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|STRATEGIC PLAN |
|2014-2019 |
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|August 2014 |
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TABLE OF CONTENTS
TABLE OF CONTENTS 2
ABBREVIATIONS AND ACRONYMS 5
EXECUTIVE SUMMARY 6
CHAPTER ONE: INTRODUCTION 12
1.1 Background 12
1.2 Challenges Facing DECF-Kenya 14
1.3 The Strategic Plan 15
CHAPTER TWO: VISION, MISSION AND CORE VALUES 15
2.1 Philosophical Framework 15
2.2 Vision 16
2.3 Mission 17
2.4 Core Values 17
CHAPTER THREE: STRATEGIC AND STAKEHOLDERS ANALYSIS 19
3.1 Introduction 19
3.2 SWOT Analysis 20
3.3 Evaluation of Past Performance 22
3.4 Recent Development 23
3.5 External Environment Analysis (PESTEL Framework) 24
3.6 Stakeholders Analysis 27
CHAPTER FOUR: STRATEGIC ISSUES, OBJECTIVES AND STRATEGIES 42
4.1 Strategic issues 42
4.2 Objectives and Strategies 42
4.3 Strategic Issue 1: Governance, Leadership and Culture 43
4.4 Strategic issue 2: Resource, Facilities and Infrastructure. 44
4.6 Strategic issue 4: Collaboration and partnership 46
4.7 Strategic Issue 5: Awareness creation about Retinoblastoma 47
4.8 Strategic Issue 6: Efficient and effective treatment and care for Retinoblastoma patients 48
CHAPTER FIVE: STRATEGIC PLAN IMPLENTATION AND ACTION PLANS 49
5.1 Introduction 49
5.2 Governance and Organization Structure 49
5.3 The Strategic Plan Implementation Matrix 50
Strategic objective 5: To contribute to the development of society through creation, storage, application and dissemination of knowledge 62
Strategic objective 6: To ensure all children with Retinoblastoma receive timely, adequate treatment and care 64
CHAPTER SIX: FINANCIAL IMPLICATIONS 78
CHAPTER SEVEN: MONITORING AND EVALUATION 81
ABBREVIATIONS AND ACRONYMS 3
EXECUTIVE SUMMARY 4
CHAPTER ONE: INTRODUCTION 10
1.1 Background 10
1.2 Challenges Facing DECF-Kenya 12
1.3 The Strategic Plan 13
CHAPTER TWO: VISION, MISSION AND CORE VALUES 14
2.1 Philosophical Framework 14
2.2 Vision 15
2.3 Mission 15
2.4 Core Values 15
CHAPTER THREE: STRATEGIC AND STAKEHOLDERS ANALYSIS 18
3.1 Introduction 18
3.2 SWOT Analysis 18
3.3 Evaluation of Past Performance 20
3.5 External Environment Analysis (PESTEL Framework) 23
3.6 Stakeholders Analysis 25
CHAPTER FOUR: STRATEGIC ISSUES, OBJECTIVES AND STRATEGIES 40
4.1 Strategic issues 40
4.2 Objectives and Strategies 40
4.3 Strategic Issue 1:Governance, Leadership and Culture 41
4.4 Strategic issue 2: Resource, Facilities and Infrastructure. 42
4.6 Strategic issue 4: Collaboration and partnership 44
4.7 Strategic Issue 5: Awareness creation about Retinoblastoma 45
4.8 Strategic Issue 6: Efficient and effective treatment and care for Retinoblastoma patients 46
CHAPTER 5:STRATEGIC PLAN IMPLENTATION AND ACTION PLANS 47
5.1 Introduction 47
5.2 Governance and Organization Structure 47
5.3 The Strategic Plan Implementation Matrix 48
5.3 Table 5.1: The Strategic Plan Implementation Matrix 49
CHAPTER SIX 76
FINANCIAL IMPLICATIONS 76
CHAPTER SEVEN 79
MONITORING AND EVALUATION 79
TABLE OF CONTE
ABBREVIATIONS AND ACRONYMS
|AMPATH |-Academic Model Providing Access to Healthcare |
|BOD |- Board of Directors |
|CEO |- Chief executive Officer |
|DFID |- Department For International Development |
|DECF |- Daisy’s Eye Cancer Fund |
|IARC |- International African Research Centre |
|HMT |- Health Management Team |
|HR |-Human Resources |
|ICIPE |-International Centre of Insect Physiology and Ecology |
|KSB |- Kenya Society for the blind |
|MOH |- Ministry of Health |
|MOU |- Memorandum of Understanding |
|NCST |- National Commission for Science and Technology |
|OCO |- Ophthalmic Clinical Officer |
|OSU |- Ophthalmic Services Unit |
|PHC |- Primary Health Care |
|SMART |- Specific, Measurable, Achievable, Realistic, and Time bound |
|SMT |- Senior Management Team |
|SOP |- Standard Operating Procedures |
|TB |- Tuberculosis |
|Rb |- Retinoblastoma |
|USAID |- United States Agency for International Development |
|CBM |- Christian Blind Mission |
|OEU |Operation Eyesight Universal |
EXECUTIVE SUMMARY
This is the second strategic plan of DECF-Kenya; it is, a milestone for an organization founded just five years ago. The organization isWe looking forward to the challenges of implementing the plan in over the next five years. We hope it shall bear fruit in to achieveing our vision, mission, and objectives. The strategic plan begins by providingwith a Background of DECF-- Kenya. The vision, as well as the mission statement, and core values are discussed in Chapter Two. The strategic and stakeholders analysis has been done in chapter three. Chapter four outlines the key strategic issues, objectives, strategies and outcomes that this plan will focus on. Where implementation, governance and structure framework are given. The significance of resource mobilization cannot be overemphasized, and we want to stress the importance of being able to mobilize locally available or “home grown” resources. Equally significant is the ability to start and run effectiveachieve resource building programmes. This that will go a long way tosupport implementation of DECF-Kenya strategies. To be successful, DECF-Kenya must network and partner with other institutions, be theyincluding government (both central and county), civil society, or even inand academic. To be able to implement its strategies, financial implication has been comprehensively discussed in chapter six. The important plank of Performance, Monitoring and Evaluation is given in chapter seven. Effective and efficient implementation of the strategies and actions programmes outlined in this plan will enable DECF-Kenya accomplish its mission and vision to achieve life and sight for the children affected by retinoblastoma. enable DECF-Kenya capitalize on DECF-Kenya will capitalize on its strengths, and overcomee its weaknesses, ; take advantage of emerging opportunities, and address any national and global challenges posed by both national and global operating environments. This will in turn enable DECF-Kenya accomplish its mission for the good of the child and achieve its vision and mission.
CHAIRMAN’S PREAMBLE
The plan summarizes our priorities and sets out a series of strategic objective that we believe will help to make Daisy’s Eye Cancer Fund Kenya (DECF-K) more efficient and effective in providing supporting the development of high quality evidence based care to for children with retinoblastoma (Rb). In particular, this plan addresses the question of how we will implement our mission going forward.
This document was assembled as a result of a deliberate planning process and received input from a range of stakeholders from a variety of backgrounds - Ministry of Health, Moi Teaching and Referral Hospital, Sally Test Pediatric Centre, DECF-K, DECF- UK, DECF- CANADA, University of Nairobi and the community sector. They represented the interests and concerns of the a full wide diversity of the entire society. We also acknowledge the immense support from Kenya Community Development Fund who without their supportwhich we would not have achieved this great milestonestrategic plan. I must also not forget our long time partner Prof. Helen Chan who through TUYF had the vision to strengthen our Canadian partners ability to perform specific functions to us.
We believe that working in partnership with others is key to ensuring a major leap forward in the understanding and treatment of Rb. Therefore, we will take a leading role in forging new strategic alliances particularly where there are opportunities to expand our efforts in providing long term solutions and challenges faced in providing quality care for Rb patients. We also seek to enhance our position as the leaders inunderstand the importance of Rb research, and continue towill invest in developing an infrastructure and environment that provides promotes acquisition of high quality evidence based to support care.
I would like to thank all of the people who took part in our consultation and offered us their insights, evidence, experience and ideas. We received a lot of input without which we simply would not have been able to develop a plan which was directed at the right realistic targets or which could possiblyto enhance care of children work in the real world. I must congratulate DECF team for keeping the children’s needs foremost in the development of always endeavoring to promote organizations goals and objectives, regardless of personal interests.
A strategic plan is a dynamic document, and that by its very nature, will be undergoing continual reassessment and refinement. At the same time, the our main objectives within this plan are felt to be clear and important to the future success of the long-term contribution of DECF-K to sustainable high quality care for children with retinoblastoma. Daisy’s Eye Cancer Fund.
Dr. Vijoo Rattansi (OGW)
Chairman- BOD
Daisy’s Eye Cancer Fund
FOREWORD FROM CEO
I am pleased to present to you DECF-K’s strategic plan 2014-2019. I want to appreciate the efforts of all who were involved: t. The Board, staff, consultants and all other stakeholders. DECF-K was able tohas demonstrated its ability to network, and promote trust, solidarity, respect and unity among its diverse members, and reinforcinge democratic practices in a transparent manner.
