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January 23, 2012

Wisman on MLI: Skepticism faded, trust grew

Ministerial Leadership Initiative for Global Health
 Rosann Wisman Photo Credit Dominic Chavez

At MLI’s high-level roundtable “Advancing Country Ownership for Greater Results” held earlier this month, I spoke about the healthy skepticism that existed at the beginning of the MLI project and, in the end, a willingness to trust and take some risks.

I first mentioned skepticism on the part of country ministry leaders like Dr. Kisito Daoh, the chief medical officer in Sierra Leone, who found it hard to believe that MLI really wanted to hear about his priorities and opinions, particularly around our request for him to help us hire a senior advisor that he could trust.  But there also was skepticism on MLI’s part when Minister Tedros Adhanom Ghebreyesus in Ethiopia wanted MLI to invest in a strategic planning and management system for the entire health sector.  And there was skepticism from donors in Mali when the ministries of health and social development wanted to expand the community based health insurance program to a national scale. 

But in each of these cases, skepticism faded and trust grew.  We took risks because we trusted each other and that led to more effective programs moving forward.

MLI was originally about building leadership.  We found there are many truly effective leaders in ministries of health.  Our work was less about building leadership, but more about unleashing that leadership and finding ways to help ministry leaders convince donors and development partners that their priorities should be supported. Their priorities, informed by civil society and local partners, had the greatest chance for success and for national impact. 

At the roundtable, MLI released its MLI Model for Advancing Country Ownership.  The Model focuses on four principles: country-led planning, demand-driven technical assistance, south-south collaboration, and strategic communications.

The MLI Model worked because we showed in five countries that we listened well; we took some risks; we built trust; and we built relationships with ministers and also with teams within ministries.  All of this assistance supported the ministries’ priorities.

Last May, the ministers from our five countries released a Call to Action to advance country-led development in health.  This document is not just rhetoric. These leaders know what their countries need, they want success, and they want programs that will improve the health of their citizens on a national scale.  The Call to Action says, ‘Listen to us and work with us.’ If we do, together we can make a difference.

There is still skepticism about country ownership. But time and money is too short to keep addressing development practice in the ways of the past. 

In our experience with MLI, we have learned that developing country governments, through their ministries of health, can lead the way. 


Additional blogs from the "Advancing Country Ownership for Greater Results" roundtable include:

Voices on Ownership: Administrator Rajiv Shah

Voices on Ownership: Minister Tedros Adhanom Ghebreyesus

Voices on Ownership: Development Leaders

Voices on Ownership: US government officials