Breaking News. PEPFAR includes condoms

As I noted in my previous post, much to the frustration of NACWOLA staff, the USAID funded programme called STAR EC had excluded the use of condoms from its prevention programme. This was despite Obama lifting the gag rule on his second day in office. This meant that no longer would 40% PEPFAR funding have to go to faith based organisations that were inevitably anti-abortion, anti condom and anti-homosexual. The issue was raised by lone NACWOLA staff member who spoke out at the last meeting with STAR EC, on 15th sept. She was shot down by the other participants.

A letter from STAR EC today however, confirms that, having finally read the new PEPFAR priorities for prevention, they will now be looking at a more comprehensive ABC (Abstinance Be faithful and Condoms approach). They will also now be looking at extending and target services to MSMs (men who have sex with men.

It's absurd this has taken so long.

Field trip to Iganga. Part 1: the tug of war

It may have been at the end of the workshop, but we got to Iganga in the end. And not only Irene and I, but the country director (CD) of a high profile development agency who had also come along for the ride. He had cancelled his attendance at a presentation, justifying his actions by explaining that while his job requires his to make mission statement after mission statement he has nothing to state because he never gets let out of the office to see anything. His mission that day was clearly stated then: to get out into the field and try and see first hand what the HIV situation was out there. Irene and I were visiting to observe what NACWOLA does, to see some psycho social support groups, a community sensitisation activity and to shadow a community support agent doing his rounds in a village.  

We arrived 3 hours or so after leaving Kampala, driven there by a female driver from Irene's agency, in traditional attire which for Uganda was pretty unusual on both accounts. The driver explained that she liked her job as a driver because it was low pressure, mentally unchallenging and physically easy. Having spent most time in Ghana where driving to the end of the road is made out to be a big job, this easy honesty was also extremely refreshing. After going around in a few too many circles following Esther’s confusing directions, we managed to find her and she hopped in the with a shy smile. We first went to the NACWOLA office: two rooms, two computers, two volunteers and a store room stacked with condoms.

While Obama changed the US HIV/AIDS prevention policy of Abstinence and Be faithful to finally include C for condoms, the USAID Star EC project was still only, by policy, offering condoms to HIV positive people as part of positive prevention. While funded by STAR EC, NACWOLA however are able to distribute condoms regardless of HIV status,  by other means. I asked how often they got deliveries and if there were enough condoms to go around. Esther explained that because the area was predominantly Muslim men tended to have more than one wife. She said, with a giggle, that it wasn’t uncommon for a man to require 3 condoms a day in order to practise safe sex with his three wives.

After picking up copies of the data collection forms and being introduced quickly to the monitoring and evaluation procedure for the project we piled back into the car, ready to visit the community sensitisation activity. However, much to my initial dismay, the CD hijacked the agenda somewhat, initiating instead that we visit the district hospital. So we missed the community sensitisation and went straight there. The hospital was crumbly and ramshackle but quiet, as Fridays apparently tend to be. I saw no men, but rather lots of women; women clustered outside on the grass, eating and talking, old women heaped up on wooden waiting benches and corridors of young mothers and babies lining the walls.

I lingered behind to take photographs while the others wove through the corridors to reach an office or other, which was locked. The person Esther had advised to the CD would not be there, was indeed, not there. We wandered on through, past a lady whose crossed legs blossomed into what looked like huge fungi where one expected feet. A vintage ambulance rusted, neglected into the earth while a shiny new one pulled up alongside it. Passing into a new block which was undergoing a shambolic reorganisation we were ushered into an office space where a nurse sat down to answer our unexpected questions.

The CD asked the nurse whether or not she thought HIV infection rates had increased or decreased. The nurse was unsure how to answer and I was unsure as to whether or not this was the CDs method of trying to find out the actual answer or just to gauge peoples perceptions. The CD thanked the nurse for her time when he was satisfied and rose to leave. I added that, actually, I also had a couple of questions and proceeded to learn from the nurse that HIV Alliance had first put community health workers in the facility, that the same people have been coming over the years but that their names have changed...from village health teams to community support agents etc. She perceived them to be doing a good job without treading on hospital staff toes.

