Tag Archives sub-saharan africa

Humanitarian Action amid Prolonged Political Crisis and Conflict: Experiences of the Daughters of Charity Tigray

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In this blog, Sr. Medhin Tesfay, Director of Social and Development programmes at the Daughters of Charity Tigray (DoC-T), shares her experiences alongside that of her organization in providing solidarity-based locally embedded humanitarian assistance throughout the course of the most intense period of the conflict in Tigray from 2020-2022. During this period DoC-T had to adopt many of its approaches and services, providing programmes including emergency relief aid, psycho-social support for victims of gender-based violence in the conflict, and more besides. Sr. Tesfay is a member of the Humanitarian Observatory Ethiopia, which is hosted by the University of Addis Ababa in collaboration with ISS as part of the Humanitarian Governance: Accountability, Advocacy, Alternatives (HUM-GOV) project.

Sr. Medhin Tesfay, helping elderly and disabled individuals reach the emergency cash distribution desk during the conflict.

Amidst the prolonged humanitarian crisis and huge internal displacement in Tigray, the DoC-T adopted a community-centered approach to humanitarian aid. With the solid believe that affected population needs both hardware (in terms of food and non-food provision of assistance) and software (in terms of empowerment) supports, DOC-T has been providing impactful and innovative mental health support to empower vulnerable communities to heal, rebuild, and claim their rights. This journey demonstrates the strength of resilience, dignity, and local leadership in overcoming adversity.

Since 1973, the DoC-T have been committed to supporting vulnerable communities, particularly during the catastrophic famine of 1984-1985 and the intense conflict between 2020 and 2022. Our focus has always been on delivering targeted assistance to women, children, the elderly, and persons with disabilities. Throughout these critical periods, the DoC-T have consistently provided essential services, especially during the two years of the conflict in Tigray. DoC-T has worked relentlessly to deliver emergency cash assistance, life-saving food, vital non-food items, and necessary psychosocial support to the traumatized individuals in our communities. We have done this with a strong sense of purpose, humility, love, and empathy. This blog underscores our significant contributions during these trying times and reaffirms our steadfast dedication to creating a lasting positive impact.

From 2020 to 2022, Tigray region faced significant consequences from a prolonged conflict, compounded by one of the longest humanitarian crisis in recorded history. During this tumultuous period, DoC-T played a crucial role in delivering life-saving assistance, especially in the early days of the crisis when Mekelle (the capital of Tigray) became a refuge for many internally displaced persons (IDPs). This demonstrate the resilience of locally rooted and embedded organizations to provide vital supports to the vulnerable segments of the society when the humanitarian space is filled with insecurities and uncertainties.

While other humanitarian organizations were still arriving, DoC-T provided daily emergency support across 27 IDP camps, feeding over 34,000 IDPs for nearly eight months, often risking the safety of its employees. The organization also helped in remote and hard-to-reach areas of Tigray inaccessible to major international humanitarian agencies. The organization confronted dire conditions caused by disruptions in essential services and identified public schools that had been converted into makeshift shelters, mobilizing resources to address critical shortages of food, water, and clothing effectively. All the while DOC-T was also stuck providing all what it could, which was not even close to how much was needed. At times when there was no food, sisters and staff even went on foot on journeys that took 4 hours daily (visiting two times a day) to just to be with the community and console them.

Despite the closure of borders amid a devastating two-year conflict, the DoC-T, led by Sister Medhin Tesfay, made the decision to remain in the region with the community. This religious order was believed to be the only one operating in the area during the early days of the war.

Moving from emergency relief to offering psychosocial support

In response to the difficulties faced by women during the conflict, the Daughters of Charity offered not only emergency food assistance but also psychosocial support for those traumatized by the conflict’s horrific consequences. This psychosocial support was delivered through Women-to-Women Listening Circles, which included a nurse, a social worker, a medical student, an aid worker, and a leader from the Daughters of Charity. We drew inspiration from the Helpful Active Listening (HAL) circles, a grassroots initiative that effectively supported survivors of the Rwandan genocide. This straightforward and cost-efficient approach trains resilient women within the community to provide basic psychosocial support to their peers, enabling quick outreach to those in need. The method has successfully empowered and healed hundreds while also addressing the stigma surrounding sexual violence and fostering solidarity among victims. This impact is captured in the phrase: “breaking down the stigma and taboo surrounding sexual violence and promoting the creation of new links of solidarity between victims.”