Considerable work has gone into shaping this plan and so that it is a result of an intense and rigorous process of thinking, analyzing, questioning, consulting and making challenging choices.
After serious deliberations with all stakeholders DECF had first considered incorporating other cancers and thus the ability to attract wider sources of funding. There was no consensus and thus we all agreed to remain with Rb only. One of the reasons is to avoid the dilemma of mission creep and introduction of inconsistency that is likely to come with diversified sources associated with strong financial position. However it is key to note that local fundraising for such a narrow cause is difficult. This also means that definitely heavy reliance financially on our external donors will continue.
Critically this plan allows my team and I to prioritize our limited resources to meet the challenges that exist. I also hope that this plan will improve participation of all the stakeholders in three perspectives; quality of local participation in both locally and externally supported projects, the depth of stakeholders influence on decision making, the range of stakeholders and the timing which relates to the stage of the process at which different stakeholders are engaged.
It provides direction for development of high quality evidence based care for children with Rb over the next 5years and also lays a foundation for an even higher performing and sustainable service for many years to come. Our six strategic priorities are value driven and define our priorities going forward. Therefore the plan seeks to give a framework of how to achieve the promise of life and sight to all children with Rb. I am confident that this plan will enable us to deliver the promise to all children with Rb.
DECF team traditionally has preferred diversified but localized resource base as a strategic option. This enhanced its ability to act on its own terms. Kenya provided more of human and material resource as opposed financial resource and just to emphasize again this has helped DECF to avoid introduction of inconsistency in the activities of the organization and vulnerability of the vision. Mobilizing volunteers and community resources is a strategy that keeps DECF to the real commitment and hence, to sustained impact. Going forward, care must be taken, least there is compromise on continuous staff recruitment and training, denying DECF a succession plan.
On the financial aspect of DECF, this plan subjects all our activities to a budget. DECF has experienced ‘silent’ internal competing strategies and interests due to limited resource base. The budget should enhance organization wide “points” of participation in joint sourcing of resources and decision on how any material or financial resource surplus should be treated. Budgets can create a pre-condition for joint problem solving in a complex and difficult area. Involving all in Planning and budgeting demonstrate willingness to empower.
Within the financial options, DECF faces two immediate decision paths. One is to generate financial resources itself. This can help protect it from having a shortfall in critical resources like salaries and operations since it can make the decision of where the surplus should be kept. An alternative option is to access or tap surplus funds created by others, which rotates around shifting heavy dependency on foreign donations to heavy dependency on domestic begging.
True sustainability seems in many instances not to be an integral part of funders thinking and practice and instead there is always a big gap in rhetoric and reality on this issue. One thing we have not answered as a team is how we are translating into operational practice our expressed expectation that the Rb program and DECF itself should be self-sustainable. For the Rb dream to survive a deliberate action is needed to create an enduring funding base. There has to be a strategy to sustain the core. Otherwise my experience and observation foresee a shameful and unfavorable context of disengagement, which is not thought through but result from funds running out, donor fatigue, and resignations of staff or just tiredness of DECF for ignoring a clear sustainability objective from the start. Creation of an endowment fund is a strategic choice that is long overdue. To put it simply in the words of David Bonbright “ how to invest in order to cease investing.”
Lastly assuming that the strategy is well understood then we must move to development initiatives. It would be important to bridge the gaps that are caused by the differences in understanding and imbalance in power between those doing the work of negotiating ‘in the field’ with stakeholders and those providing or mobilizing resources.
Brian Ouma
Chief Executive Officer
Daisy’s Eye Cancer Fund
CHAPTER ONE: INTRODUCTION
INTRODUCTION
1.1 Background
DECF K is part of a global fund, whose mission revolves around the management of Retinoblastoma (Rb). Established in 2004, DECF is a registered charity in England, a special fund at the Hospital for Sick Children in Toronto, Canada, a registered NGO in Kenya and, since 2012, a registered nonprofit organization in the USA. We are working towards the day when no child faces death and blindness, secondary to Rb.
The story of DECF begins with an English girl, Daisy, who endured four years of treatment in England and Canada in a marathon battle to overcome Rb in both eyes. Her family established a fund to help meet the costs of treatment in Toronto, Canada. Shortly after their return to England in the summer of 2004, they learned of a child, Rati, in Botswana, who had a life threatening Rb relapse. They wanted Rati and her family, to share the hope they had been given, and donated money from The Daisy Fund to help her access the best chance of cure in Canada. Rati had a single tumor in one eye. Curative treatment was available in Botswana, but delayed diagnosis, poor understanding of pathology results and lack of follow up care, led to life threatening relapse. Though she received expert care in Canada, Rati’s treatment came too late. Delayed diagnosis and incomplete care in Africa led to her death, at age four and a half years, in August 2006.
DECF evolved from the generosity of Daisy’s family, creating light from the darkness Rb brought to her life and Rati's. They are helping to save the lives and sight of children, with Rb, in other countries who are just as loved and valuable to the world. Their experience reminds us that early diagnosis is critical to enable best evidence based practice to save a child’s life and sight. Rati taught us that many opportunities to save children’s lives are missed in the developing world, and much can be done to improve care and share hope.
John White was born in Kitale, Kenya. He was diagnosed with bilateral retinoblastoma in Nairobi in 1946.He was subsequently treated at the London Moorfields Eye Hospital in the UK, there being no appropriate, advanced (for the time) treatment available in Kenya. He grew up and his daughter, Abby also has bilateral retinoblastoma. Her family history inspires her in her job as current CEO, DECF UK. With her family ties to Kenya, Abby White, motivated Kenya to start DECF K, Brenda Gallie with her clinical and genetic skills advanced Kenyan Clinical, Scientific and Technological solutions. Brian Ouma established DECF in Kenya but with all the three individuals still tackling overlapping issues. The influence and personal contacts of Brian Ouma and Founding Board members, Dr Vijoo Rattansi, Dr Melvin D'lima, Dr Kahaki Kimani, Lucy Muhinga and Mitchel Ongaro were instrumental in laying a foundation in Kenya for the entry of DECF K into the Kenyan Retinoblastoma mix. Using the personal contacts of Brian and Dr Melvin D'lima, ties were rapidly forged with the College of Health Sciences, University of Nairobi and in particular its Department of Ophthalmology and School of Dental Sciences in which DECF K has invested heavily in terms of equipment and training. Brian and Vijoo took this relationship to a higher level by bringing in their relationship with Dr George Magoha, Vice Chancellor. University of Nairobi to enhance the DECF K/UON relationship. Melvin's influence at the Medical Practitioners and Dentists Board considerably hastened the temporary licensing of Brenda Gallie and other clinical instructors over the years. Brian's close ties with the then Minister of Health, Prof Anyang Nyongo, boosted the credibility of DECF K in the government and Kenyan Health Policy making and regulatory environment. DECF K, is characteristically an informal organization committed to being internally and externally, people centric. It is important to highlight that in the past, people centeredness has been an ignored area in many similar Kenyan organizations. A significant feature of DECF Kenya organizational life is that it relies on interpersonal networks. These networks enhance inter-organizational, formal cooperation and resource mobilization, even if this process is sometimes perceived as informal. These networks are familial and customary and have remained very powerful to date in shaping how DECF K as an organization and its internal processes practically, work. Besides networking a spirit of volunteerism has enriched the DECF K mission. Teresa Beyer (USA), Lucy Nyarwai, the Barasa siblings; Hilda, Faith and Victor as well as Anne Nkoidila have soldiered on, often with no financial reward, for the greater cause of Kenyan Rb Kids. They have been joined at various times over the years, by Prof. Helen Chan, Dr.Helen Dimaras and Mr. Justin Liu and several Canadian University of Toronto, exchange students. The success of DECF K is therefore not measured in terms of Growth and ability to spend but rather with the profitability and output in terms of improving treatment and early diagnosis of Rb. One agenda that DECF has continuously perused is to look for strategies that will tie us more firmly with our own economy.
DECFK identity boils down to the integrity and honesty with which the leaders and staff adhere to the founding principles and voluntary values
1.2 Challenges Facing DECF-Kenya
The fund is facing major challenges, characterized by dwindling resources, against a background of an increasing demand for treatment of retinoblastoma cases. Factors such as economic downturns, and limited philanthropic and donor contributions coupled with the need to ensure that treatment is affordable have seriously diminished the financial resources for DECF-Kenya. Other challenges include scanty data which makes it difficult for the fund to make decisions, organizational politics among stakeholders, donor dependency for funding the organizations projects, inaccessibility to patients medical records poses the most crucial challenge, and as a result of this, patients miss to get the timely attention from the organization.
The fund’s operations on the other hand has gaps due to lack of permanent medical experts, the digital equipment is underutilized. as a result of lateness of data submission, Implementation of set objectives is a bottleneck because of the contextual differences, the working style of doctors is different depending on where they originate from (this applies more to the foreign nationals). There is also lack of commitment from a section of medical personnel, since the incentives provided does not match that offered by other service providers.
In the recent past, the search for the way forward has yielded significant insights into the nature of challenges facing the fund; initiatives are being taken to deal with some of these challenges, which include getting local donors and volunteers to provide services.