The nurse explained too that the structure of HIV testing had changed and was now being offered across all the wards. This was news to the CD who became genuinely excited and exclaimed "this is brilliant, this should be rolled out all over the country." Irene later confirmed that this was already national policy.I asked if this had impacted on the ability of the already overstretcheed staff to offer pre and post testing counselling to everyone but she seemed not to think so.  

We then paid a visit to the ante natal unit to look at PMTCT care (prevention of mother to child transmission). A couple of CSAs from mother2mother, our main competitor in the business model, were there. I took the opportunity to stop for a chat and to find out that mother2monther approach NACWOLA for staff recommendations and that NACWOLA had recommended and pretty much handed the lady over to mother2mother to take on. Rather than feeling that the mother2mother contract was a short term offer (1 year) with limited opportunities for skills learning, as NACWOLA staff believed, she thought that her contract would be renewed because of good performance and she noted receiving higher skills training and that she was now even taking blood for testing. 

We sat down with another nurse, this time with a brilliantly twee uniform and a couple of dolls in her office (one black and one white). A scrawled note to “always ask for information on family planning” was, like the other posters, fixed clumsily with brown tape to the wall.The CD proceeded to ask questions about drug and testing kit availability and HIV infection rates. This time he was able to do spot checks in the nurses records to see how many mothers out of ten had tested positive. I asked about the counselling offered to discordant couples and men, and she said that while it was “a tug of war" to get men into the hospital for HIV services at all, they had received 3 couples that week.The CD continued with spot checks for a further ten minutes or so. He was optimistic that these promisingly low infection rates could be indicative of a regional trend, despite them reflecting a group of women that were already accessing treatment and services, in a fairly low risk community compared to the fishing villages, plantation workers and truck stop over sites further out. The CD was charming, and offered his card to the nurse, saying "if you ever come to Kampala we will take you for lunch...call if you need anything." The nurse looked at the card, confused, and checked: "I can call you if we have a problem here?" Irene stepped in to clarify that he would be more likely to put her in contact with the relvant service rather than offer direct assistance. We thanked the nurse for her time and left, but not before I got a picture of their wonderful hats.

Job hunting begins...

Workshop Day 3: Paving the road ahead

Today my group had halved its numbers. By midday we lost Ismael to visa bureaucracy and by mid-afternoon I was a one woman band. However, progress was made, and was probably made quicker by the reduction in numbers of people whose opinions and input had to be solicited, and whose ownership had to be encouraged and assured. This could potentially cause more problems in the long term however.

In the morning we openly discussed the challenges that we would face in the coming months, with Harry asking what would be the most difficult-the beginning, the middle, or the end?  Some optimistic people shouted “the beginning!” but the more realistic among us answered “the middle” and Julie took her cue to relate to us some of the challenges that been faced with the India programme and the challenges of long-distance (business) relationships between two cultures. Lack of (reliable and regular) communication from the NGO side was a central challenge, and Julie tried to manage our expectations about what we should consider to be reasonable . For the main part this would require a reduction in expectation from the corporate side, and for the NGO staff the advice was given that if you don’t have time to respond, at least communicate that you have no time, and reschedule tele-conferences etc, rather than just not tuning in for them, as had commonly been the case.