The service has enabled survivors of gender-based violence (GBV), who once experienced deep shame and found it difficult to communicate with their children, parents, or spouses, to overcome shame and become advocates for marginalized individuals facing stigma. In the Bora district, these survivors have formed their own group and gained recognition and vital support from the local authorities. Haftu Gebru, head of the Bora District Education and Health Office, emphasized their transformation from passive victims to proactive advocates tackling the root causes of GBV showcasing the agency of the victims to advocate for solutions.

In these difficult times, the DoC-T achieved remarkable progress, but we were not in this endeavor alone. We were fortunate to receive essential assistance from numerous donors, particularly CARITAS Germany, which has dedicated considerable resources to enhance the lives of individuals in Tigray, especially in the Abergele district, which has been severely impacted by conflict and disasters.

As a valued long-term partner, CARITAS Germany has played a crucial role in the rehabilitation of specific schools and health centers, as well as repair of water points severely damaged by conflict. These initiatives have significantly reduced student dropouts, improved access to education, and ensured the availability of clean water, thereby safeguarding the community against waterborne diseases.

Lessons Learned and the Necessity to Support Local and Contextualized Intervention

The biggest lesson we learned was that with a bit more effort, it is possible to create formidable advocates in every intervention effort that can help to ensure the sustainability of the intervention by creating lasting community ties that can pass down experiences and create a structure for others to follow.

The DoC-T have been aimed to be a symbol of hope in Tigray during challenging times. We hope that our initiatives in healthcare, food security, education, and community support have positively impacted lives and fostered resilience. However, the ongoing violence and the situation faced by internally displaced persons (IDPs) have created a dire need for urgent, coordinated emergency and development responses. We urge a collaborative effort to tackle the humanitarian crisis in Tigray, leveraging our extensive experience in assisting marginalized communities in challenging circumstances.

The HUM-GOV Project is supported by a European Research Council (ERC) advanced grant, under project number: 884139

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question

About the Author

Sr. Medhin Tesfay

Sr. Medhin Tesfay is a Director of Social and Development programmes of DoC Tigray, Ethiopia. She is committed to empowering marginalized communitiess by improving access to essential services and fostering sustainable development which earned her the 2023 Romero International Award offered by Trocaire during their 50th anniversary for her courageous advocacy for justice.

Contact email; medhintesfay@yahoo.com

 

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Medical Drones in Africa: A Gamechanger for the Continent’s ‘Ailing’ Health Sector?

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While medical drones can be lauded as game-changing health technologies that help save lives, and usher efficiency and cost-effectiveness in the often contextualized as fragile African health systems, Edwin Ambani Ameso and Gift Mwonzora argue that this is not the complete picture.

The sight of desolate buildings, makeshift health settings characterised by a shortage of drugs and machinery and demoralised workers is an enduring reality of African health care centres. Medical professionals staffing these under-resourced health institutions work under depressed morale. The deplorable state of the African hospitals and clinics continues to affect in large part the underprivileged and often impoverished citizens. To fill in the gap where governments are failing to implement the right to health, some non-state actors like the Melinda and Bill Gates foundation have perennially stepped up. Thanks to the presence of vertical medical programmes funded through the assistance of donor agencies like USAID, UKAID, GIZ, DANIDA, NORAD, CIDA and more, this has saved somewhat dire situations.

While such assistance has helped improve the healthcare contexts for citizens, most African states have been left with the solitary and unfashionable role of coordinating healthcare initiatives rather than providing health as a public good accessible to all its citizens. Critical to note, however, has been the endless political rhetoric by African elites seeking political office who entice the electorate with the hype of ‘Health for All’. Often such public pronouncements are not met with clear-cut plans for providing universal access to healthcare for largely underprivileged portions of global citizens resident in the continent.

These governments anchor their political promises to the global health agenda of universal healthcare delivery with lofty promises of leaving no one behind.  It is in such contexts characterised by fragility, shortages, stock-outs, postcolonial legacies of poor infrastructures, and more grounded structural concerns that we are witnessing a rapid uptake and use of digital health technologies, notably medical drones, to leapfrog the aforementioned challenges. Thus,  questions arise  whether the real and imagined futures of healthcare access in Africa can in the long durée afford and embrace medical drones as the future of healthcare delivery.

