Part 4: Leading Major Donor Projects

The four authors in Part 4 have led projects or programs funded by major donors, either as donor staff or as a contracted implementer. Such projects and programs are generally of a different magnitude than most of the projects mentioned by other authors. They require meeting both the expectations of the donor and the expectations of the local stakeholders, which adds a significant “both/and” paradox to the leaders.

Nicole Rouvinez-Bouali, the author of Chapter 13, is a neonatologist who has led projects to reduce neonatal mortality in Benin and other countries. She writes that as a leader she initially creates a safe-space for the local healthcare leaders she is working with by acknowledging that neonatal mortality is the result of a multisystem problem and not only their fault. Using the “humble inquiry” approach, she focuses on building a close working relationship based on mutual trust, recognizing that the local leaders own the problem and the solution. Dr. Rouvinez-Bouali admits that her biggest challenge as an expert with knowledge of international best practice has been initially believe that her Western solution to improve newborn survival was the best solution for the local low-resource environment. As she writes “we tend to ask local teams to ‘change’ their procedures based on innovation and proof of concept issued from international evidence, which may or may not yield the same results in local conditions. Instead, it may be more appropriate to stimulate local solutions to generate culturally appropriate and affordable solutions that can be sustained by the local teams and health system” through the process of “Co-Production” that derives from partnerships based on shared values.