Late morning and early afternoon was spent in our teams (or in our case-pair), working on the final business model to be presented that afternoon. Irene and I laid out our PESTEL analysis and later, alone, I consolidated all our existing work into one vivid green and yellow power point presentation. It was nice at least to take a break from the role of trainer that I had been required to adopt over the previous days, to ensure that the group made progress. At 2pm the groups dribbled slowly back into the room and the presentations began, kicking off with an extremely professional presentation from the PACE SMS project. Presentations were meant to last for 20 mins, followed by 10 mins question time from the group who would role play as the senior management team. In practise the presentations lasted up to 40 mins and questioning veered off onto tangential topics that would have been better addressed in the breaks, eg. Right before moving on to the next presentation a non Ugandan participant asked “what is the situation of malaria in the country? I really feel this needs to be discussed now.” Fortunately a Ugandan participant gave an unusually concise, well structured and highly informed answer. Harry certainly had a tough time with the timekeeping.

Many of the groups had developed impressive and promising business models through the course of the workshop, although it was often unclear as to who exactly would be doing what exactly over the next 6 months. This was concerning as without allocating tasks and persons responsible it is likely that nothing will happen, or that lots of activity will occur in an unstructured and ineffective way as often happens on development projects. One group was at least clear in what their proposed activities were: to follow the 6 steps to putting together a business model. This however had been the entire purpose of the workshop and I wondered what they had been doing instead. The time for questions was extremely helpful and the senior management team played its part gently, offering helpful insights, suggestions and constructive criticism.

Last but not least, I presented the NACWOLA Community Systems Strengthening model. This was very well received and attracted many compliments afterwards on the work and progress that we had made. I presented our intentions to research and review other models of using community health workers including our own. This would include looking at the other agencies using CSA/CHWs and village health teams (essentially different names for the same group of people in practise doing very similar things but for different donors/gov.) Rather than suggesting that NACWOLA should do this to avoid duplication and overlap, Jon CD of Marie Stopes said that we should be looking to maximise the benefit of this overlap and work in collaboration with one another. Streamlining the use of CHWs is clearly a crucial step that needs to be taken nationally, and the workshop process had helped this issue to be identified and brought to the fore. More on this later

The end of presentations was met with a feeling of relief for many, and had re-enthused others to continue work on their model and to plan out, step by step how things could be taken forward. A round of thanks was dedicated to Harry and Julie for their hard work. I felt embarrassed and upset that we hadn't arranged for a thank you gift to be presented to Julie who has dedicated her professional life to the Pepal mission, and whose vision, energy and dedication and good humour had made the whole thing possible. Beers and chatter followed and I was delighted to be introduced to Maya, the acting country director of NACWOLANACWOLA and Pepal while in country. Having reached the point where I really felt like I was beginning to get to know the other participants, and having shared so much in so little time, it seemed sad to say our goodbyes.

Interlude: the story of the bore hole

When discussing the value proposition for our respective business models, a Ugandan participant offered the following story as food for thought.

...On visiting a rural village in Uganda, the world bank saw that women were having to walk 2 miles each way everyday just to fetch water. Seeking to lessen their work burden, the world bank built a bore hole for the women to access water from the convenience of their village. Returning some months later they were astounded to see the bore hole relatively unused, and the women still walking to fetch water. What they hadn't realised was that the 2 mile walk filled a function above and beyond the collection of water; it provided valued time in which women could talk freely, outside the confines of their huts and away from men.

While this story acted as a vivid warning against making rash assumptions, the development of each groups value proposal was based on assumed value factors that we had essentially plucked from the air by brainstorming. While local NGO partners formed the majority of each teams it would be incorrect to assume that they completely understand and can represent the values of the users and end-users of their product. Admittedly they stand a better chance than the world bank employees who made a quick day trip from Kampala in a white 4 wheel drive, but the local knowledge of an NGO worker is full of its own assumptions, and biases and is not infallible.

While our group had come up with some suggested value factors for the purpose of this workshop, a business model that based itself on these without verifying them first would be absurd. However, identifying the value factors of a group of people in the limited time the pepal groups were allocated (e.g 2 days) poses a great challenge. I warned the group about taking peoples answers at face value to, noting that answers change according to who is asking the questions. As recipients of aid have learned to frame their needs and desires in alignment with what an NGO or donor like the world bank is offering, it takes time and effort to get beyond those answers and to identify peoples actual priorities. However, it is also problematic to assume that these are somehow completely different and independent of the development projects and BCC campaigns that have come before.