Against this background, there is a need for robust research on whether African countries need these drones. If so, to serve which health  areas and how successful  have they been in saving lives in areas where they have been utilised so far? If found ineffective, what should be done, and with what urgency, to remedy the situation? Issues of the procurement and supply chain management of these drones at a government level also remain critical. This is considering African government elites’ proclivity to flout tendering processes: a trend reeking of grand corruption schemes.

These schemes have birthed what others have referred to as the ‘tenderpreneurs’ within the African healthcare systems. Worth noting have been the cases of looting of COVID-19 funds and the subsequent inflating and overpricing of medical accessories among various African countries. How then do we guard against state-led grand heists and corruption clothed under the procurement of moon-shot medical technologies with lofty promises of saving thousands if not millions of lives in much of Africa?  We contend that to simply adopt such technology without also addressing the governance side in several states would simply be tinkering on the edges.

We maintain that even if African governments embrace the digitalisation of the health sector without a change of conduct all efforts will come to naught. Digitalising the health sector is ideal but seems to be favouring private players such as drone companies whose contractual engagements with African states guarantee their health funds cut. This then leaves the health care budgets skewed to the detriment of the whole health system where human resource deficits, stockouts, and ill-equipped health settings persist.

Africa’s New Era of Digital Health Technologies

To then celebrate the digitalisation of the health sector without the concomitant financial support of the sector will be an disingenuous act  on the part of African ruling elites who are failing as duty bearers to guarantee the fundamental right to health for all citizens. This is sometimes in ways hard to see if one is to swallow the populist narratives of ‘health for all’ spewed during election campaigns.

Currently, the urge to embrace these technologies as essential to meeting the World Health Organisation’s triple billion target seems to be a politically driven promises of precision health delivery.

Drones or No Drones: Time for a Reality Check

Today, more than at any point, unlucky children and adults are dying from kwashiorkor, malaria, and snake bites in remote areas in rural Africa. What should be done? Is digitalising medical health including access to medical care and attention the panacea to cure this malady

Numerous benefits of medical drones range from the facilitation of emergency medical supply delivery, rapid response to disease outbreaks, improvement of maternal and child healthcare, provision of telemedicine, and facilitation of remote consultations. These drones have also proved useful in other contexts in mapping and the surveillance of disease-prone areas. Further, it is observed that medical drones can also be effectively used in humanitarian aid delivery, especially on impassable roads. Others have even stated that relying on road traffic can only go so fast and so far. Undoubtedly, these drones are convenient for providing emergency relief and aid, especially in low-lying areas such as Malawi, Mozambique, and Zimbabwe. These are contexts prone to recurrent floods and cyclones.

The Road Ahead

In the end, successful adoption twinned with sustainable use of these drones requires a multi-stakeholder buy-in. This will include the collaboration between governments, healthcare institutions, donors, drone service providers, the aviation industry, and local authorities.  Further, the buy-in (reception and acceptance) by the community is also paramount. It needs to be rehashed that without addressing the structural and underlying factors affecting Africa’s health care system, relying on drones alone as the magic bullet to cure challenges affecting the sector will be missing the forest for the trees. Medical technology needs to be anchored in a socio-economic, cultural, financial and political context which is not only permissible for innovation to thrive. The political will to stem corrupt practices, bad governance and other bulwarks that may militate against the full adoption and use of medical technology should be available. Absent due diligence, embracing medical drones in Africa without addressing the underlying structural, institutional, political, and governance factors will be akin to lofty ambitions of flying a kite where there is no wind.

This article was first published on EADI

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question.

About the authors:

Edwin Ameso

Edwin Ambani Ameso is a postdoctoral Researcher at Universität Leipzig, Germany. He researches on “off-the-grid”: Infrastructures, processes of spatialization, and drones in Africa. His areas of research include health insurance, social protection and welfare, digital health technologies, infrastructures of care.

Gift Mwonzora

Gift Mwonzora is a Research Fellow in the Willy Brandt School of Public Policy at the University of Erfurt, Germany. He researches on digitalisation, politics and the future of work in Middle-Income Countries. His areas of Research include development policy, digitalisation, governance, democracy, human rights, social justice.