As a whole, internal stakeholder’s perception of the organization is positive, while external stakeholder’s perceptions have improved significantly. The tremendous improvement in virtually every aspect of the fund has influenced these positive perceptions. The fund faces competition for scramble for donor support from local and foreign institutions, this has significant implications for the strategic positioning of the organization.
The fund has valuable strengths, however. Its unique services, is one of the pillars this plan is built on. The pursuit of excellence in all aspects of DECF life has been unrelenting and has continued to receive recognition in various quarters at the national and international levels. The fund therefore has a strong foundation and pillars upon which to anchor its strategies for dealing with the challenges it faces.
1.3 The Strategic Plan
The strategic plan was developed through a highly participatory and inclusive process. In order to ensure the much-needed “ownership”, commitment and leadership of the strategic plan, as well as the corresponding support for its implementation by its various stakeholders, a participatory, consultative and iterative approach was employed throughout the process of its formulation and development. This was done with a view to ensuring as far as practicable, the necessary participation of the various categories and levels of DECF-K’s key stakeholders. With particular regard to the procedure and methodology employed, the development of this strategic plan involved intensive and extensive consultations with DECF-K board members and staff, as well as other stakeholders-whereby they participated effectively in sharing and inputting ideas into the draft plan document, as well as intensively discussing them.
During the plan formulation process, reference was made to, inter alia.s An extensive review of relevant and related DECF-Kenya documents was also done. More data was collected from a wide cross-section of the funds stakeholders through personal interviews, self-assessment and consultations. List of stakeholders from whom data was collected is given in Annexure 2
The strategic plan is thus home-grown as it is a reflection of the views of the DECF-Kenya external and internal stakeholders. The data collected formed the basis of SWOT and PESTLE analysis and subsequent development of strategic issues, strategic objectives and strategies.
CHAPTER TWO: VISION, MISSION AND CORE VALUES
CHAPTER TWO
VISION, MISSION AND CORE VALUES
2.1 Philosophical Framework
Strategic planning is a process that attempts to shape the future of an organization. It is based on the premise that the future of an organization can be changed. It is not pre-destined. The future of an organization is determined by today’s decision and actions. Such planning requires that three fundamental questions be answered:
Where are we now? (Situation / SWOT analysis)
Where do we want to go? (Vision, mission, objectives)
How do we get there? (Strategies / road map)
Through strategic planning, organizations are able to improve efficiency, economy, effectiveness and excellence. This way, they achieve the best use of physical, financial and human resources available to them. The strategic plan articulates strategies to be employed in confronting challenges facing an organization, developing sustainable competitive advantage and finding the right place in the environment.
The development of a strategic plan is a collaborative process involving all key stakeholders. Thus, the process is all encompassing and the implementation efforts require support by all and sundry.
Undertaking this task, the organization is guided and energized by not only concrete achievements of the past but also its core business of restoring life and sight for every child.
The management is responsible for the organization standards as a whole .The organization accepts its moral responsibility to empower people’s lives and connect with stakeholders.
2.2 2 Vision
Vision is a common way of seeing the future. A good vision is something that people can see; can almost taste; and that affects them at an operational level. It is an inspiring view of the preferred future. A vision is therefore a guiding image of success formed in terms of contribution to society. Features of an effective vision statement include clarity and lack of ambiguity; vivid and clear picture; description of a bright future; memorable and engaging wording; and realistic aspirations.
The demand for a shared vision for the organization arises from the new strategic direction that will propel the institution to higher level of effectiveness, efficiency and relevance in pursuit of its mandate. Arising from the analysis and arguments made in section one, the fund aspires to this common vision:
Life and sight for every child
2.3 Mission
A mission is a concise statement of the basic purpose and role of our organization. It specifies the functions (activities) and purpose of the organization mission is any activity or programme, individual or corporate, centrally co-ordinate or otherwise that is undertaken with the intention of reaching out to those who do not currently access our services. Deriving from the vision, the organization is:
To create awareness on Retinoblastoma and empower the medical fraternity to provide high quality evidence based patient and family centred care through training, innovation and research.
2.4 Core Values
Core values describe the standards that govern the operations of the Fund and its relationships with society. Suppliers, employees, community, regulators and other stakeholders. Core values articulate principles, which guide actions and ethical behavior. Our values are a way of expressing how we do things. All our programmes are motivated by our primary desire to bring quality care to each individual child and family, to protect and promote their complete well being, we unite and inspire our supporters worldwide to champion every child’s right to special care and protection, quality medical treatment and good health, survival and dignity, love and understanding. We shall be guided by the following values
a) Excellence in Evidence Based Care
We focus on innovation under-pinned by solid evidence to achieve excellence in retinoblastoma care for all children and their families worldwide.
Our programs do not replace statutory responsibilities within any area in which we work. Our activities provide a vehicle to maximize the application and value of available resources and skills.
b) Collaboration
We encourage collaboration to broaden understanding and lead action that translates knowledge and evidence into optimal care. United team spirit promotes mutual support and respect, co-operative working, and a fun, friendly and enjoyable work environment. We nurture multi-disciplinary, multi-centre teams that build achievable solutions to secure early diagnosis, deliver optimal management as close to home as possible and provide effective family support to minimize burdens on families and health care systems, and raise quality of life for patients and their relatives. We rely on our international networks and unique expertise to test radically new approaches to achieve optimal care in challenging circumstances. We seek to work in partnership with all parents, survivors, medical experts, researchers, organizations, institutions, donors and other who share our goal or improving outcomes, enhancing quality of life, building hope and reducing burdens for children with retinoblastoma and their families worldwide.
c) Sustainability
DECF-Kenya programs seek to establish sustainable retinoblastoma care, both in resource limited and resource rich environments. We promote unbiased collaborative application of knowledge and resources, realistic programs based on need and available human and material resources and development of reliable funding streams within partner countries to underpin these programs. We encourage families, medical teams and communities to be active leaders in this process
d) Professionalism
At all times DECF-Kenya will act professionally, thus providing quality, reliable and responsible service
e) Creativity and Innovation
In our effort to accomplish the vision of DECF-Kenya, the management, employees and stakeholders will be flexible and imaginative. We will thus be open to new knowledge and skills. Flexibility will be within the organizations principles.
f) Integrity and trustworthiness
DECF-Kenya will uphold honesty and fairness, be genuine and truthful in what it does.
g) Quality and efficient Service delivery
We are committed to helping those children who need eye care medically, materially, and psychologically, matching the results to the desired outcome while bearing in mind that Greatness is measured by the level of service to others.
h) Team spirit and team Work
DECF-Kenya recognizes the need to continue supporting and encouraging each other in all its activities. It shall continue to complement each other’s effort and build trust in each other. Together, and with child in our minds, the Fund shall develop the organization to great heights.
i) Good corporate governance and ethics
DECF-Kenya complies with applicable laws and regulations and generally accepted practices in all its operations. Additionally, our operations are governed by DECF-Kenya corporate governance principles, DECF-Kenya ethical principles and values, and good management practices.
CHAPTER THREE: STRATEGIC AND STAKEHOLDERS ANALYSIS
STRATEGIC AND STAKEHOLDERS ANALYSIS
3.1 1 Introduction
The need to develop a roadmap for the DECF-Kenya required a critical strategic analysis of the key factors past performance and the recent developments, both internal and external, that influence its success in achieving its mission and goals during the Planning period. This was accomplished through an assessment of both the internal and external operating environments.
3.2 SWOT Analysis
This section analyses the organizations strengths, weaknesses, opportunities and threats, which will help the organization, determine its strategic direction.
3.2.1 Internal Environment Analysis
The purpose of internal analysis is to identity the Organizations capability, which includes its assets, resources, and skills. This analysis resulted in identifying key strengths and weaknesses. Strengths are aspects of DECF’s operations that represent activities that the Organization does well or resources it controls. On the other hand, weaknesses are activities that the DECF does not do well or resources that it lacks. The analysis was done in the areas of DECF’s facilities and equipment, and functional areas of human resources administration and organization, financial resources and ICT.
3.2.2 Facilities and Equipment
DECF is a relatively young organization. It is therefore yet to accumulate physical facilities and equipment. However, within the short time it has been in existence, the Organization has managed to acquire valuable assets which include a high-powered Digital scanner, Retcam, Laser , microtome, cryotherapy machine,slides and block cabinet and an ultra sound machine.~ used by the organization in its operations.
3.2.3 Human Resources
DECF recognizes that people are the critical mass and its mission, vision goals and objectives will be realized through proper management of these resources.
The DECF human resource includes the Board of Directors, employees and volunteers. Volunteers form the largest portion of the DECF human resource. These volunteers include doctors in almost all hospitals in the 47 counties, nurses, pathologists, parents, survivors and child life leaders. Effective human resource management will build a strong foundation for the organization. DECF should therefore strive to maintain its responsibility to be good stewards over the human resource under the care of its leadership. The organization will therefore put in place training and development programmes to encourage peak performance, efficiency and satisfaction for the overall growth of the organization.