Short of spending 6 months conducting ethnographic research to identify actual value factors, a pragmatic compromise might be to use tools like the participatory consensus workshop method taught by the Institute of Cultural Affairs. The beauty of this method is that it enables a group to reach consensus on an issue, whilst facilitating input from everyone present, regardless of the power hierarchies at play.
"The method involves a five-step process that guides people from generating and collecting ideas, through organising those ideas into meaningful groups, to reaching agreement on the question they are facing and identifying some next steps to move forward.The method generates new creative ideas, incorporates both rational and intuitive approaches to problem solving, and builds team spirit and consensus."

I was awarded a scholarship to attend the basic training in this method before I came to Uganda and feel that it will serve me very well here. I intend to run workshops with CSAs and PLWHAs to identify actual value indicators. This however, will require some creative thinking around how to adapt the tools to suit an illiterate group who speak another language. No doubt pictorial representations and a translator will be my best friends.

For more information on the consensus workshop method and ICA trainings, please visit http://www.ica-uk.org.uk/gfm-group-facilitation-methods/

Workshop Day 2: Selling peanuts for more than…peanuts

With a later start time of 9.30, many groups mixed business with breakfast, meeting early to get a head start on their projects. Today was a more theoretically orientated day, which unfortunately meant even less time dedicated to group work. We had 5 steps to take that day, and a lot of theory and powerpoint slides to get through first. Harry outlines the order of the day: 1)establish a new revenue model, 2) Design the new organization 3) discuss what could be outsourced 4) How to make space for Open Innovation and 6) to determine how much value is created for stakeholders. 

Admittedly, much of what was covered that day, from micro-franchising to open innovation was lost on my team at least. A quick glance around showed them dis-engaged with the business concepts being presented and engaged in answering the work emails that streamed in on their laptops. For the other NACWOLA team  who were creating a model for an agricultural co-operative through which WLHIVs could sell peanuts, how to add value was a very quantitative exercise; figuring out how to sell peanuts for more than peanuts involves looking at the price of transport, key farming inputs etc. However, for our team the value proposal was qualitative, looking at how to improve the experience of the end users and users according to qualitative indicators like ‘a sensitive approach.

When the time for group work began and we set to work on the value proposal for users (CSAs) it was extremely hard for the group to see the other organisations that NACWOLA trained women could work for as competition. Other NGOs target and recruit NACWOLA CSAs to work for their own organisation because of the critical skill set they have already developed through NACWOLA support. In business terms such organisations needed to be presented as competitors, but are seen by the NACWOLA staff as complimentary. This is because they offer good salaries and opportunities for the very women NACWOLA is trying to support-WLHIV.

Much work with other organisations is also part time and so leads to no clash in time commitments. CSAs also learn new skills from both agencies, adding value to their work with both.  However, with some organisations like Mother2mother recruiting/poaching CSAs for full-time work, NACWOLA is left to fill their gap by training a replacement. Essentially NACWOLA find themselves draining their own resources to provide skilled and knowledgeable staff to other organisations. Our value proposal for users then, was designed to try and retain NACWOLA volunteers by offering them a competitive package of benefits.  Alternatively we noted that NACWOLA needs to negotiate a better deal for itself when government and other donors decided to recruit its volunteers, rather than handing them gladly over.

In our group work at the end of the day, time pressure was really beginning to be felt and the teams worked doggedly until 6pm when we were invited back into the conference room to listen to a talk by an intern at the Acumen fund Kenya, who had flown over especially for the occasion.  The Acumen fund offers capital patient loans to social enterprises, meaning they don’t mind waiting years and years for a small return on their investment because what they invest in are enterprises that are socially as well as financially profitable. We listened attentively to the eligibility criteria which unfortunately excluded most of our enterprises in the short term, but did offer a possible source of capital for the medium term.  

