Locally-led aid is more effective and sustainable than traditional top-down approaches. The South-South learning initiative led by Genesis Analytics is pioneering new ways to shift traditional power imbalances within global development and making investments in health go further.
For decades, the Global North has largely dictated how donor money should be spent in countries in the South but times are changing.
We know after decades of effort and evaluation… that locally-led development supports local institutions in the most effective manner,” USAID Administrator Samantha Power recently told the news service Devex. [It] nurtures sustainability, and prioritises the perspectives and preferences of those we hope to serve: Recipient governments, civil society organisations, and host country professionals.
Headquartered in Johannesburg, Genesis Analytics has co-created public health solutions with local stakeholders and international clients for nearly a quarter of a century.
Genesis Analytics experts have brought their decades of experience in programme design, implementation and evaluation, and health system strengthening to more than 90 countries around the world.
In 2020, Genesis Analytics launched the South-South Learning Network with funding from the Bill & Melinda Gates Foundation to enable 10 Sub-Saharan African countries to share lessons in HIV prevention. HIV prevention, many believe, has received less attention than HIV treatment in the last decade and remains more difficult to implement. Genesis Analytics developed and now facilitates the South-South learning programme, which allows countries to build new relationships, capture previously undocumented HIV prevention lessons and fill gaps in cross-country learning and joint problem-solving. Although implementers and donors of South-South learning initiatives are still finding ways to quantify their impacts, the method has the potential to multiply the impacts of other health investments as it helps countries avoid repeating the mistakes of others.
Learning to make aid go farther and do more
Initially, Genesis Analytics supported network members to create country teams comprising of government officials, national aids council members, implementing partners and civil society representatives. More than 120 high-level country representatives, called country champions, now take part in the project.
Genesis Analytics then assisted these teams to evaluate national HIV prevention programmes using the latest UNAIDS prevention self-assessment tools (PSATs).
These self-assessments revealed critical gaps in HIV prevention services aimed at high HIV risk groups, such as men who have sex with men and young women. Countries like Kenya and Uganda went on to use their results to support requests for targeted donor funding or technical assistance.
For years, donors have offered technical assistance to countries to improve HIV programmes, Bill & Melinda Gates Foundation Senior Programme Officer Gina Dallabetta explains, but historically support hasn’t been well used. The South-South Learning Network is helping countries identify what technical assistance they need, she says, and is set to help countries better access this in the future.
“Some countries essentially said that this was the first time they’d been allowed to decide on their own priorities instead of having those set by a donor,” Dallabetta says. “As a donor, that was eye-opening.”
Peer learning unearthed new lessons about HIV prevention in ways countries could use
Next, Genesis Analytics used the self-assessments to design a facilitated, experiential learning programme — pairing countries who did well in areas such as addressing human rights issues or distributing condoms with others that were struggling.
During these small, focused group gatherings, countries shared real-life learnings and challenges from implementing programmes in similar settings — learning and connecting in novel ways.
“Governments and health ministries can be like oil tankers — they sail in a certain direction and getting them to change course isn’t always easy because they’ve been doing things in the same way for a long time,” explains Saul Johnson, managing partner of Genesis Analytics health practice. “Because our deep technical knowledge comes from years of working with governments and ministries, we spend a lot of time thinking about the levers to push and pull to help them make better decisions and improve the quality of programmes.”
“Part of that is thinking about the kind of knowledge translation that works to help governments and ministries make those changes,” Johnson adds, “and it’s not always through academic research.”
For countries, South-South learning allowed them to learn practically while also building a community of support.
“I like the fact that the sessions are small,” a South Africa country representative reflected in one of the frequent feedback sessions. “It’s intimate so it allows [representatives] from other countries to really learn how they can go about improving the component that they have and [responding to] the challenges that they have.”
“There’s a lot of global guidance and tools on what an HIV prevention programme should look like but what’s missing is that experiential learning and self-reflection component that is unique to the South-South Learning Network,” explains network director Kerry Mangold. “Pitching learning at a practical, real level is unique to the network and something that countries really welcomed.
But, Mangold warns, this didn’t happen passively.
“Facilitation is critical to driving the process, whether that’s setting up meetings and ensuring follow-up or keeping the work at the top of participants’ agendas amid busy schedules and competing priorities.”
Process and outcome: How do you know when learning leads to results?
Since the 1990s, countries have been looking to South-South learning to provide contextually relevant answers to developmental challenges. Genesis Analytics’ South-South Learning Network is one of two such South-South learning networks supported by the Bill & Melinda Gates Foundation. Both networks have pushed experts, including donors, to think long and hard about how to track their impact, says Siobhan Malone, Bill & Melinda Gates Foundation senior programme officer.
“It’s easy to say people participated in a webinar or even a country learning visit,” Malone says, “but if we can’t show that the information that’s been transmitted has been used to make programmes more efficient, effective, or of higher quality then funders are going to have trouble making the case for funding these networks.”
In the future, Malone says countries who take part in the South-South Learning Network could, for instance, be asked to report bi-annually on the project’s impact. Genesis Analytics, in consultation with the Bill & Melinda Gates Foundation, also continues to work towards solutions for better monitoring and evaluation of the project.
Likewise, Dallabetta says the network is going to have to do more to deepen relationships between network members to encourage countries to share not just when HIV programmes went well, but also where they stumbled or even failed.
“There wasn’t a lot of social capital between agencies and countries when the network started so Genesis Analytics spent a lot of time building that but there’s still a way to go,” she says. “Meetings as part of the network tend to focus on what countries have done right but there haven't been many countries who have shared stories of how their programmes overcame hurdles.”
She continues: “For that, we may have to build a little bit more trust and social capital among people.”
Still, the South-South Learning Network remains an important tool to shift traditional power imbalances within aid — and make health investments go further.
Ultimately, South-South learning supports those working in counties to identify their own national HIV prevention needs and what kind of support they need from donors," Mangold says. "But it goes farther than that: It builds a community that can support them in which lessons — and failures — can be shared to ensure that we all do better at stopping new HIV infections."