3.2.4 Administration and Organization
For DECF to work more effectively, one of the identified priority areas is the governance at all levels. When the organization and administration is smooth a good working relationship is maintained deadlines and targets are met. The highest governing body of DECF is the Board of Directors which provide strategic direction and is responsible for governance, financial sustainability, and property acquisition implementation of set strategies and serve as an important link to the Donors and other stakeholders. Board Of Management has 6 Kenyan citizens, 1 Kenyan resident, 1 UK citizen and 1 Canadian citizen as at May 09 2014
BOARD COMPOSITION
Chair - Dr Vijoo Rattansi Kenyan
Secretary - Dr Melvin D'lima Kenyan
Treasurer - Dr Kahaki Kimani Kenyan
Member - Mitchel Ongaro Kenyan
Member - Sarah Ellen Mamlin Kenya Resident
Member - Abby White UK
Member- Prof Brenda Gallie Canadian
Ex- Officio - Brian Ouma (CEO) Kenya
3.2.5 Financial Capacity
Finance is a critical resource for the development and operational needs of an institution more so for a young organization DECF currently relies on donors and well-wishers for its financial requirements. As it plans its financial independence, there is a need for transparency, accountability and probity. These will be achieved through proper budgets and policy documents such as procurement, accounting and project management. Financial management will come with risks that will need to be mitigated. Such risks include liquidity, credit and market risks, which must be prudently managed.
3.2.6 Information Communication Technology (ICT)
ICT covers any product that will store, retrieve, manipulate, transmit or receive information electronically in a digital form. For example, personal computers, digital television and email.
Human Communication is essential in a situation where there is a wide audience that needs to be informed as lack of information leads to gossip and misrepresentation of facts as well as growth of an informal source of communication (grapevine). Therefore proper communication channels need to be in place to avoid a situation where others are left to interpret actions and events in their own ways. Communication has been defined as the sending of a message through a medium to a recipient. For communication to be effective, it has to be timely, accurate and relevant.
3.3 3 Evaluation of Past Performance
DECF has performed reasonably well since its inception. Through the Kenya National Retinoblastoma Strategy Group and its collaboration with the universities, teaching hospitals and the ministry of health, DECF has been able to deliver a national guideline that streamlines the treatment and management of Retinoblastoma in Kenya. This means that all children diagnosed with eye cancer in Kenya undergo standardized treatment and management.
DECF has worked with the Ministry of Public Health to include information about early signs of retinoblastoma in the Mother and Child Health booklet. This systemic nationwide education to parents and primary health workers will aid early referral, diagnosis and treatment, improving prognosis and reducing burdens on the health system and parents. Prior to roll-out, a study of children diagnosed with retinoblastoma in a two-year period recorded age and stage of disease at diagnosis. This baseline data will enable assessment of the booklet’s impact on diagnosis.
DECF initiated child life training at the Sally Test Paediatric Centre in Eldoret, giving doctors, nurses and other health advocates skills to deliver child centred care and family support. Child life promotes effective coping through play, preparation, education and self-expression activities based on natural child development. Training is led by our Certified Child Life Specialist, Morgan Livingstone. In class learning and hands on practice includes training in medical play and simple explanation to prepare children for procedures; self-expression tools for a non-verbal or distressed child; distraction play and comfort positioning to reduce procedure anxiety and increase co-operation; massage and guided imagery to control pain and help the child relax; palliative care, including grief and bereavement support for the family; and recreational activities to lift spirits. Child life can reduce treatment costs, for example, by eliminating the need to anaesthetise children during procedures like lumbar puncture and radiotherapy.
Cycle of Light / NHIF enrolment etc…
DECF has also improved the management of patient information through eCCRb; an online database that ensures patient information is recorded and made available to any doctor managing the patient wherever they are referred. We however face challenges in getting complete data especially where physical infrastructure for example computers and Internet are lacking.
In supporting the development of skills, DECF has facilitated training for ocular and orbital pathology Pathology and Clinical Retinoblastoma at The Hospital for Sick Children,Toronto, Canada, We have also facilitated training of 18 histopathology technologists in-country and we continuously offer training on treatment and management of Rb to doctors through our international team that operate on complicated cases together with the local doctors once a year.
Research and Innovation is also at the core of DECF and since its inception it has supported three research projects of which one is complete and the paper published. The other two are currently ongoing. The research completed helped to establish baseline Rb epidemiology in Kenya and the other two are focused on assessing the quality of processing of specimens so as to improve histopathology and in the long run, diagnosis.
3.4 4 Recent Development
KNRbS scale to East African National Rb Strategies (Country Focus Strategy to Global Focus Strategy)
There has been keen interest from Ghana, Ethiopia and Uganda for DECF K to have a presence or invest its resources and expertise in these countries. Delegations of Rb workers from Uganda and Ethiopia have experienced the KNRbS making process, first hand and wish to replicate the model in their countries, with technical support from DECF K. We have unique competencies that can be exported to Uganda and expose workers to a new management paradigm. The opportunities for DECF K to scale the KNRbS to an East African Country National Rb Strategies remain a pregnant point. Uganda is particularly interested in collaborating in the development of their own national strategy. Logistical challenges have limited the scope of DECF K outreach activities. However DECF K technical experts have traveled to Kampala, Uganda and Addis Ababa, Ethiopia on capacity sharing activities, which have required some financial outlay. Kenya and Uganda in particular are socio-culturally similar countries and can easily leverage on each other’s synergies to develop a strong Rb co-competency in the region. DECF wishes to play a leadership and catalytic role for a renewed push for all east African countries to have their own national Rb strategies. This wish must be communicated to all stakeholders. We have developed a guide handbook that outlines step by step how Kenya reached where it is now, lessons learnt and best practices. We are very excited with this next phase of DECF.
In summary, DECF must realize that with its leading competitive advantage in the region, it is in a unique Strategic space. Moving from a domestic to an international presence has various strategic challenges. DECF must aim to meet this challenge effectively by crafting a strategy for the entire network that does not require strong coordination from the centre but is responsive to national and regional environmental needs as we pursue a ‘’One Rb World” integration. The different countries should be encouraged to respond to local needs unless there is reason for not doing so. The degree and the level of, standardization of the future National and Regional Guidelines is a conversation that has already been initiated by some key COECSA operators and other stakeholders.
3.5 5 External Environment Analysis (PESTEL Framework)
The external environment of the DECF-Kenya is divided into general and operating environments. The general or macro-environment includes external factors that usually affect all or most organizations. These factors include political, economic, social-cultural, technological, demographic and legal (PESTEL) forces. The operating environment, on the other hand, includes those external forces and groups that external influence that affects DECF-Kenya growth, success and survival. These are “owners “ “customers’, “competitors”, “suppliers”, ‘government regulators”,” pressure groups” and “employees”. The outputs of external environment analysis are the opportunities (favorable conditions) and challenges (unfavorable conditions) facing the DECF.
3.5.2 2 Political Environment
• Devolution has affected DECF-Kenya in the classification of hospitals.
• Co-ordination office: changes no longer centralized.
• Difficulty in monitoring patients.
• Public Doctors boycott (due to poor remuneration and working conditions)
• Understanding devolution challenges.
• COECSA (EACO/OSEA) – a unifying body for all ophthalmologists and advantage to DECF-Kenya.
• Peaceful environment in the Country has encouraged doctors from other countries to come and work and carry out research
• Doctors from different regions perceive issues differently this leads to conflict of interest.
3.5.3 3 Economic Environment
• Resources; there is a scramble for resources by all NGO’s which has lead to financial challenges.
• Government funding has gone down so DECF-Kenya is forced to pay for the services they offer to the public e.g. (printing of posters)
• Consortium – it is hard to get into the consortium to enable bid for funds/ finances, allocation of funds in the consortium is marked with politics during the resource allocation
3.5.4 Social-cultural Environment
• The socio-cultural environment encompasses characteristics, values, ideas and attitudes of people. Family life is the pillar for socio-cultural characteristic and these might greatly be influenced by various factors in a society including politics, education economic status and changing lifestyle. Some of the values may be pegged on traditional and cultural beliefs, norms, taboos and practices that may interfere with complete medication or treatment and care of a patient. Some ethnic groups may not have shed off witchcraft beliefs and practices, which contradict the process of treatment. This is therefore a challenge to DECF’s mission.
• High poverty levels limits chances of survival for eye cancer patients.
• Minimal survival chances for eye cancer patients as a result of poor access to health care / medical facilities. Distances to the medical facility (accessibly to medical/health care)
• Age factor is an issue since it affects children of younger age between 1-7 years. Parents abscond responsibility to take care, value older ones more than young children.
3.5.5 5 Demographic Environment
Population growth, shelter and housing, health and related disease pandemics are most external issues affecting families in the communities. The segment of the population aged 1-7 years form a critical resource for the future, it is therefore important to invest in young people’s health and development. Disparities in the provision of health services continue to widen in Kenya especially in terms of access and affordability. People are known to travel many kilometers in many parts of the country to seek medical services, with the small number of Doctors offering quality medical services may not be forthcoming. In addition many families find it difficult to meet medical expenses due to declining income and constantly increasing costs. As a result, there’s increasing tendency to delay seeking medical attention. Many children are therefore at risk complications and death due to delayed medical services. DECF-Kenya is challenged in this area and need to seek support from government and well wishers in order to provide proper timely treatment and care to children with retinoblastoma countrywide.