After sifting through some of the NACWOLA and Global fund documents I joined the others for the BBQ, buffet and beers outside and listened to the live music courtesy of Kampala Music School. Singing a mixture of local songs and more western ones - sometimes in tune, sometimes completely out - they were entertaining and were, in our new language, a great value proposition to the evening, offering a new dimension and richness of experience. I particularly liked the Rwandan style of dance where the dancers crouched low to the ground and pushed their hands out and up with palms to the sky and all the while  with small pots balanced on their heads. Impressive. The BBQ social also provided the opportunity for me to introduce Brooke, the fellow anthropologist and the work she was doing to Jon, whose house I would be spending the next few weeks in. To my relief it was agreed that she could stay too, meaning I would have some company in the big house on the top of the hill. As I went to bed I passed the usual crowd gathered at the Wi-Fi hot spot of the restaurant balcony, furiously trying to connect with their lives back home.

Workshop Day 1: “Think big, start small, act now”

The workshop kicked off shortly after 9am, with the participants making their way into the conference room of the hotel. A U-shaped seating plan had been set up, complete with stationary for each of the participants, a projector and Harry at the front to introduce the programme. After Julie facilitated personal introductions Harry outlined the shape and purpose of the programme. The purpose was twofold: 1) To develop and document a new or existing business model that would provide a solution to a problem at hand, e.g. an income generating social enterprise for economically and socially excluded WLHA (new), or the Marie Stopes’ health voucher scheme (existing). Documentation of this model could then serve as the basis of a funding proposal. 2) To increase participants capacity to innovate future BMs in their own context and work. The programme would consist of 6 steps which we would complete over three days.

Today, the first day, was dedicated to the first step of each team articulating a defined product, a solution to a problem at hand, and an experience that the product was offering. This new BM outline would include a Value Proposition (VP) to demonstrate how it adds value and justify itself. After an introduction to key concepts and steps towards BM innovation, Harry encouraged us to step outside of the box with our thinking and to conduct a PESTEL analysis in our groups for inspiration. We broke away then to identify and discuss enabling factors in the political, economic, social, technological, environmental and legal context. I had been told the day before by Sandra that my team might be unable to make it, which would have meant the project being scrapped and me joining forces with the other NACWOLA project- a peanut cooperative for WLHA. However, I was delighted that overnight my group numbers had not dwindled but rather increased to 6. New additions included Jacqui, the regional director of NACWOLA for eastern region, Esther, a project coordinator in Iganga and Ismael who is based at the head office in Kampala.

Our group discussion was therefore very fruitful, with lots of input from everybody on the team. We were able to identify key opportunities, one of which was the provision of solar powered mobiles to CSAs to allow timely transfer of data through SMS messaging & to send messages on safe sex practises, and health facility appointments. Joining the main group again, we reported back on enabling factors in the format of a group discussion. Harry then took us through the process of articulating a Product, Solution and Experience and identifying its users and end users. In our break away groups then we put ourselves into the place of users/end users to brainstorm on value factors (what they valued in the product) and to identify where we could add value. The time allocated for break away time was on the slim side. There was little sense of urgency among the Ugandan NGO staff and exiting/ entering the room and sitiing at a different table took considerably longer than Harry had probably anticipated, shaving off about 15 mins of working time.

By moving at a motivated pace however, our team managed to articulate a product, solution and experience, and to outline possible value factors for end users, the PLWHAs. Where CSAs were performing poorly, we discussed how to add value. Taking confidentiality as a value factor then, Sandra explained how frequent visits from a CSA can act as almost a default disclosure, and that on top of that, some CSAs were indiscrete and disclosed the HIV status of their clients. Community sensitisation on the role of the CSA as a general health worker was suggested as a way to reduce rumour, and continuous appraisal of CSA performance, including spot checks with clients, was suggested as a way of increasing CSA discretion. These ideas were then included in our VP and we mapped this out visually using the strategy canvas format suggested.

