Country Ownership and the Tao of Leadership

Jim Rice

Former LMG Project Director

Hospital administrators talk in the early morning in Rwanda. Photo by Todd Shapera

Photos: Todd Shapera

The concept of country ownership for health sector gains is not new—U.S. Government agencies in partnership with host country partners have been working to accomplish sustainable, country-led and country-owned responses for many years. There is increasing local responsibility for health and development, and opportunities for new partnerships with donor countries (See June 2012 USAID Interagency Report on Country Ownership).

The LMG Project teams draw upon the over 40 years that the people of MSH pursue the mindset and practices needed to “walk-the-talk” of the Tao of Leadership. This approach of engaging in the field with local leaders and organizations serves us well as we explore ways to work with Sub Saharan Africa organizations like AREMF, ACHEST and AHLMN to implement the key characteristics of country ownership in our work. The concept of country ownership is multifaceted-true country ownership requires strength in several different factors.

Political Ownership. The host government has a clear aspiration for what should be accomplished in each stage of program development, implementation and monitoring, generated with input from their own cities and rural areas, civil society, NGOs, and private sector, as well as their own citizens. National plans are therefore aligned to national priorities to achieve planned targets and to apply scaled-up evidence-based best practices.

Institutional and Community Ownership. Host country institutions (inclusive of government, NGOs, civil society, and the private sector) constitute the primary vehicles through which health programs are delivered and take responsibility for each program. They manage funds and implement transparent, evidence-based policies/regulations for priority areas that align with national plans.

Capabilities. The host country has effective organizations, systems, and workforce able to perform activities and carry out responsibilities at multiple levels to achieve priority health outcomes. National coordinating bodies and local institutions have the ability to gather and analyze epidemiological and program data to plan and measure program progress and results. Additionally, they have the ability to perform or oversee activities for programs and subsequently modify them based on evidence and feedback from monitoring processes.

Mutual Accountability, Including Finance. The host country is responsible to country citizens and international stakeholders for achieving planned results. The host government is responsible for financial stewardship over health, while explicit roles and responsibilities are described with appropriate management. Information and processes are transparent and there are mechanisms for input and feedback from civil society, the private sector and donors.

James A. Rice, Ph.D., is the Project Director for the Leadership, Management & Governance (LMG) Project.