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Four ways to boost investment in women-led small businesses

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Oxfam’s conversations and projects with entrepreneurs across the globe reveal a big gender gap in access to finance, says Windy Massabni. Women in business tell us that better support for them will include loan guarantees, alternative credit scoring systems and building the gender awareness of lenders.

Women selling mangos on the streets of Oyam, Uganda (picture: Windy Massabni)

“In Uganda where I come from, women still do not have the right of inheritance. All the assets and properties go to the male heir,” explains Marion Etiang, the founder of the Shea Care company in Uganda. “It’s up to men to give what they deem fit to the female in the family. Typically, when a woman goes to the bank to seek a loan for her business, the bank would require collateral which is often asset-based, even if she has the cash flow.”

Marion highlights a major root cause that holds women-owned businesses back: discriminatory gender norms over inheritance capital, capital that is therefore only available to men, not women, to grow their businesses. Such regressive gender norms lie behind the glaring gender gap in access to business finance.

BRINGING INVESTORS CLOSER TO WOMEN-LED SMES

In the realm of entrepreneurship, there’s often a disconnect between investors and small and medium-sized enterprises (SMEs). While much effort is dedicated to making women-led SMEs “investment-ready”, little attention is paid to fostering “SME-readiness” or openness among investors or financial institutions. This oversight perpetuates inequalities in access to finance, particularly for women entrepreneurs.

But what if we could bring investors closer to women-led SMEs? In a survey conducted as part of Oxfam Novib’s project to support SMEs, the Impact SME Development programme, lack of collateral or assets was cited by women-owned businesses as a major obstacle. We also found that while 57% of businesses owned by men and 68% with mixed gender ownership sought external finance, only 46% of female-owned businesses did so.

Interestingly, women-owned SMEs had a 95% success rate in securing external funding, compared to 77% for male-owned and 93% for mixed-gender-owned businesses. This suggests that women entrepreneurs may be more reserved in seeking external funding. This is backed up by research by the Financial Alliance for Women, which found that women who are customers of financial service providers were more “risk conscious” then men, and more likely to sacrifice a potential upside in exchange for lower risk or less debt.

So how can we support women entrepreneurs to get the finance they deserve and that can help their firms thrive? Tackling root causes such as sexist inheritance customs and laws will of course be crucial for long-term change – but alongside this the women we talked to pointed out how NGOs and other support organisations can take action now to help them in four broad areas.

1. LOAN GUARANTEE SCHEMES

Many women emphasised the potential effectiveness of long-term guarantee schemes and partnerships. These local guarantees effectively protect financial institutions from losses if borrowers default, incentivising them to lend to women-owned businesses, even without collateral.

Abrar Shahriyar Mridha, Enterprise Development Project Manager at Oxfam GB, oversees a multi-country programme providing access to sustainable capital to help SMEs grow, and says such loan guarantees can transform the prospects for women-owned enterprises. “Partnering with banks and financial institutions gives us leverage to access women-led MSMEs, making them more bankable. These enterprises have created almost 18,500 jobs for women and reached 55,000 farmers, with 49% women in leadership positions.” Abrar’s example vividly illustrates the transformative effect that guarantee schemes can have on women-owned enterprises, fostering economic empowerment and gender equality.

2. ALTERNATIVE CREDIT SCORING – AND INCLUDING “SOCIAL PERFORMANCE”

Women are more reliable borrowers then men. Financial Alliance Women found that men are far more likely to be failing to keep up with repayments than women. Yet women continue to be underserved when it comes to accessing loans.

Different ways of assessing credit-worthiness  can help. That means analysing cash flow and business performance, rather than relying solely on traditional collateral-based assessments.

What could make a big difference is looking not just at conventional metrics but at the social capital created. Hassan Hajam, the Executive Director of Platform Impact, the Impact SME programme’s main partner in Cambodia, says: “Investors should design innovative, alternative financial instruments for impact-driven SMEs We have to move away from the typical balance sheet, profit-and loss statement, cash flow etc.. by integrating social and environmental dimensions at the end of the profit-and-loss statement if we want to see real impact thrive.”

