Scaling-up and rooting-down: a case study of North-South partnerships for health from Tanzania

Abstract

Background: North-South Partnership (NSP) is the mandated blueprint for much global health action. Northern partners contribute funding and expertise and Southern partners contribute capacity for local action. Potential Northern partners are attracted to Southern organizations that have a track record of participating in well-performing NSPs. This often leads to the rapid ‘scaling up’ of the Southern organization's activities, and more predictable and stable access to resources. Yet, scaling up may also present challenges and threats, as the literature on rapid organization growth shows. However, studies of the impact of scaling up within NSPs in particular are absent from the literature, and the positive and negative impact of scaling up on Southern partners’ functioning is a matter of speculation.

Objective: The purpose of this study is to examine how scaling up affects a Southern partner's organizational functioning, in a Southern grassroots NGO with 20 years of scaling up experience.

Design: A case study design was used to explore the process and impact of scaling up in KIWAKKUKI, a women's grassroots organization working on issues of HIV and AIDS in the Kilimanjaro region of Tanzania. Data included documents, observation notes and in-depth interviews with six participants. The data were analyzed by applying an established systems framework of partnership functioning, in addition to a scaling up typology.

Results: KIWAKKUKI has experienced significant scale-up of activities over the past 20 years. Over time, successful partnerships and programs have created synergy and led to further growth. As KIWAKUKKI expanded so did both its partnerships and grassroots base. The need for capacity building for volunteers exceeded the financial resources provided by Northern partners. Some partners did not have such capacity building as part of their own central mission. This gap in training has produced negative cycles within the organization and its NSPs.

Conclusions: Northern partners were drawn to KIWAKKUKI because of its strong and rapidly growing grassroots base, however, a lack of funding led to inadequate training for the burgeoning grassroots. Opportunity exists to improve this negative result: Northern organizations that value community engagement can purposefully align their missions and funding within NSP to better support grassroots efforts, especially through periods of expansion.

• North-South Partnership
• synergy
• scaling-up
• grassroots
• capacity building
• Tanzania

Acknowledgements

The authors wish to thank the staff, volunteers and recipients of KIWAKKUKI who willingly gave their time, knowledge and energy to this project. We also would like to thank the anonymous reviewers whose insightful feedback greatly improved the final version of this paper. The research was funded by the University of Bergen.

Notes

¹An example of such an introduction is: ‘In terms of the partnership project, what I am interested in is your individual experience with when partners from the North are involved in projects, provide expertise or whatever the partnership arrangement is. When it works well – how does it function? And what's the communication like? What roles do people play? Who are the leaders of the partnership? And how does the work get done? Can you tell me about your experience working with Northern partners?’

²The overall aim of the research was to use the Bergen Model of Collaborative Functioning to examine KIWAKKUKI as a case of mostly successful NSP. After the interviews were conducted, transcription and initial analysis revealed many themes emerging about growth processes related to success. Using the iterative qualitative process described by Creswell (Creswell, 2007), we formulated this specific question to guide a more defined analysis of the data.