3.5.6 6 Technological Environment
DECF-Kenya accesses minimal patient information of the thus a lot of gaps are created which makes it difficult to monitor or assist the patient further e.g. Genetic information or doctors detailed information which has strict procedures to obtain
E- Cancer records (physical files) unveiled, tracking the movements of the file from one point of treatment to the next point is a challenge therefore it is difficult to monitor a child to facilitate check up and provide for drugs and fare.
Centralized Lab UON, Dental School/College of ophthalmic merge an advantage to DECF-Kenya operations.
3.5.7 7 Legal Environment
Regulations on Ethics regarding patient’s information is an issue/challenge to DECF-Kenya since the process of getting Ethics approvals is quite lengthy and sometimes by the time you get it, the need for the data is long overdue.
Implication of the PBO act to be included.
3.6 Stakeholders Analysis
A stakeholder is any person, group, that can place a claim on the DECF resources, attention, or output, or is affected by its output. A stakeholder analysis is the means for identifying who DECF-Kenya customers/stakeholders are; how they influence DECF-Kenya; what DECF-Kenya needs from them; and how important they are to DECF-Kenya. There are two types of stakeholders: external and internal stakeholders.
An external stakeholder is any person or group outside DECF-Kenya who can make a claim on DECF-Kenya attention, resources, or output or is affected by DECF-Kenya output while an internal stakeholder is any person or group inside the and DECF-Kenya (employees and the volunteers’ and DECF-Kenya leaders). The key stakeholders of DECF-Kenya are summarized in table 3.1.
Table 3.1: The key Stakeholders of DECF
|STAKEHOLDERS |EXPECTATIONS |
|EXTERNAL STAKEHOLDERS | |
| |To be consulted and involved when changing Rb management strategy and policy |
|Children, parents, survivors and their wider family. |They expect to receive exemplary care, to be treated with respect and |
| |understanding, to be told what DECF is doing to help them, how and why this will |
| |make a difference. They need to be educated about how they can aid the process |
| |so more families benefit, to be given a platform from which to safely share their|
| |expierences without fear, to become ambassadors for other families and for DECF |
| |to help advance the org’s mission. |
|Ministry of Health- |To be involved and consulted in major key areas affecting DECF especially those |
|O.S.U |related to the management of Rb |
|K.N.H | |
|M.T.R.H | |
|Coast Provincial | |
|Kenya Society for the Blind | |
|Private / mission hospitals working within the KNRbS, e.g. | |
|Kikuyu, Lions, Lighthouse, | |
|Ministry of Education- | |
|U.O.N- |To be consulted and involved when changing Rb management strategy and policy |
|School of Medicine (Depts of Ophthalmology and Pathology) | |
|School of Dental Sciences (Dept of Oral and Maxillofacial | |
|Surgery, Oral Medicine, Oral Pathology and Radiology) | |
|County Authority |To be considered as key partners in the management of Rb |
|Suppliers of the organization | |
|Roche East Africa |To be engaged in the supply of goods and services pertaining to the management of|
|Faram EA Ltd |Rb |
|Eye NGO's |To provide benchmark and the support in the management of Rb |
|CBM | |
|OEU | |
|Sightsavers | |
|Kenya Society for the Blind | |
|Other NGO's |To be engaged in wider consultation in the areas of local funding |
|Kenya Community Development Fund | |
|Kenya Palliative Care Network | |
|Individual and corporate donors to the organization. | |
|REGIONAL STAKEHOLDERS |To be engaged all the time during major decision making affecting DECF |
|COECSA | |
|Makerere University | |
|Mbarara University | |
|Addis Ababa University | |
|INTERNATIONAL STAKEHOLDERS |They expect feedback on programs progress and to be engaged widely |
|DECF UK, CANADA AND USA | |
|University of Toronto - Dept of Ophthalmology and Vision Sciences| |
|The Hospital for Sick Children, Toronto | |
|Indiana University | |
|Child life trainer / facilitator | |
|Donors to DECF International | |
|INTERNAL STAKEHOLDERS | |
|DECF-Kenya -Board of Directors |To oversee policy formulation and implementation and to keep operations within |
|- Management Team |country laws and policies |
|Volunteers | |
3.6.1 Strengths, Weaknesses, Opportunities and Threats (SWOT) of the DECF-Kenya
After an in-depth analysis of the internal and external environment the following strengths, weaknesses, opportunities and challenges (SWOT) for the DECF were agreed on Table 3.2
Table 3.2: Strengths Weaknesses, Opportunities and Threats (SWOT)
|STRENGTHS |IMPLICATIONS |
|Skilled and well-focused human resource. |Creating technical assistance programmers' (KNRbS)- a database|
| |of the skills available |
| |Highly qualified super specialists in the treatment of cancer |
|Teamwork amongst staff board and stakeholders. |It creates a participatory system of management and ownership |
| |(programmes) |
|Monopoly – DECF-Kenya is the only organization that deals with retinoblastoma (Rb)|There is no competition from any other organization |
|core competency in Kenya. |DECF-Kenya is branded as Rb champions in the region |
|Enjoy tax exemption. |Encourages local donations and maximum utilization of |
| |resources |
|KNRbS Model; Inclusion and accountability. |Ensures DECF’S Legitimacy |
|Established in all medical teaching institutions in Kenya. |Brings about sustainability of the programme. |
|Produced The First Rb Best Practice Guidelines in the region. |Positioned to be a leader in Clinical care. |
|Strong Institution in DECF |Better able to negotiate or make demands on government and |
| |public servants on behalf of the Rb child |
|Unique programmes targeting capacity building of medical personnel and eye care |Highly qualified super specialists in the treatment of cancer |
|workers. | |
|The already existing awareness of retinoblastoma countrywide. |Provides public knowledge of Rb, |
| | |
| |Ensures early diagnosis thus reduced mortality rates |
|Published the first national guidelines on Retinoblastoma. |There is policy change |
| |Gives high level of treatment sustainability (Standardized |
| |treatment) |
| | |
|Partnering with centers of excellence (MTRH, UoN-Dental School, KNH, MoH-DOS) |Encourages research (Continuously provide solutions to Rb |
| |patients because there is ongoing research) |
| |Comprehensive medical care |
| |Encourages synergistic relationship |
| |Creates an opportunity for Medical tourism in Kenya |
|Modern and powerful digital microscopy scanning machines. |Better diagnosis which means better treatment |
| |Comprehensive storage of data |
| |Availing services through technology transfer. |
| | |
| | |
|Diversity in Top Management Team and Governance |Provides a multifaceted approach in solving problems |
| |Better leadership and direction |
|Experienced and highly networked board members |Gives a better direction for DECF-Kenya |
|Commitment to the children |Leads to the attainment of the DECF-Kenya Vision |
|Up to date Documentation of the fund by DECF |Provides information for prudent management of the fund |
|Cohesive dedicated and hardworking team |Steers the organization to greater heights |
|Keep close with big decision makers |Good for the organization future |
| |
|WEAKNESSES |IMPLICATIONS |
|Unmet expectations due to lack of financial resources. |Inability to achieve goals |
| |Inability to implement the strategic plan |
|Lack of control and monitoring of valuable assets (Scanners, microtome, Retcam |The equipment will be underutilized |
|camera etc.) when partnering with the Department of ophthalmology, Department of |DECF-Kenya inability to realize its objectives and service the|
|Maxillofacial Surgery and Dental school of the UoN |equipments effectively |
|Over dependence on foreign donors. |The programme is limited in scope |
| |There is no incentive to independently source funds locally. |
|Lack of a standard operating procedure for implementing enjoined DECF-Kenya / UoN |Poor service delivery |
|operations | |
|Monitoring of patient is not effectively streamlined due to insufficient data. | |
| |Management of patients is compromised |
| |Decision making is inadequate |
| |Loss of life |
|Rb only affects a few patients relative to other childhood cancers |Unattractive funding proposition |
| |Low adaptive viability to donor trends. |
| |Makes the trajectory to local capacity and ownership much |
|The initial intervention did not figure as highly in terms of local motivation and|harder. Means more staff time, energy, patience and skill, as |
|so the “buy in” has been slow. |well as strategic ability. |
|Insufficient, integration, consolidation of sustainable benefits that arise from |Stagnation, fatigue, collapse and non-sustainability of |
|development initiative |tangible benefits and other gains of the program |
|Ineffective and inefficient communication amongst the board, professionals and |Miscommunication |
|stakeholders |Inability to implement the strategic plan |
| |Demoralized workers |
| |Dissatisfied stakeholders |
|DECF-Kenya’s minimal provision to parents of eye cancer (Retinoblastoma) patients |Organization will lack experiential information about RB |
|participation |Future plans for awareness and care will be affected |
|Lack of localized website for DECF-Kenya |Communication breakdown |
|Historical weak investment in leadership, management and structural development |Looming leadership deficit |
| |
| |
| |
| |
|OPPORTUNITIES |IMPLICATIONS |
|Improve psychosocial care of children and families by expanding child life program|Equal access to family support, improve quality of life for |
|and family support, to all hospitals treating children with Rb. |children and families, reduce treatment costs and related |
| |burdens. |
|Working with families and survivors as advocates for other families and for DECF. |Greater buy-in by families and higher visibility with donors, |
| |fight stigma, aid peer-peer support, ensure the #1 stakeholder|
| |has a strong voice within the org. |
|Medical practitioners from mother country (Canada) |Exchange programme, research, training |
|Ability of our ECCRB model to go worldwide |Formation of a One RB World and better follow up |
|Potential development of partnership with Ruharo (Keith’s centre), Ghana, |Gives DECF a chance to benchmark. |
|Ethiopia. | |
|Genetic testing and counseling with the help of our Canadian Partners |Ability to develop a sustainable genetic counseling model in |
