Making Multi-Sectoral Partnerships Work Most national AIDS policies—and every project supported by the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)—call for multi-sectoral partnerships as a core strategy for scaling up national programs. Yet implementing these partnerships continues to challenge donors, governments, and private institutions around the world.
Through its global activities and mandate from the U.S. Agency for International Development (USAID), the Leadership, Management and Sustainability (LMS) Program of Management Sciences for Health is strengthening multi-sectoral bodies to oversee health programs and coordinate multi-donor assistance. LMS uses proven leadership practices, strengthened management systems, and participatory approaches to reconcile different perspectives and priorities.
What Does "Multi-Sectoral" Mean?
Government staff often view multi-sectoral as "from other ministries," "central and local government," or "health ministry and non-governmental organizations (NGO)/faith-based organizations (FBOs) working in health." NGOs may see multi-sectoral as "government and NGOs." However, a multi-sectoral approach often includes all of these sectors as well as the private for-profit sector and representation from the community. Our work over the last 10 years shows there are stages of progressive engagement in any partnership:
- Communication – exchanging information between interested groups
- Coordination – aligning efforts on a common activity, but not sharing funds
- Collaboration – explicitly planning and organizing activities together, using pooled or jointly budgeted funds for implementation
- Formal partnership – implementing planned activities using a Memoranda of Understanding (MOU) or contract to define the terms of collaboration, content, and funding
What Makes Partnerships Work?
Experiences with the GFATM, the President's Emergency Plan for AIDS Relief (PEPFAR), the World Bank's Multi-Country HIV/AIDS Program (MAP), AIDS Commissions, and the multi-donor Rapid Funding Envelope for HIV/AIDS in Tanzania have shown that partnerships work best when:
- the goal and expected end-results of the partnership are defined by the partner institutions together;
- the roles, responsibilities, and mutual obligations of each partner are clearly defined in a document available to staff and concerned stakeholders;
- each partner has a specific work plan and budget defining its activities, funds, and in-kind resources needed to carry out the activities;
- there is a genuine and continuous effort for transparency and feedback among all partners, including collaboration in monitoring progress towards objectives and documenting results;
- each partner sees clearly the advantages from the partnership, the loss of control, and the additional burden of partnership coordination.
Defining each partner's role and identifying the strategic advantage each contributes are vital.
| Type of partner | Role and responsibilities |
| Lead partner | Responsible for managing the partnership and implementing the common plan of work. Role may be limited to financial and program management or may also encompass specialized technical assistance. Leads planning, management, monitoring, reporting, and evaluation of the partnership activities. May conduct procurement of goods and services. Requires extensive experience in financial and program implementation management and coordination. |
| Implementing partner | Collaborates in designing the partnership and its activities. Carries out a work plan and is responsible for specific activities. May serve a specific geographic zone or target population. May provide capacity building assistance to other partners or beneficiaries. Participates in planning and oversight of activities. |
| Technical resource partner | Provides specific technical, clinical, training, management services, or capacity building assistance needed to execute the plan of work. May have a limited role in planning, monitoring, evaluation, etc. of partnership activities. |
| Beneficiary institution or sub-grantee | Usually local civil society organizations, but could also include academic institutions, local governments and committees, and the private sector. Receives technical support, drugs/supplies and capacity building assistance to offer services to a specific target group or in a specific geographic area with whom the beneficiary has privileged access. |
Within the new GFATM partnerships, the lead partner is the Principal Recipient, while the implementing partners and technical resource partners are called the Sub-Recipients. Similarly, in public-private partnerships to offer essential health services, district or regional health authorities are often the lead partners, while private organizations may be contracted as implementing partners to support service delivery at health facilities.
Informal and emergency multi-sectoral partnerships may be created to cope with events such as national vaccination days, health emergencies, and the influx of refugees from civil unrest or other disasters. Once the immediate crisis is recognized, one or more lead partners will come forward to organize the efforts of others and mobilize or manage funds.
Partnerships require continuous work. Efforts must be made to set up the partnership process and to manage partnership activities and communications. GFATM projects around the world are failing to scale up because the responsibility for partnership coordination has not been assigned or taken up by the Principal Recipient or one of the lead Sub-Recipients, nor have activities to promote and nurture partnership been planned or budgeted. To give partnership a chance, time and funding are needed for: planning meetings of all partners; the development of an intranet or website for continuous communication and access to standard information; a procedures manual governing work, and a common reporting framework; and groups or steering committees to coordinate specific technical areas.
Additional Reading and Resources
The following issues of The Manager, MSH's award-winning periodical:
- "Forming Partnerships to Improve Public Health," The Manager, Volume 7, Number 4, Winter 1998/99.
- "Coordinating Complex Health Programs," The Manager, Volume 12, Number 4, 2003.