Back in the main group, Irene presented our strategy canvas and VP for PLWHHAs with humour and energy, and Harry offered valuable feedback. On the basis of this feedback we changed our product from ‘an empowering and supportive community to increase the demand, quality and uptake of HIV and wrap around services’ to the more concrete and project specific product of ‘training workshops for CSAs.’ Harry also noted that we still needed to produce one for the CSAs, the users, which would include an evaluation of the performance of competitors ie. Other organisations that community members could choose to work for. In reporting back, the workshops process of taking small steps to innovating a BM with potentially life saving impact was captured perfectly by one of the participants. He said, simply and succinctly, “think big, start small, act now.”

While some groups did struggle to articulate their product, solution and experience, and chose to follow their own alternative format, most made excellent progress and had established the core of their BM. Having completed these first and most difficult steps, morale was high and team members seemed to have bonded really well. Despite the intensity of the day and a late finish of 6pm, many NGO staff stayed for dinner, to talk further with their teammates and other participants. There was a buzz in the air, and many teams stayed together, working well beyond the delicious buffet dinner, and into the night.

Plan C (the day before the workshop)

I woke up to the alarm I had set for 6.30, giving me half an hour to get ready for sunrise and our planned departure to Iganga. Shared a sleepy cup of tea with Julie before she revealed that there had been a change of plan late last night and that we were now due to leave at 9am. I sloped back to bed and then met Sandra, from NACWOLA when she arrived on time, but unfortunately without the vehicle to leave in. Plan A of a UNAIDS car had, despite assurances, not materialised, so we reverted to Plan B which was to travel in the NACWOLA vehicle. However, this had already been booked so we resorted to Plan C which was to stay in the hotel and work from there to get an idea of the project. This actually worked out for the best, allowing us time to ask questions and for me to get a clear enough picture to put together the 1500 word initial project outline that (Prof) Harry had assigned to be completed and submitted by that evening (!!!).

Joined by Irene, a former journalist and current fellow in the communications dept at UNAIDS, Sandra began to guide us through NACWOLAs activities and multiple projects across Uganda. NACWOLA is unique in that it is the only national NGO for women living with HIV/AIDS (WLHA) that is also predominantly staffed by them. Sandra, a project officer in Iganga, was able to outline the impact of NACWOLA by tracing her own experience with the organisation, first as a member of the network and beneficiary of services and psychosocial support, through to her current of offering those services and support as a NACWOLA employee. Sandra showed how, in no exaggerated terms she owed her life to the NACWOLA. By encouraging her to be tested and providing support through the whole process as well as follow up, she was tested, began ARV therapy, was empowered and enabled to live positively. She now has two of her own children, a husband and an adopted HIV orphan in her family.

NACWOLA offer holistic support for PLWHAs. They recognise that women’s wellbeing is inseparable from that of their immediate families, and that care goes beyond facilitating ARV treatment to include psychosocial support, access to information and legal services, community sensitisation and assistance with income generating activities and nutritional support. At the heart of their work are Community Support Agents. These are PLWHAs themselves who NACWOLA recruits and trains to mobilise community members to get tested and access treatment and wrap around services. Community based CSAs do door-to-door visits to recruit new members into the network and refer them for testing and other health services. They also continue to support existing members. Facility based CSAs meet NACWOLA members who have been referred for testing and treatment at the health facility, and guide and support them through the process, offering pre and post testing counselling. These CSAs form a bridge between community members and health service providers, to increase demand, uptake and the quality of HIV/AIDS and wrap around services.