| |Kenya |
|Political goodwill from the Kenyan government |Enforce the implementation of the guidelines |
| |Assist in distribution of guidelines |
| |Agreeable to DECF-Kenyans request |
|Strong support from and ownership by stakeholders. |Implementation of guidelines will be easier |
| |Lower cost on implementation |
| |The organization will be much stronger |
|Local Willing donors |There will be leeway to work with the money as they understand|
| |the people therefore better implementation of grassroots |
| |projects |
|Operating Environment is conducive for growth and development. |Research and Training. |
| |DECF-Kenya can continue building its brand |
|Opportunity for supporting the crafting National Strategies for the different |Fosters regional collaboration. |
|countries in the region. | |
|Opportunity for supporting the Crafting and Guiding National Strategies for the |DECFK to begin crafting a Matching strategy, which takes into,|
|different countries in the region. |account its strength and weaknesses to exploit opportunities |
| |and deal with threats. |
|Wide Scope of growth for research. |There is evidence based care |
| |Publications and exchange programmes |
|Collaboration with stakeholders. |Better understanding among stakeholders therefore efficiency |
| |and effectiveness in running programs |
| |Harmonized ideas |
|The paradigm shift towards non-communicable diseases including Retinoblastoma |More funding opportunities |
| |Increased interest in the disease |
| |More awareness campaigns-Means early diagnosis and higher |
| |survival rates |
| |More professionals going into cancer issues therefore more |
| |expertise |
| |More research opportunities expected |
|Formation of College Of Ophthalmology East, Central and Southern Africa (COECSA) |Provides a platform to share DECF-Kenya experiences and |
|has created an opening to the international community. |disseminate research |
| |Provides an opportunity to learn from others |
|Cloud computing enabling electronic medical records specific for Retinoblastoma |Available information as and when needed |
| |More complete records available |
|Development of a business model for sustainability (Digital Microscopic slide |DECF-Kenya can charge for use of scanner to raise money and |
|scanner) |servicing of the scanner |
|Existence of histopathology of plants and animals |Possibility of partnering with the college of agriculture and |
| |veterinary science-UoN, KARI, ILRI and ICIPE |
| |Create opportunity for diversification of products and |
| |services |
| |Income and long term sustainability |
|Establishment of a technical assistance facility to generate revenue for |Consultancy for startups and related NGOs |
|DECF-Kenya endowment | |
|Public benefit organization Act dealing with civil society. |We can engage in business to raise funds for implementation of|
| |programs |
|Lead in research |Lack of competition which is a plus to the organization |
|Creation of National Cancer Institute (NCI) under the Kenya Cancer Prevention and |Increased visibility and sponsorship opportunities |
|Control Act. | |
| |
|THREATS |IMPLICATIONS |
|Lack of much investment on sustainability |Works against true empowerment and substantial development. |
|No accountability of seconded staff and stakeholders (Doctors, |Shift of control to local organization will never be achieved due to lack|
|researchers) to DECF oversight role. |of capacity. |
|Rb guidelines not part of National Cancer guidelines |Unsustainability |
|Different cultures between collaborations partners |Under achievement of goals. |
|Lack of a centralized budgeting system- internationally |Slows down service delivery |
| |Unequal distribution of funds to programs. |
| |Great danger of power play. |
|Lack / need of a proper process through which all stakeholders |Threats from Individual Regional Operators. |
|influence and share control over decisions and resources that affect |Internal process of engagement occasionally simply treated as a co-opted |
|their lives. |input, and means for making externally supported development happen more |
| |effectively. |
| |. |
|Emerging challenge of different treatment regimes. |Un guided pattern of Development of several Best practice Guidelines but |
| |implicit; is Quality and standardization will be in direct proportion to |
| |the skills and expertise available. |
| |Picks peace meal ideas on Guidelines and Implements in their countries |
|Over reliance on external funding. |Inability to sustain organizational projects |
|Reliance on project funding; Short term in relation to ultimate goal. |A lead to abrupt termination rather than phased withdrawal as appropriate|
|Focus on deadlines. |conditions are created; creates state of insecurity. |
|Inadequate source of funding for supporting families. |Life threatening to the children with Rb. |
| |. |
|Need for financial Incentives to gain professional staff (business |Runs counter to the spirit of voluntarism and self-motivation and the |
|overlap). |organization culture that goes with it. Creates; tension, conflict of |
| |conscience and personal conflict. |
| |Sway DECFK attention towards donors as primary stakeholders, rather than |
| |towards those who provide their legitimacy. |
| |Inconsistencies simply accepted for reasons of organizations survival. |
|Inability to efficiently utilize equipment provided by donors for |Wastage of resources |
|research purposes in between grants. |Compromises accountability to the donor |
| |Obsolescence of the equipment |
|Inability to develop and fund locally developed programs, |Kills innovation, morale and spirit of innovation. |
|Lots of funding directed to other strategies |Too many strategies blurs the focus of the intended strategy |
3.6.2 The Need for Change
Time has now come for DECF-Kenya to reassess its position and to strength its leadership role in health services .To this extent it is evident that the fund has to embark on a process of strategic change. This is necessary for greater relevance and efficiency in the manner in which it fulfils its mandate.
The level of effectiveness also needs to be increased through, DECF having well developed Standard Operating Procedures on how all its major activities should be undertaken.
The increase in cancer cases faces rising expectations and demands and experiences serious resource shortfalls. Planning therefore must take cognizance of all these challenges and respond to them effectively. DECF-Kenya has to continue to demonstrate greater accountability and sensitivity to the needs of stakeholders. There’s an odd duality whereby the fund is taking on greater responsibility while the level of its financial support from the donors is dwindling in real terms.
This new paradigm requires greater autonomy for the fund and a new strategic direction guided by a shared vision, strategic thinking and agility and positioning in a worldwide context. This paradigm is the major driving force for strategic planning in the organization.
This strategic plan assumes that the need for change is a genuine concern for all stakeholders, that the concerned parties will seek appropriate solutions and that they are capable of working together for the common good. The fund’s performance has been very good as it has maintained a leadership position locally in saving lives of children with retinoblastoma, the fund must sustain this leadership position, to continue to be the best and maintain its leadership locally and regionally, it has to embrace quality assurance, lead in quality, retain the right human capital within its rank and file and mobilize additional resources to provide the strategic direction in the long run.
The organization is over reliant on donor funding. To strengthen its financial sustainability, this situation has to change, and additional funding has to be sought from other sources. The sources include endowment, fundraising, establishing private-public partnerships or alliances.
CHAPTER FOUR: STRATEGIC ISSUES, OBJECTIVES AND STRATEGIES
STRATEGIC ISSUES, OBJECTIVES AND STRATEGIES
4.1 Strategic issues
A strategic issue also known as critical success factor is anything that must be addressed if the organization is to succeed. Inadequate attention to these issues will adversely affect the performance of the organization. Strategic issues In the light of the situational and SWOT analysis the identified the major strategic issues for DECF-Kenya which are outlined below:
1: Governance, Leadership and Culture
2: Resources, Facilities and Infrastructure
3: Research, Innovation and Technology
4: Collaboration and Partnerships
5. Awareness creation about Retinoblastoma
6: Efficient and Effective Treatment and Care for Retinoblastoma Patient
4.2 2 Objectives and Strategies
Performance objectives are long range results needed to carry out the DECF-Kenya mission. They represent answer to the question “Where do we want to go?” “Good” objectives must state what, how much and by when it is to be accomplished. In summary, good objectives must be specific, measurable, achievable, realistic, and time bound: SMART).
Strategies are major courses of action that an organization must take to achieve its objectives. They describe how objectives will be achieved. They answer the question “how do we get there”. Organizational strategies should be derived from analysis of operating environmental opportunities and problems; and resources and capabilities of the organization concerned.
After pertinent consultations and evaluations the key stakeholders of the DECF-Kenya formulated the following objectives and corresponding strategies for every strategic issue were formulated.
4.3 3 Strategic Issue 1: Governance, Leadership and Culture
The Board of Directors is the apex body in the governance structure of DECF-Kenya. The executive management under the direction of the chairperson constitutes the decision-making organ. Upon the promulgation of Kenya (2010) constitution and the subsequent review of various legislations, the legal landscape upon which the organization operates dramatically changed. The devolvement of health services to the counties has made it important for DECF-Kenya to recast its management structure and align itself to the counties to make it effective and efficient in the long run. As the organization charts its way forward, it is imperative that it reposition itself to fully comply with the new demands while taking advantage of the new opportunities in the operating environment, thus setting itself for maximum competitiveness and growth.
