Building stronger organizational systems in South Africa

A client learnds how to sew at Sophumelela's Thembalethu income generation program.

"When we started, we were only an ARV service delivery site. We did adherence monitoring, but we didn't have the capacity for testing," says Dr. Ethné Schaefer, Medical Director of the Sophumelela Centre in East London, South Africa. "The clinic was managed by volunteers. We were three people flapping around trying to do everything! We saw the need to change—we wanted specialized care for patients and their families."

With support from JSI and the PEPFAR New Partners Initiative (NPI), Sophumelela's desire to expand and better serve its clients soon became a reality. After becoming an NPI grantee in 2008, the clinic added HIV counseling and testing and home-based care to its list of services. A building purchased with Sophumelela's own resources was renovated as a palliative care facility to care for its sickest patients. Sophumelela also established a daycare centre and school for the children of clients and other AIDS-affected orphans and vulnerable children in greater East London. To round out this list of comprehensive services, Sophumelela created a social enterprise and development program called "Work for All," to assists patients with skills-building, job creation, and placement.

Sophumelela staff participate in a TA-NPI training to help strengthen networks to serve the needs of clients.
But while the NPI funds allowed Sophumelela to expand its list of wrap-around HIV services, additional support was needed in various organizational areas to truly make it an effective and comprehensive HIV service provider. Sophumelela also received technical assistance to strengthen both its management and programmatic systems through TA-NPI, a combined team of John Snow, Inc. (JSI) and its partner Initiatives Inc. To address these needs, TA-NPI worked with Sophumelela to develop targeted trainings to strengthen specific organizational areas that needed attention, such as resource mobilization, program evaluation, client engagement, establishing systems and resources, and overall grant management.

"TA-NPI picked up on the gaps," says Andre Bezuidenhout, Sophumelela General Manager. "Within a month of identifying our needs, they called us in for referral network training. They also helped us to develop a system of client assistance service providers."

Sophumelela Centre, East London, South Africa.
"When we apply for grants, one of the questions funders often ask us is, 'do you have a financial system and policies in place?' We can now say yes because TA-NPI helped us establish them," says Dr. Schaefer. "'And have you got an M&E officer?' We do now! This no doubt helped us win our recent Global Fund award and will help us win future funding, because it shows we are trying to run our organization well."

Mr. Bezuidenhout concurs. "Currently, in the East London region, we're the only organization with an M&E system in place. Every other organization eliminated themselves from the Global Fund award because they had no M&E system."

With TA-NPI's support, Sophumelela has made tremendous progress. Program managers now have the skills to effectively run their departments and, as a result, have taken the lead in day-to-day management. Sophumelela now provides its patients with the quality HIV care and comprehensive support services they need. In addition, Sophumelela is now a strong partner for other organizations and the government in the Eastern Cape.

"TA-NPI has only helped us," says Dr. Schaefer. "Yes, there's extra work, but they made us into a better organization. It's actually established our NGO."

To date, Sophumelela has reached more than 3,800 people with its comprehensive services and hopes to continue expanding in the coming years, in response to the needs of the community and national priorities.