart of Amref’s decision making.
Maximising Impact
Our country teams work with communities and their health management teams to identify key priorities, challenges, and any gaps they have, when deciding where to allocate resources. That way we can be sure we're addressing a gap and complementing existing work rather than duplicating anything. Amref’s goal is always to ensure the support we receive is having the greatest impact.
Do we ever refuse funding opportunities from potential partners?
On occasion – yes, we do. We are always really honest with donors about where we have and don’t have expertise. Sometimes, where we are lacking sufficient experience or networks, we bring on a partner with the expertise needed to deliver a project or suggest the donor work with a different NGO. Similarly, if we can’t find common ground between Amref’s priorities in Africa and what a donor is looking to fund, we will say no.
We do sometimes have to refuse gifts from certain places and people. Amref doesn’t endorse products or accept funds from areas we feel conflict with our work and ethos, such as companies making profits from conflict zones or weapons manufacturing.
How do we monitor our projects whilst they’re being carried out?
On the ground, where the project is being implemented, our country teams have monthly internal reviews to look at the progress made, the gaps we are experiencing, the context within which we are working and how that is impacting our progress. Our country offices receive weekly updates from different counties to understand where we need to support each other, the changes that have taken place within counties and any new guidance from government ministers.
Our colleagues in Africa country offices also work with the county’s department for health at a national level and technical working groups to look at key data and indicators for an issue, for example reducing malaria indicators, and discuss each person's contributions to this process. A committee of experts will give updates on a quarterly basis in terms of progress, research, new knowledge and understanding, and to share experiences. The UK and country programme managers catch up monthly to discuss what is happening on the ground and if we need to make any changes to keep our projects on the right track.
Monitoring in the UK
Here in the UK, our monitoring is mainly focused on the requirements of the donor and in particular, the budget. Throughout a project we look at whether we are achieving what we set out to, whether we are on track to achieve it within the timeframe and using the money available. A ‘log frame’ is used to keep track of our objectives and what we hope to achieve for each of them. For example, if we are carrying out a TB and malaria project, one objective may be to train 300 health workers. We would be monitoring this regularly, checking whether we are on track to train the total number by the end of the project. We also look beyond this, and track whether the training of health workers is leading to the lasting health change we want to see on the ground – e.g., increasing the number of TB and malaria patients being supported. Lastly, we look at whether we are achieving our objectives using the money we have budgeted for the project. We track how much we are spending and whether we need to reallocate resources to be able to reach our goals, without overspending or compromising the quality of our work.
During the COVID-19 pandemic, there were many external factors affecting our programmes and their impact, that were outside our control. The numbers of people accessing our services dropped due to lockdown restrictions. Health workers dropped out of training courses, for various reasons. When issues affecting the progress of a project occur, the team flag concerns as and when they happen, keeping the donor informed and quickly coming up with solutions to mitigate them.
How do we learn from our projects?
We learn through co-creation workshops with key stakeholders including at the national and sub national level of countries we are working in; listening to what their priorities are, what is working well and what isn’t working. This informs and changes our activities on the ground to ensure we are addressing the most urgent needs.
Throughout a project we have regular feedback sessions with the communities themselves and government officials to hear directly about the impact the project is having locally. Amref also sometimes include a research component in our projects which informs future work.
When a project is successfully completed, we conduct an endline assessment (having already done a baseline at the start as well as continuous monitoring and evaluation). This looks into how effective the programme and our approach was and gives recommendations for future work. We look to find evidence which tells us whether we should continue our approach for future projects or whether we need to change it. Amref takes this approach into every project to make sure the work we deliver is effective, impactful and to ensure we are constantly learning from it.
Steve Murigi
Head of Programmes and Strategic Partnerships
Amref Health Africa UK
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