For a break for the groups working at the hotel, lunch was had in the beautiful Speke resort. The ambling walk there and back allowed plenty of time for chit chat and inter-group introductions and mingling, I sat with Irene and Sandra, hoping to get to know them a little better and move beyond the wall of politeness that had been established. However, they soon slipped into Luganda, their shared local dialect while I sat lemon-like. I interjected at a couple of points to ask what they were speaking, and which language would be best to learn. As they returned to Luganda after answering I realised that, should I be posted to Iganga for 6 months I was going to be completely isolated unless I learnt the lingo.

At 7pm those remaining the hotel (mainly the private sector folk who had flown in from the US and Europe) were all officially welcomed into the programme by Julie, the CEO and founder of Pepal. A huge buffet and relaxed seating arrangements gave us all a chance to relax, mingle and get to know one another and the different projects/business models that were going to be developed in the coming days. While those who were new to Africa appeared shocked by the poverty they had seen, the field trip experiences had been "powerful" (as Bonnie said) and provided the motivation needed to really work hard to develop the business models that could make a positive impact.

Krikey, it's cold in Kampala!

Arrived on Sunday 12^th to a cool and breezy morning in Kampala. I was met at the airport by Bruno, a tall Ugandan driver for NACWOLA, with a bassy laugh that humoured my many questions en-route to the hotel. As we passed along good tar roads I noted the typical red African earth and the vivid greenery of a landscape that seemed permanently dressed for Christmas.  Lawns were well manicured, the shrubbery on the sides of the street trimmed and neat, and the many small shops and shacks appeared well swept and kept, many newly painted in the canary yellow branding of MTN, the countries main mobile phone network provider. I checked into the very homely Royal Impala Hotel near Lake Victoria in which Pepal had reseved all the participants who had travelled a room for the week. Marvelled at the climate and slipping on another laying of clothing, I climbed gratefully under the mosquito net and into bed for a long awaited sleep.

Spent the afternoon with another of the participants with whom I wandered along to the swampy shore of lake Victoria, aka “the beach.” There we had a strangely British lunch of fish (pulled fresh from the lake) and chips (cassava and potato) that were bubbling away in great vats of oil. Many women were had gathered there to cook and sell to families on their Sunday stroll to the lake shore. Young boys relaxed in moored fishing boats, music beat softly from large speakers and a great and greying stork observed our lunch with hope.

Moving onto one of the most expensive and beautiful resorts, the speke resort, we enjoyed a Nile special beer, watching Uganda’s richest families relax, play football, fly kites and, as one boy did, ride around repeatedly on a motorised 4by4 scooter on the expanse of lawn by the lake.

We returned before sunset and in time to meet two other participants who had just returned from a gruelling and eye opening field visit to the North, where they hope to establish a women’s agricultural cooperative farming peanuts. This would offer livelihood strategies for 1600 women living with HIV/AIDS (WLHA) in the remote and difficult to access area of Amoru. This is the other project in which NACWOLA staff will form a team for, and that I will possibly join too.

Innovation in Uganda: the concept

I currently find myself in Kampala, the capital of Uganda, as an LSE student participant on the Pepal Innovation in Uganda Programme. Developed in collaboration with the LSE, the programme pairs professionals from across the globe with Ugandan non-profit organisations to devise new, market-driven approaches to HIV, malaria, women's health…. and the new team addition of Kampala School of Music which is now twinned with Kensington Symphony Orchestra.

After initial field visits to meet the intended beneficiaries of these new approaches, 6 teams will participate in a three day workshop on Business Model Innovation, led by Prof. Harry Barkema of the London School of Economics management department. During the workshop process, the teams of Ugandan NGO staff and international experts from the corporate sector will work together to develop new innovative business models and to innovate existing ones to create better products and services.  

I will be forming a team with staff from the National Community of Women Living with HIV/AIDS (NACWOLA) with whom we will be documenting and innovating their existing model for Community Systems Strengthening (CSS) for HIV/AIDS. More on CSS later :)

For more information on Pepal please go to http://www.pepal.org