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Aug 16, 2023   |   Blog Post

How to Transition Well: A Q&A with VillageReach Sustainability Leaders

By Tom Foot

Communications Manager

When VillageReach proves that a program is working, we don’t just pat ourselves on the back and continue on. Instead, we work to transition program management or operation to the government, so that it can be sustained for the long term. This may seem counterintuitive, but it’s actually one of the most important things we can do to improve health outcomes for people in need.

I met with Claudia Shilumani, Vice President for Partnerships and Impact, and Dr. Bannet Ndyanabangi, Vice President for Global Programs to discuss VillageReach’s Transitioning Well initiative.

Why is it important that we transition our programs to government?

Claudia Shilumani:

Thank you, Tom. It’s akin to the adage: you can give someone a fish or teach someone how to fish. In development, the idea is to support governments to do things for themselves. Recognizing that governments won’t always initially have the capacity and resources to cover all of their priorities, we actively seek out these resources and use our capacity to work with governments to initiate programs, on the understanding that these will eventually be handed over. That’s how development becomes sustainable.

We adopt this method because we see that government must be the primary caretaker of health; they’re tasked with delivering quality health care services to their citizens. They might lack the capability initially, so we step in, bolster that capacity, showcase the value in the programs we’re rolling out, and then assist them in securing the necessary funding to continue this work. This process is often lengthy. Once they’re prepared and have allocated their budgets for these initiatives, we pass the baton and let them take the reins. This ensures sustainability.

Bannet Ndyanabangi:

Claudia nailed it. In my previous work, I have seen projects and programs that were conceptualized without involving governments or their communities. These initiatives would arrive with considerable resources, such as equipment, vehicles, and expatriate contractors. They’d set up systems under the guise of “health system strengthening”, but after a five-year span, the project would conclude with a cold handover to the government, expecting them to scale it up . Yet, in such cases, a short while later, it’s apparent that the project is not scalable without massive resource injection. Many erroneously blame the local governments or communities for the project’s demise. The truth is, the foundational design and implementation of these projects didn’t account for sustainability post-completion.

VillageReach’s Transitioning Well approach, I believe, learns from these past experiences. From the onset of a program, we’re looking five years ahead, contemplating the needs for sustainability. We design in collaboration with stakeholders, such as governments and communities, planning for the future. As we roll out a program, we continuously evaluate and monitor to ensure the resources and methods we employ can be maintained. This forward-looking approach, which emphasizes sustainable transition, is why VillageReach’s methodology is highly regarded, particularly among government officials.

Are there situations where an NGO like VillageReach shouldn’t transition a program?


Alright, let me try to tackle that! No, we should not operate programs on a governments’ behalf, but we still may maintain some role post-transition. One program that immediately springs to mind is outsourced transportation. Outsourced transportation aims to synergize government and private sector efforts, enabling governments to outsource transportation tasks to the private sector for better operational efficiency. Historically, trust deficits have marred the relationship between the two entities, with the government often skeptical about the profit motives of the private sector and vice versa. While overall management of outsourced transport will transfer to government, we (or another partner) may maintain a limited independent role in verifying the performance of transporters, to address any ongoing trust issues. This program, among others, requires an intersectoral approach.

Bannet, any additional thoughts?


To supplement Claudia’s point with another tangible example, consider “Health Center by Phone” and its implementation in Malawi. The government’s model has been lauded internationally, showing the power of the Transitioning Well approach. However, we retain an interest in the telemedicine sector and as advisors to government, particularly as it relates to advancements in technology that may bring forth evolution in the solution. Initially, the focus might have been on establishing a hotline and pre-recorded messages, but today we’re exploring AI, telemedicine, and even ultrasounds. Likewise, in “Drones for Health”, such evolution is evident: from transporting lightweight items to considering repurposed small aircraft for heavier medical supplies.

Transitioning is valuable, but VillageReach should retain its role as an advisor on the latest technical trends. We should be consistently engaging with stakeholders, updating them on technological advancements, and introducing new solutions. It’s not about withholding transition, but rather maintaining an advisory role. Solutions, especially tech-driven ones, are ever-evolving. It’s our duty to remain proactive, driving innovation, research, and aligning solutions with emerging technologies. So, while Transitioning Well is crucial, our commitment to support governments is ongoing.

Our approach has often led to governmental 'aha' moments where the true value of the work becomes apparent ... it's about our courage to implement, transition, and then seek out the next horizon. Click To Tweet
What differentiates VillageReach from other organizations focused on sustainability?