By prioritising investments in businesses that can show such “social performance” – supporting gender equality and empowering women economically – investors can address disparities in access to finance.

3. FLEXIBLE PRODUCTS WITH SMALLER LOANS

An often-overlooked aspect of addressing gender inequality in access to finance is reassessing the size of investments. Many investors typically focus on offering large loans, often exceeding $1 million, which may not align with the needs of small and medium-sized enterprises (SMEs), especially those owned by women. These businesses frequently require smaller investments ranging from $100,000 to $500,000 to scale effectively.

Recognizing this disparity, initiatives such as our newly launched Pepea Fund aim to bridge the gap by providing smaller loans with a gender-lens tailored to SMEs, in this case with a focus on climate change mitigation. While we acknowledge that smaller investments may pose higher costs for investors, it’s imperative to take account of the social impact of such investments alongside the financial returns. We offer “mezzanine” loans, flexible loans with flexible terms that do not necessarily require tangible assets as security. This flexibility makes them more accessible to women entrepreneurs who may lack traditional collateral, such as property or equipment.

4. GENDER DIVERSITY AND GENDER AWARENESS IN FINANCIAL INSTITUTIONS.

Ensuring lenders have a gender-diverse team is also crucial in addressing the biases and barriers faced by women entrepreneurs. This requires gender balance at all levels of a financial institution – from the executive level to front line staff.

At the ANDE x Sasin Business School Women Impact Entrepreneurship Day 2024, one business leader shared her experience of intimidation while applying for a loan at a bank.

As the head of a sustainable packaging company in Thailand, she had all the necessary documentation for the loan and met all the requirements, yet faced extensive questioning from the predominantly male staff. She felt compelled to prove her legitimacy, showcase her qualifications, and justify her ability to manage her business alongside motherhood.

This unsettling encounter underscores the need both for gender balance and for gender-sensitivity training for bank staff so they can better serve women. Alongside this lenders  will need a gender-lens investment strategy, fostering an environment where women entrepreneurs feel respected and supported, without encountering undue scrutiny or bias.

BUT WE ALSO NEED TO KEEP CAMPAIGNING ON ROOT CAUSES

Initiatives such as guarantee schemes, alternative credit scoring methods, and promoting gender diversity in fund management teams are essential steps in bridging the gender gap in SME financing. However, while these efforts do help alleviate immediate barriers, they do not address the root causes of gender disparities.

NGOs such as Oxfam and enterprise support organisations have a crucial role to play, not just in providing support through initiatives like those above, but also in advocating for policies and practices that tackle root causes, that change norms and systems and lay the foundations for true gender equity in access to finance.

This article was first published on Oxfam’s Views & Voices blog

Opinions expressed in Bliss posts reflect solely the views of the author of the post in question.

About the author:

Windy Massabni is an Impact SME development specialist based at Oxfam Novib in the Hague. She coordinates the influencing, learning and training component of the programme in all countries.

Development Dialogue 2018 | Who decides who gets social protection? by Maria Klara Kuss

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Colourful pens

Social protection interventions have recently been scaled up in sub-Saharan Africa. While international aid donors have invested much money, time and effort into the policy design phase, the real politics start to unfold during its implementation phase. This is when people experience who will receive benefits and who is excluded. What can the case of Zambia tell us about the political debates  on who ‘deserves’ social protection and who does not?

THE POLITICS OF IMPLEMENTING SOCIAL PROTECTION

In sub-Saharan Africa, the social protection agenda has been largely driven by international aid donors who have invested many resources into influencing the design and scale-up of these interventions. It is therefore not surprising that much evidence exists on the positive impacts of social protection interventions on a range of indicators (e.g. on poverty, health, and education). Moreover, recent research into the politics of social protection has shed light on the political drivers of the expansion of social protection in sub-Saharan Africa. Thus, much attention has been given to the policy design rather than the implementation phase.

This can however be particular misleading in in the area of social protection. This is because the deep politics – and thus the negotiations for social justice – unfold after its implementation. This is when it becomes more visible for the public who will and who will not receive those benefits (see Grindle & Thomas, 1991). This can be illustrated by the findings from my PhD research that analyses the politics of implementing social cash transfers (SCTs) in Zambia.