Objective 1: To manage the organization efficiently
Strategies
• Review the composition of the board structure, skills and competencies of the board members
• Create the oversight role of the Board
• Review Administrative structures and systems at the management level
• Creating a culture of ownership and effective strategy and policy execution
• Create mechanism for entrenching the core values of the organization among staff and stakeholders
• Enhance leadership skills and management capacity at all levels of DECF-Kenya
• To review Mission and Vision Statement of DECF-Kenya
• Create mechanisms for succession at the board and management level
Expected outcomes:
• Improved efficiency and effectiveness
• Effective monitoring and evaluation, and
• Enhanced commitment and loyalty to DECF
• Enhanced strategy implementation and execution
4.4 4 Strategic issue 2: Resource, Facilities and Infrastructure.
The ability of the organization to deliver on its mandate will depend on the availability and efficiency of their resource deployment. The resources are the finances, human capital and the total support infrastructure. This strategic plan will need an up-scaled level of resources to deliver the planned outcomes. Failure to pay adequate attention to the resource challenges will lead to sub-optimal performance.
Objective 1: Encourage all trusts, funds and all DECF’s confederates to give money for an endowment fund
Strategy
• Establish an endowment fund as soon as possible.
Objective 2: To expand the organizations resource base and enhance productivity
Strategies
• Invest in fundraising training to skill up those responsible for in-country income generation.
• Increase the organization revenue by partnering with the local donors
• Improve staff motivation
• Entrench the use of ICT in the organization
• Aggressive resource mobilization initiatives by DECF-Kenya
• Innovative mechanisms for resource mobilization
• Explore alternative means of investment
• Acquire property to enhance and improve financial resources
• Build a home for the parents of the Retinoblastoma patients during treatment
• Awaken philanthropic spirit in Kenya
• Develop a plan for the maintenance of acquired equipment from suppliers and donors
• Efficient utilization of available resources
• Underpin all Rb activities in the overall organizational budget
Expected outcomes
• Increased and sustainable financial performance
• Increase of physical infrastructure
• Effective use of ICT in research and administration
• Productive and motivated workers
• Achieve a strong financial base
• Enhance savings of funds
• Addresses all priority areas and prudent financial management
4.5 Strategic issue 3: Research Innovation and Technology
Research, innovation and technology transfer have great potential for wealth creation and contribution to sustainable national development.
Objective 3: To promote Evidence Based Research and advocate for modern medical equipment that will facilitate treatment and enhance research.
Strategies
• Enhance the capacity of researchers to develop winning proposals
• Improve research infrastructure and grants management systems
• Enhance dissemination of research outputs to society
• Partner with other stakeholders for joint research
• Enhance the implementation of research findings
Expected outcomes
• Enhance research output
• Enhance donations and collaboration
• Improve efficiency in grant and donor funds management
• Increase innovations and impact of research output
4.6 6 Strategic issue 4: Collaboration and partnership
In age of globalization, the trend is for institutions to foster networks, partnerships and linkages to enhance their competitiveness. The DECF-Kenya occupies a position of great advantage and can be used in fostering mutual linkages and partnerships with peer institutions and industry. Whereas the DECF-Kenya has a number of existing linkages, more value adding networks, partnerships and linkages need to be established at the national, regional and international levels if the Fund is to reposition itself in the global arena as a viable and vibrant organization.
Synergy-building relationships with various key stakeholders are critical to the overall success of DECF-Kenya. It is important that it positions itself in such a manner that mutual benefits of all parties are best achieved. Given the nature and scope of its activities, the various categories of relevant stakeholders that DECF-Kenya comes into contact with, is enormous. The key stakeholders that have been identified include the private sector, government agencies, peer organizations, and the DECF-Kenya stakeholders. It has emerged that the various stakeholders are positively predisposed to work on joint agenda with the DECF-Kenya.
Objective 4: To enhance value adding partnerships and collaborations
Strategies
• Increase collaborations and engagement with stakeholders
• Enhance partnerships and collaborations with public and private sector locally and internationally
• Deepen partnership with UON and MTRH
• Work closely with MoH department of DOS
• Support development of awareness materials and facilitate workshops for eye care workers countrywide
• Strengthening existing partnerships and linkages and develop new ones
• To enhance partnership and collaboration with national Cancer institute
• Enhance participation in policy making, events related to cancer
Expected outcomes
• Improve quality of research
• Cordial relationship with stakeholders
• More volunteers on board thus enhancing collaboration and performance of DECF-Kenya
• Retinoblastoma information incorporated in mothers and child booklet to enhance awareness countrywide
• Field eye care workers encouraged and motivated
• Adapt serious partnerships and alliances locally
• Enhanced visibility
4.7 7 Strategic Issue 5: Awareness creation about Retinoblastoma
Strategic Objective: To contribute to the development of society through creation, storage, application and dissemination of knowledge
Strategies
• Sensitizing public about retinoblastoma using electronic, print media
• Mother and child Health booklet and Website.
• Sensitize the maternal health workers and pediatric community on Rb
• Improve communication style
• Facilitate training
• Expand to other countries by providing retinoblastoma guidelines
Expected Outcome
• Create awareness through electronic and print media
• Develop awareness materials e.g. posters
• Conduct workshops for eye care workers
• Collaborate with ministry of health’s department of DOS to include information in the health materials (Literature)
• Improve management of Retinoblastoma information
4.8 8 Strategic Issue 6: Efficient and effective treatment and care for Retinoblastoma patients
Objective 6: To ensure all children with Retinoblastoma receive timely, adequate treatment and care
Strategies
• Implementation of the National Rb Guideline.
• Early, timely diagnosis of Retinoblastoma
• Facilitating patients treatment
• Improve data capture mechanism for decision making
• Engage specialized doctors
• Planning treatment schedule for patients who require specialized attention
• Organize for patients counseling
Expected outcomes
• Enhance early detection thus reduce mortality rates and increase survival rates
• Fast/quick medical attention
• Enhance monitoring of Retinoblastoma patients
• Improved treatment and care
• Improved maintenance and efficiency of equipment
• Restoring sight
• Enhance support of patients family
• Saving life and restoring sight
• Psychological support
CHAPTER FIVE: STRATEGIC PLAN IMPLENTATION AND ACTION PLANS 5
STRATEGIC PLAN IMPLENTATION AND ACTION PLANS
5.1 1 Introduction
Plan implementation is the action stage of strategic management. The activities central to plan implementation are establishing annual objectives; devising policies; allocating resources, altering an existing organizational structure; revising reward and incentive systems; minimizing resistance to change; developing a strategy-supportive work environment and organizational culture; adapting operations, service delivery; and information systems; and developing an effective human resource capacity to deliver the plan.
5.2 2 Governance and Organization Structure
The appropriateness of an organizational structure is judged according to how well it aids in the achievement of the DECF-Kenya objectives and how it affects the behavior of the individuals in the DECF-Kenya. In general the characteristics of an ideal organization structure are that:
The structure should clearly show the positions in the organization and the authority that go with it;
The structure should show explicitly the chain of command in the organization, and the reporting relationships with clear indications of who has supervisory powers over whom and what the boundaries of such powers are;
It should bring out clearly both line and staff responsibilities, and show which positions are in the direct line of command (those charged with the achievement of primary organizational objectives) and which positions are advisory (staff positions) to line authority.
The structure should bring out an appropriate span of control (management), and the number of people that can directly and effectively report to the manager;
The structure should be able to show activities of each unit and how the activities relate to other units (coordinating role) and contribute to the overall performance of the organization;
The structure should minimize bureaucracy and delays in the provision of services to stakeholders; and indicate when and where deviations from planned performance are occurring and therefore facilitate corrective actions.
Using the DECF-Kenya Vision, Mission, strategic objectives, and the above characteristics of an ideal organizational structure, as frame of reference, the DECF-Kenya management has developed an administrative structure to guide its operations and facilitate in the implementation of the strategic plan.
5.3 3 The Strategic Plan Implementation Matrix
The matrix indicates what activities are going to be undertaken, by who, when, with what resources, and the expected results. Action plans serve as a link between plan formulation and monitoring and evaluation; help in both the appraisal of performance and in the identification of any remedial actions, and contribute to better motivation of staff through explicit assignments of responsibilities for implementing and monitoring the programme. The relevant action plan matrices for DECF-Kenya are presented in Table 5.1.
