Management Lessons Learned. ❑ Joint planning and implementation beginning with the development of the proposal and detailed implementation plan paved the way for the success of CS Project interventions and sustainability. ❑ CARE’s commitment to service oriented leadership and empowerment built capacity among the members of the MOH Municipal Management Team to assume roles in health stewardship in the Municipality of Matagalpa. ❑ Creation of permanent structures such as the Municipal Health Commission and the Survival Cooperative laid the groundwork for sustainable health benefits. ❑ The competency based training approach characterized by learning-by-doing, with the concurrent delegation of responsibility, built excellent managerial and technical capacities of CARE Extensionists and MOH staff. ❑ CS staff comments about the lessons they have learned personally include: ❑ “Work with a multi disciplinary team improved the quality of our activities.” ❑ “Weekly team meetings helped us to stop and reflect on what has been done and use the results to improve implementation.” ❑ “We feel that this project has been a school where we have learned how to do things differently and better, and how to evaluate our own strengths and weaknesses and ask for help.” ❑ “We learned to use a different type of language to eliminate top-down attitudes and prejudice in community work.” ❑ “The most important thing is we learned how to facilitate and not do everything ourselves, even though it took longer.” ❑ The men on the team experienced a paradigm shift regarding machismo, a valuable experience in shortening the gap between men and women in Nicaragua ❑ The implementation of TQM along with quarterly assessments, exit interviews and the development of supervision systems, guides, and checklists contributed to a culture of quality improvement and improved the utilization of services. ❑ The absence of staff turnover, especially within the MOH Municipal Team and Health Post personnel was crucial to building solid local health systems.
Management Lessons Learned. This was the first ever grant that Plan Cameroon received, and it was managed vertically. It was a challenge to constantly dialogue and negotiate with all Plan Programs and staff, as well as project partners. Being open and in constant communication helped the project become successful and respond to various issues, situations, challenges and successes. A more participatory approach toward management would have helped the project achieve even higher results and more impact as staff would have been more organized and the work more coordinated. Project partners also would have benefited more directly had there been a more integrated approach toward project management.
Management Lessons Learned. Financial Management
Management Lessons Learned. The preparation, adoption and update of a clear Partnership Agreement between SC and the DHO have been effective in building capacity, mutual trust and transparent financial management. Decentralizing the management of certain DHO activities through Health Zone Coordinators is effective. However, this organizational structure relying on the competence and attitude of the individual Health Zone Coordinators has led to project delays or poor performance in certain areas of the district where the Zone Coordinator was absent or did not cooperate. Rigorous management of even limited financial and logistical resources allows the implementation of most of the PEAQ Project activities. The maximum amount allowed at each level of signatory power needs to be adjusted to the actual value of the local currency to avoid delays and undue burden on the managers.
Management Lessons Learned. There are a few management lessons that were learned during the course of CLICS. One was that a consultant that is unfamiliar with the program aspect is unable to design an MIS system. This resulted in CLICS having to develop the system internally and it has functioned effectively and satisfied project needs. Another lesson is that the community is not only able to monitor its own health status but is eager to do so. In addition, the VCCs have demonstrated an ability to monitor and pay CLICS doots. Paying the CLICS doots through the VCCs has been found to be important to make them accountable to the community. It also increases the possibility that the VCC will contribute to the support of the CLICS doots after project funding ends, thus helping in the sustainability of the project activity. They can provide incentives and disincentives to the CLICS doots depending on their performance.
Management Lessons Learned. All key project documents should be available to all partners in clear, local language that can be understood by all. • Roles and relationships should be negotiated ideally during the project design phase, and then reconfirmed in writing through formal agreements prior to writing the DIP so that these agreements enter as part of the DIP and are clear to all, keeping in mind Xxxx Xxxx’s experience of developing teamwork, rather than individual roles and responsibilities. • A start-up workshop is critical to help everyone, especially newly hired or recruited project implementers, understand the project’s goals, objectives and desired results. However, a start-up workshop is not sufficient to ensure continuing understanding and focus as project team members change. Orientation is necessary every time new members enter and periodic review for existing members is important. Projects should build this function into their management plans from the beginning, with a process that is well described so that all new members receive adequate information about the project. Projects may want to consider developing a short brochure for municipal authorities and health service directors and providers that includes key information about the project goals, objectives, desired results, partners, roles and relationships, timeline, source of funding, requirements for participation (if inviting participation, for example, many people interviewed suggested that municipalities should be required to contribute its own funds and/or materials to participate). • Supervisors need to assess field staff capacity at the beginning of the project, determine in which areas staff needs strengthening, develop a plan to strengthen these areas and follow-up to ensure that these plans are implemented and that they are producing the results desired. It is not sufficient to rely on indirect supervision through reports and meetings to assess skills.
