By: Dyness Kasungami and Amanda Coile
Locally led development is at the center of today’s global health agenda. But putting this concept into practice has been a longstanding challenge. To improve health around the world and ensure that global health investments are making a difference, we must change how we work and think.
To this end, JSI’s Reimagining Technical Assistance (RTA) initiative uses nine critical shifts to promote changes in development assistance norms, policies, and practices. These critical shifts arose from a co-creation process led by government representatives, local and international implementing partners, funders, and community advocates in the Democratic Republic of Congo and Nigeria. They were later expanded and validated by diverse actors from 13 countries and experts from three funding agencies.
Today, RTA is a JSI-led initiative to guide changes in the way the health sector conceptualizes, prioritizes, funds, delivers, and evaluates health investments. We used the critical shifts framework to develop a benchmarking tool to help people at all levels of the global health ecosystem — from project to policy — advance locally led development. In our work, we focus on the health sector, but the critical shifts can also be applied to other fields.
A Framework for Change: The Critical Shifts Benchmarking Tool
The Critical Shifts Benchmarking Tool offers a framework for identifying and implementing the changes needed to move toward a more locally led, coordinated, and equitable health system. More specifically, it is a guide for shifting the practices, structures, relationships, funding mechanisms, and mindsets that shape our work. Designed to help people throughout the global health ecosystem work and think differently, it involves four basic steps: 1) establish a baseline, 2) identify a shared vision, 3) determine the changes needed to achieve that vision, and 4) monitor and evaluate progress.
Benchmarking typically involves measurement, a comparison to an identified standard or norm. In the complex field of global health, however, it is difficult to quantify progress toward locally led development. The benchmarking tool offers a qualitative approach, a mechanism for tracking this progress. By facilitating dialogue, reflection, learning, and alignment, it helps actors at all levels identify what is working and what needs improvement. Its aim is to promote honest conversations and change how we work and think. This is, of course, easier said than done. Where do we start? What needs to change? How do we change? Answering these questions requires difficult but important discussions that the benchmarking tool can help guide.
The tool can be integrated into existing processes for decision-making, planning, and implementation. It can be used at any time and involve any scope. The important thing is to approach it with an open mind. Indeed, to truly shift the way we work and think, we must establish an environment in which we can challenge each other and work together to overcome the systemic barriers that impede local leadership and prevent health investments from achieving their full potential.
Real-World Applications
Benchmarking offers an opportunity to test and model new ways of working together. At JSI, we have used the Critical Shifts Framework and the Benchmarking Tool to inform partnerships and project design, assess and document progress and learning, monitor and evaluate our work, and hold ourselves accountable for advancing locally led, coordinated, and equitable health programming. In Zimbabwe, for example, we used the tool to reflect and learn, generating insights about the importance of time, flexibility, and collaboration for project success. We also used it to assess and document a project’s transition from JSI to local leadership in Uganda (manuscript forthcoming). In Ethiopia, in collaboration with all project stakeholders, we used the tool to articulate a common vision of success and map the path to get there. This included identifying resources, increasing accountability, and guiding and framing related conversations, strategies, and implementation. We use the learnings and recommendations from all these experiences to inform our ongoing efforts to advance locally led development.
The benchmarking tool is not just for implementing agencies; it is for everyone in the global health system. For example, a funder might use it to inform policies, strategies, and funding structures. Government representatives can use it to set expectations and boundaries for external partners, agree on partnership and engagement principles, and foster mutual accountability. Policymakers, advocates, and networks can use the tool to support coordination, collaboration, and accountability.
Join Us
The Critical Shifts Framework and Benchmarking Tool recognize that how we work is as important as what we do. Beyond the projects we design, fund, support, or implement, we must (re)consider the ways we relate to each other, organize our teams, and manage our initiatives and organizations. The Critical Shifts Benchmarking Tool can help guide the way. We invite you to test and adapt the benchmarking tool and corresponding guidance brief and to share your ideas and perspectives at: reimaginingtawg@jsi.com.