VillageReach is continually seeking to help governments solve their most pressing challenges. I’ve often said this, so please quote me on it: through Transitioning Well, we aren’t working ourselves out of a job but working ourselves into the next problem. Organizations often specialize in a niche skill set, fearing irrelevance if they transition, making them hesitant to do so. But at VillageReach, we’re fearless explorers of the unknown, determined to showcase tangible benefits. Our unique approach has often led to governmental ‘aha’ moments where the true value of the work becomes apparent. It’s not just about innovation or technology; it’s about our courage to implement, transition, and then seek out the next horizon. Whether it’s transitioning the Health Center by Phone to government, OpenLMIS to the private sector organization Vitalliance, or Kwitanda Community Health to a local NGO, we prioritize teaching others how to fish. This proactive, innovative, and fearless approach truly differentiates us.


I would encourage others to feel the fear and do it [transition] anyway. Before joining VillageReach, I hadn’t given much thought to the concept of transitioning. The structured, evidence-based approach, built on real experience, is unparalleled. Few organizations can claim to as systematic approach as Transitioning Well. I agree with Claudia – typically, organizations take a long time to even initiate discussions about transition. VillageReach, on the other hand, has a proactive approach: ideate, collaborate, and then systematically transition, ensuring all knowledge is shared transparently.

What should donors, governments, and technical partners be aware of when embarking on program transition?


It’s essential for stakeholders, especially those who finance these initiatives, to prioritize and embed transition from the outset. Echoing Bannet’s sentiment, while there’s been a historical emphasis on sustainability, transitioning tends to be overlooked with sustainability often limited to government financing. True sustainability can only be accomplished when governments’ primary role as guardians for their citizens is recognized.

Funders should prioritize programs that emphasize transitioning and sustainability. By only offering short-term financial support, we inadvertently hinder long-term development in countries. Hence, donors should ensure that their recipients are held accountable for instilling government capacity, paving the way for sustained efforts. Sustainable programs demand consistent funding, ideally from the host country eventually, as governments are inherently best placed to understand communities and ensure their welfare.

It's imperative that partner governments ... are aware of their rights to query and engage from the onset. VillageReach's Transitioning Well approach can be used to empower these governments. Click To Tweet


Joining VillageReach opened my eyes. On my initial trip to Malawi, within my first two weeks with the organization, I met Carla [Blauvelt, overall Transitioning Well lead], the transitioning guru! That interaction was an epiphany. The importance of establishing a transition plan with the beneficiaries from the beginning became clear. Our interaction with the Malawi Ministry of Health further emphasized this, as they felt like proud stewards of these programs, rather than feeling they were thrust upon them without proper consultation.

It’s imperative that partner governments, the primary recipients of these programs, are aware of their rights to query and engage from the onset. VillageReach’s Transitioning Well approach, tools, and learning modules can be used to empower these governments, enabling them to pose relevant questions, even in the early stages of program development.

What’s next for the Transitioning Well agenda?


There are a few things we’ve been discussing. One is the idea of providing consulting services to tackle other organizations’ stickiest transitioning problems, as we’ve been there, done it, and got the tee-shirt. We’ve built strong technical capacity in managing transitions, and the more funders push for sustainability in their proposals, there greater the need for these skills become. We are of course continuing our own organizational effort to transition programs to government – including Last Mile Supply Chain in Mozambique, Supply Chain Investment Coordination in DRC, and M-Vaccin in Cote d’Ivoire – and sharing learning through communities of practice. The more we promote this approach, involving governments, private sectors, and funders, the greater the global emphasis on transitioning programs will be.

One more point: to successfully transition solutions and programs, we must demonstrate their cost-effectiveness. Governments have limited resources, and we need strong evidence of value to drive investment.


Claudia touched on the issue of costing. In fact, just two days ago, the Drones for Health team presented their recent analysis. They provided excellent data on costs, demonstrating how costs can be reduced while improving reach. We need to lean into evidence generation. When claiming that something works, we require evidence.

Relatedly, on Transitioning Well, we need to publish more of our findings; collaborating with universities or even writing a book on Transitioning Well, which is a novel concept. Understanding government and partner needs and desires from the outset, and then building solid evidence that a solution is effective, affordable, and can be integrated smoothly over time, will save a lot of effort and expense on programs that sadly come to nothing. This is groundbreaking work, let’s document it!

Thank you both, I appreciate your time. Take care and goodbye!

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