TY - JOUR
T1 - From External to Local
T2 - Opportunities and Lessons Learned from Transitioning COMSA-Mozambique
AU - Rodríguez, Daniela C.
AU - Macicame, Ivalda
AU - Adriano, Antonio
AU - Chicumbe, Sergio
AU - Duce, Pedro
AU - Kante, Almamy
AU - Mavie, Victor A.
AU - Mbalane, Etelvina
AU - Nhachungue, Sheila
AU - Titus, Nordino
AU - Van Dyk, Fred
AU - Amouzou, Agbessi
N1 - Funding Information:
COMSA was developed by the Institute for International Programs at Johns Hopkins University (JHU) in partnership with the Instituto Nacional de Saúde (National Institute of Health [INS]) and the Instituto Nacional de Estatística (National Institute of Statistics [INE]) in Mozambique, with funding from the Bill and Melinda Gates Foundation. JHU provided technical assistance, and INS and INE were the primary implementers in-country (Table 1). The Gates Foundation established the grant with JHU, with a subcontract to INS. A memorandum of understanding guided the collaboration between INS and INE, with INE overseeing data-collection operations nationwide. A national advisory group was established to advise on strategic, programmatic, methodological, and financial aspects
Funding Information:
The specifics of the COMSA system and results are described elsewhere.19 From a transition domains standpoint, leadership of COMSA was shared by all three institutions, with JHU offering technical expertise and INS/INE providing implementation know-how; program management and operations were likewise shared responsibilities (Figure 2). JHU held the primary responsibility for financing and design as the primary recipient for funding, whereas INS and INE held the primary responsibility for implementation. Because INS and INE were already responsible for implementation of activities on the ground, COMSA fit a Type B transition, which includes domains of leadership, financing, and program management. We begin by briefly describing the transition process, followed by reflections by each domain type.
Publisher Copyright:
Copyright © 2023 The author(s)
PY - 2023/5
Y1 - 2023/5
N2 - Donor transitions, where externally funded programs transfer to country ownership and management, are increasingly common. The Countrywide Mortality Surveillance for Action – Mozambique (COMSA) project established a nationwide surveillance system capturing vital events at the community level with funding from the Bill and Melinda Gates Foundation. COMSA was implemented in partnership between Johns Hopkins University (a U.S.-based academic institution) and the Instituto Nacional de Saúde (National Institute for Health) and Instituto Nacional de Estatística (National Institute for Statistics), two Mozambican public institutions. Midway through the project, the Gates Foundation directed COMSA’s partners to develop and implement a transition plan that ensured COMSA’s activities could be institutionalized after Gates Foundation funding ended. Here we describe the process and activities that COMSA underwent for transition planning, including stakeholder engagement and advocacy, securing financial commitments, documenting operational activities, capacity building, and supporting strategic planning. Facilitators included a project model that already embedded significant implementation and management responsibility with local agencies, high-level commitment to COMSA’s activities from local stakeholders, establishing dedicated personnel and budget to manage transition, and fortuitous timing for financing. Challenges included needing to engage multiple government agencies to ensure buy-in, navigating tensions around future roles and responsibilities, reviewing and adjusting existing implementation structures, and the reality that this transition involved shifting financing from one development partner to another. Transition implementation was also constrained by the COVID-19 pandemic because key stakeholders were engaged in response efforts. COMSA’s experience highlights lessons and threats for future programs facing donor transition in uncertain environments.
AB - Donor transitions, where externally funded programs transfer to country ownership and management, are increasingly common. The Countrywide Mortality Surveillance for Action – Mozambique (COMSA) project established a nationwide surveillance system capturing vital events at the community level with funding from the Bill and Melinda Gates Foundation. COMSA was implemented in partnership between Johns Hopkins University (a U.S.-based academic institution) and the Instituto Nacional de Saúde (National Institute for Health) and Instituto Nacional de Estatística (National Institute for Statistics), two Mozambican public institutions. Midway through the project, the Gates Foundation directed COMSA’s partners to develop and implement a transition plan that ensured COMSA’s activities could be institutionalized after Gates Foundation funding ended. Here we describe the process and activities that COMSA underwent for transition planning, including stakeholder engagement and advocacy, securing financial commitments, documenting operational activities, capacity building, and supporting strategic planning. Facilitators included a project model that already embedded significant implementation and management responsibility with local agencies, high-level commitment to COMSA’s activities from local stakeholders, establishing dedicated personnel and budget to manage transition, and fortuitous timing for financing. Challenges included needing to engage multiple government agencies to ensure buy-in, navigating tensions around future roles and responsibilities, reviewing and adjusting existing implementation structures, and the reality that this transition involved shifting financing from one development partner to another. Transition implementation was also constrained by the COVID-19 pandemic because key stakeholders were engaged in response efforts. COMSA’s experience highlights lessons and threats for future programs facing donor transition in uncertain environments.
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U2 - 10.4269/ajtmh.22-0284
DO - 10.4269/ajtmh.22-0284
M3 - Article
C2 - 37037432
AN - SCOPUS:85159545523
SN - 0002-9637
VL - 108
SP - 47
EP - 55
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
ER -