SOCIAL CASH TRANSFERS IN ZAMBIA – A RICH HISTORY IN TARGETING

In Zambia, around 54% of the population lives in poverty, and almost 41% in extreme poverty (CSO, 2015). Similar to other African countries, most of the country’s poor (77%) live in rural areas (CSO, 2015). To reduce poverty and eradicate the intergenerational transmission of poverty (see MCDMCH, 2012), international aid donors have supported the Government of Zambia in initiating different SCT schemes. Since 2003, in total four small-scale SCT schemes were piloted – each targeting different groups of poor people (e.g. children, female-headed households, old people, and people with disabilities or chronic diseases). These schemes were strongly driven by Zambia’s aid donors while the Government of Zambia has long remained reluctant in taking the schemes beyond its pilot phase.

Finally in 2014, the Government of Zambia took the vital decision to introduce a single nation-wide SCT scheme. The commitment to implement a single SCT scheme meant that the Zambian Government took a vital decision about whom they considered most deserving of receiving support in form of SCTs. The proposed targeting approach of the new scheme included a range of household compositions such as households with old people, people with disabilities, as well as households with young women caring for children. Given the variety of households included, the new SCT scheme was named ‘the Inclusive Scheme’.

THE TRANSFORMATIVE IMPLICATIONS OF ZAMBIA’S ‘INCLUSIVE SCHEME’

The targeting approach together with the formal policy objective of the ‘Inclusive Scheme’ signalled a potentially transformative change of Zambia’s welfare regime with its underpinning values of social justice. This was because it included young women and their children who previously did not receive any benefits. My research findings however indicate that the Inclusive Scheme did not result in a transformation, but rather in the continuation of Zambia’s political settlement with its values of social justice.

Only shortly after the implementation of the scheme in local communities, strong local opposition emerged because as it became clearer who would and would not benefit from the Inclusive Scheme. A series of debates about the deservingness of young women and their children followed. But instead of transforming the perceptions of powerholders about their deservingness, the powerful local resistance resulted in a drastic change of the targeting approach of the Inclusive Scheme. This fundamentally changed the values of social justice that underpinned the scheme.

THE DEEP POLITICS OF SOCIAL PROTECTION

In order to understand the deep politics of social protection, it is therefore crucial to pay attention to the implementation phase. This is not a phase where decisions are carried out in a bureaucratic manner, but where political reactions are likely to occur since the implications of the policy design become apparent. People will understand who will be included and who will be excluded from receiving social protection benefits. If these policy ideas are competing with people’s perceptions of social justice, local opposition is likely to emerge. This can pose a threat to the sustainability of the initial policy design with its underpinning values of social justice and thus compromise the investments made during the design phase.

­­­­­Disclaimer:

This blog article builds on the findings of PhD research by Maria Klara Kuss which analyses the negotiations of Zambia’s welfare regime and is based at the United Nations University MERIT’s Graduate School of Governance at Maastricht University in the Netherlands. For more information see: Kuss, M. K. (forthcoming). After the scale-up: the political drivers of sustaining social protection in Zambia. GIZ policy brief. Eschborn: GIZ.

References:
CSO (2015). 2015 Living Conditions Monitoring Survey Report. Lusaka: Central Statistical Office.
Grindle, M., & Thomas, J. (1991). Public choices and policy change. Baltimore: The Johns Hopkins University Press.
MCDMCH (2012). Harmonised Manual of Operations. Social Cash Transfer Scheme. Lusaka: Ministry of Community Development, Mother and Child Health.

This blog article is part of a series related to the Development Dialogue 2018 Conference that was recently held at the ISS. Other articles forming part of the series can be read here,  here , here, here and here.

About the author:

PhotoMKussMaria Klara Kuss is a PhD fellow in Public Policy and Policy Analysis at the United Nations University MERIT’s Graduate School of Governance – supervised by Allister J McGregor (Sheffield), Mark Bevir (UC Berkeley), and Franziska Gassmann (Maastricht). She is also affiliated to the African Studies Centre at Leiden University (ASCL). Her PhD research is interdisciplinary in nature and draws on anthropological and sociological approaches to public policy analysis. It analyses the de facto negotiations of Zambia’s welfare regime with a focus on the transformative impacts of social cash transfers.