5.3 Table 5.1: The Strategic Plan Implementation Matrix
| Strategic Objective 1: To manage the organization efficiently |
|STRATEGY |STRATEGIC ACTIVITIES |PERFORMANCE INDICATORS / TARGETS |TIME FRAME |RESPONSIBILITY |RESOURCES |
|Review Administrative structures |-Develop a new |Undertake |2 years |CEO |Financial Budget |
|and systems |administrative structure |gaps/skills/competencies | | |Consultants |
| | |assessment once in 2 years | | | |
| |-Develop Finance Manual, |Draft documents |2 years |Administration & operations |- Consultant |
| |Succession plan, SOP’s |Reviews | |manager |-Financial budget |
| |with collaborators |Approvals | | |-BOD |
| | |Consultative meetings | | |-Senior Management |
| | |All documents are developed | | |Team |
|Review the composition of the |-Undertake an assessment |- A well documented BOD |3 years |CEO |Financial Budget/Funds |
|board structure skills and |of BOD skills and capacity|structure. | |Secretary of BOD (CEO) |Consultants |
|competencies of the board members |- Hold a BOD workshop for |- An all round board with | | |Human resource |
| |review. |required core competencies | | | |
| |-Hire a consultant to |(balanced mix) | | | |
| |facilitate this process |To be undertaken annually | | | |
| | | | | | |
|Create the oversight role of the |Creating relevant BOD |Existence of functional BOD |1year |Chair |HR |
|Board |committees |committees. | |CEO |Finance |
| |Meetings |Proper documentation of this | | | |
| | |committees | | | |
| | |Minutes and resolutions | | | |
|Creating a culture of ownership |Annual meetings with all |Documented outcome of the |1 ½ years |-BOD and management |- Finances |
|and effective strategy and policy |stakeholders. |meetings. | | |-BOD and top management |
|execution |Inclusion of all |Buy in by all stakeholders. | | | |
| |stakeholders in the |Existence of well developed | | | |
| |development of policies. |MOU’s. | | | |
| |Drafting joint MOU’s |Training BOD / management on | | | |
| | |change management | | | |
|Create mechanism for entrenching |Documenting and Framing |Framed core values in DECF-Kenya |Annually |Administration & operations |- BOD, |
|the core values of the |the core values |office. | |manager |- Management |
|organization among staff and |Daily practice of core |Existence of the core values in | | |- Stakeholders |
|stakeholders |values. |the policy documents. | | |- Consultants |
| |Hold meetings to assert |Minutes of the meetings held | | | |
| |the values (team |Training management on change | | | |
| |buildings) |management | | | |
|Enhance leadership skills and |Undertaking trainings at |Well-documented number of |Annually |-BOD |- Finance |
|management capacity at all levels |all levels |trainings and seminars attended. | |-Management. |- Human Resource |
|of DECF |Attending seminars. |Core competencies gaps filled | | |-Consultants |
| |Continuous recruitment of |through recruitment. | | | |
| |required skills. |Support from BOD and donors | | | |
| |. | | | | |
|To review Mission and Vision |- Holding a one day |- A well documented, fitting, |Immediately |- Consultant |- Consultants |
|Statement |discussion with a |catchy, vision and mission. | | |- DECF team/ Stakeholders |
| |consultant | | | | |
|Create mechanisms for succession |-Developing a Human |Draft documents |2 years |BOD |Consultants |
|at the board and management level |resource strengthening |Reviews | |SMT |Management |
| |Strategy |Approvals | | |BOD |
| |- Developing a |Consultative meetings | | |Finance |
| |Sustainability strategy |- Well-documented HR, Finance and| | | |
| |- Developing a Finance |Sustainability strategies. | | | |
| |strengthening strategy | | | | |
|Objective 2: To expand the organizations resource base and enhance productivity |
|STRATEGY |STRATEGIC ACTIVITIES |PERFORMANCE INDICATORS / TARGETS |TIME FRAME |RESPONSIBILITY |RESOURCES |
|Increase the organization revenue |- Engaging with local |3 successful proposals done |Annually |Programme Manager / BOD |- Finance |
|by partnering with the local |donors (corporate, |1 local MOU signed | | |-High net worth individuals. |
|donors |individuals, foundations) |Number of joint activities | | |- |
| |Writing proposals to local| | | | |
| |donors | | | | |
|Improve staff motivation in |Incentives (awards, |Successful implementation of a |Annually |- BOD |- Finances |
|DECF-Kenya |monetary etc. |training plan. | |- HR |-Consultants |
| |Career development |Successful implementation of | | |-Relevant Institutions |
| |(training, seminars, |career advancement plan. | | | |
| |workshops, mentorship |Favorable annual appraisal | | | |
| |etc). |Certification | | | |
| |Recognition. | | | | |
| |Job enrichment | | | | |
| |Improve employee welfare | | | | |
| |(e.g. medical insurance). | | | | |
| |Competitive compensation | | | | |
| | | | | | |
| | |Benchmark with industry. | | | |
|Entrench the use of I.C.T in the |Training |Certification |Annually for five years |BOD |Finances |
|organization |Procuring requisite |Annual relevant trainings | |CEO |Technical expertise |
| |software, licenses and |undertaken | |Programmes manager | |
| |hardware. |Relevant software and licenses | | | |
| | |acquired | | | |
|Innovative mechanisms for resource|Develop a technical |Technical assistance provided |In 5 years |CEO |- |
|mobilization |assistance facility |once. | | |Finances |
| |(KNRBS) and equipment | | | |Technical resources |
| |servicing). | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Commercialization of |Amount of revenue raised. |5 years | | |
| |digital pathology. | | |Finance Manager/CEO |Finances/Human Resource |
| | | | |Finance manager/CEO |Finances/Human Resource |
| |Documentaries (crowd |2 successful crowd funding | | | |
| |funding). |initiatives done. | | | |
| | | |In 5 years | | |
| | | | | | |
| | |3 Signed partnership MOU’s | |CEO |Finances/Human Resource |
| | | |5 years | | |
| |Formation of strategic | | | | |
| |alliances. | | | | |
| |(Create partnerships for |Opportunity cost of skills and | |CEO |Finances/Human Resource |
| |skilled HR) Seek donations|services offered | | | |
| |of expertise from | | | | |
| |corporate | |5 years | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |Leverage existing HR |Prioritization of resource | | | |
| |skills and services with |Mobilization efforts. | | | |
| |probono support from | | | | |
| |corporates & skilled | | | | |
| |individuals. | | | | |
|Efficient utilization of available|Underpin all Rb activities|- Spending based on budget |Within two months of the |BOD |- Finances |
|resources |in the overall |created |financial year |CEO |-Human Resources |
| |organizational budget |- Proper allocation of resources | |Management | |
| | |to address all priority areas. | | | |
| | |- Existence of internal and | | | |
| | |external accountability, | | | |
|Engaging with the central and |To align the DECF-Kenya |-Avail documentations e.g. cancer|Within 2 months from |CEO/BOD |-Finances |
|county governments to mobilize |activities to government |control Act, PBO Act |implementation period | |-Human Resources |
|resources |policies and instruments | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
| |
| |
| |
| |
|Objective 3: To pursue Evidence Based Scientific Research and provide modern medical equipment that will facilitate treatment and enhance research |
|STRATEGY |STRATEGIC ACTIVITIES |PERFORMANCE INDICATORS / |TIME FRAME |RESPONSIBILITY |RESOURCES |
| | |TARGETS | | | |
|Enhance the capacity of researchers to |Training workshop/s |Development of 3 successful |5 years |CEO / International and local |Financial |
|develop winning proposals | |grants | |experts (AMPATH) |Human resources |
|Improve research infrastructure |Develop policies for |An increase in publications |2 -3years |CEO |Finances |
| |training, maintenance of new |Improved Research into new | | |Equipment & training |
| |and existing equipment and |areas | | | |
| |Obtaining more equipment |Efficient working of equipment | | | |
| | |More equipment | | | |
|Enhance dissemination of research |Publish in peer reviewed |5 publications | |CEO |Finances |
|outputs to society |journals | |Annually |Research committee |Researchers |
| |Present research findings at |5 presentations | | | |
| |local and international | | | | |
| |conferences | | | | |
| Partner with other stakeholders for |Hold a stakeholders’ forum | | |Research sub-committee | |
|joint research |for NCST, universities & | | |appointed by the Board/CEO | |
| |development partners |One forum annually |Every year | |Finances |
| |including DFID & USAID | | | |Human Resource |
|Enhance the implementation of research |-Review clinical SOPs once a |Annual review |Annually |Research committee appointed by|Time, Financial and |
|findings |year | | |the Board/CEO |Human resources |
| |-Review non-clinical SOPs |Bi-annual review |Biannually | | |
| |once every two years | | | | |
|Strategic Objective 4: To enhance value adding partnerships and collaborations |
|STRATEGY |STRATEGIC ACTIVITIES |PERFORMANCE INDICATORS / |TIME FRAME |RESPONSIBILITY |RESOURCES |
| | |TARGETS | | | |
|Improve collaborations and engagement |Identify potential |Number of new collaborators per|Continuous but yearly |Board/CEO |Time, |
|with stakeholders |collaborators eg |year |accountability for 5 years| |Financial |
| |National Cancer Institute, |number of stakeholder forums | | |Human |
| |Oncology society, Pathology |Increased visibility | | | |
| |society, Pediatric society, |Increased awareness | | | |
| |private sector, MOH, DOS, UoN. | | | | |
| |Stakeholder forum to identify | | | | |
| |how we collaborate | | | | |
|Enhance partnerships and collaborations|Develop MOU’s and SOPs on ways |Increased two-way |Yearly (2-3 MOUs) |Board /CEO |Time |
|with public and private sector locally |to make collaboration |communication, breaking | | |Finances |
|and internationally |worthwhile to partners |communication barriers | | |Human Resources |
| | |Inclusion in national policy | | | |
| | |making decisions | | | |
| | | | | | |
| | | | | | |
|Deepen partnership with Universities |Develop MOU’s &SOPs with |Sub MOU’s with the 4 | ................
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