YOU ARE HERE:
The Salvation Army
   Last updated: 16.08.02
“Concept Transfer” Approach to Scaling-up
Implementers

The Salvation Army provides regionally based support to local field programmes in the areas of HIV/AIDS, health, and development. A key mission has been to support and expand local community capacity development for care and prevention, while influencing policy at multiple levels through sharing the meanings of community capacity and experience. The focus of this case study is the Salvation Army’s work through its Africa Team in 12 African countries.

Background
Based on an integrated home-based care and community prevention approach that started in 1987 at Chikankata Hospital, Zambia, the Salvation Army developed a process of “concept transfer” as the foundation for further expansion. This is an approach to promote the response to HIV/AIDS at the local community level, and the process lies at the heart of much of the work that the Africa Team is conducting throughout the continent.

The concept transfer process breaks new ground in capacity building and scaling up for HIV/AIDS programming. From 1990 to January 2000, this approach has been used worldwide by the Salvation Army to develop 88 programmes in 37 countries, with estimated coverage reaching 3.5 to 4 million people.

The approach is based on the use of international and regional “facilitation teams” that work with local stakeholders to explore such key concepts as participatory caring, community as “belonging,” change, leadership, and hope. Using such concepts rather than a “one size fits all” programme design model, the teams work with the local Salvation Army and others in the context of local communities, so that responses are based on the community’s capacity for addressing HIV/AIDS prevention, care, and support. The aim is to improve and expand the impact both of the response within communities (defined by the Salvation Army as scaling out) and within and between organisations (defined as scaling up). The approach is non-prescriptive regarding protocols and planning tools, yet appropriately supports understanding of development planning cycles and processes within each setting.

The teams are involved in three “learning pathways”: programme-to-programme visits, attachment or “loaning” of team members to organisations, and courses focusing on health-related community development.

Objectives and main activities
The overall goals of the program include:
• Increased community capacity to cope with and take responsibility for HIV/AIDS and its impact.
• Improved quality of life for individuals, family, and community members affected by HIV/AIDS.
• Decreased transmission of the virus, measured through behaviour change at the community level.
• Capacity development through the sharing of lessons learned and transfers of ideas and linkages with other organisations.
• Development of a pool of skilled people from within field programmes who can facilitate programme development in other locations.

Major activities include assessment and relationship building, participatory programme design and support, participatory evaluation, documentation, co-ordination of programme-to-programme visits, regional and sub regional consultations, inter-organisational sharing for increased capacity development and influence on policy development/formation, reflection and application of lessons learned from HIV/AIDS to other areas of health and development work, analysis of the processes that facilitate change, and sharing of lessons learned.

The process of expanding the African community response has included:
• Demonstration that local community programmes have the capacity to act, to measure their own change, and to transfer concepts to other communities.
• Support from the Salvation Army’s International Headquarters Health Services for team formation.
• A consultation workshop to solicit input on the facilitation team process from field people and some leaders, as well as UNICEF.
• Responding to an increasing volume of requests from the field and from national leaders.
• Appointment of an Africa-based co-ordinator in 1995 and a co-co-ordinator in 1996.

Regional programme activities in Africa for 1999 included development of a participatory evaluation process with clinic teams in Ghana, a community counselling workshop in Malawi, and health management consultations in Zimbabwe and Ghana.

Resources and timeframe
While the Salvation Army cannot support entire funding of the programme, the 25 percent component is symbolically significant to signify ownership and to motivate external donors.

Internal organisational implications
The team facilitation approach has required the Salvation Army to redefine all of its core functions in order to become a real and meaningful resource in the countries where it works. It has also meant that there is a constant need to look outwardly and develop new perspectives that put local community capacity at the moral and spiritual centre of all of the work. Recruiting new people to facilitation teams and becoming involved with new partner organisations also expands the organisation’s perceptions and functioning.

Staff and volunteers have been energised by the evolution of such new approaches, although the experience can sometimes be confusing and even threatening because there is some loss of central control. Yet as this form of control has diminished, the organisation has gained in influence. Because of the clear benefits of this approach, organisational commitment to expansion is strong and plays a key role in sustained involvement.

Overall, the Salvation Army has gained important experience in community capacity development approaches involving health and other development issues, new perspectives on facilitation and local participatory approaches, and successful mutual learning pathways. Budgetary concerns have become less important as “participation” becomes more important than “provision.”

Evaluation
Monitoring activities include on-site visits by the international team to each regional team, regional and international consultations, and mutual accountability and support. Evaluations are also done on a local basis using a participatory design, with the help of a multicultural facilitation team.

Lessons learned
Overall, programme experience—affirmed by an external evaluation conducted in June 2000—demonstrates that local participatory design and evaluation done with the help of a multicultural facilitation team can be very successful. Such success has led to growing quality in resource pool development, the greater involvement of local and regional leadership, and smoother inter-organisational sharing.

Important barriers to progress remain, though. Some resistance to these concepts is still evident among leaders and some institutional based programmes. Areas that require improvement include the further development of team leadership and “decentralisation” from the two co-ordinators, with even greater leadership involvement, and greater understanding of the external evaluation process. The team approach needs to involve a highly developed sense of collectively shared consciousness and vision, and refers to the responsibility and presence of team leadership.

Other key lessons learned include the following:
• Successful community-to-community transfer is an incentive to other local communities.
• During the early stage of an activity, it’s important to identify leadership among team members from the resource pool stage and to commit to intensive activity.
• The scaling up process is helped by a shared vision of local community capacity development and developing complementary ways of working that serve local responses.
• It’s critically important to include local implementers in planning cycles and to involve service beneficiaries.
• Discussing leadership and personal security issues strengthens teams and helps bond the team to local stakeholders.
• Frequent policy discussion based on concept and process analysis is necessary and must include field implementers and members of the community.

Source: A Question of Scale
This is an extract from A Question of Scale: The challenge of expanding the impact of non-governmental organisations’ HIV/AIDS efforts in developing countries,
by Jocelyn DeJong, published by the Horizons Project of the Population Council with the International HIV/AIDS Alliance in 2001. To view the whole report follow this link.

To download, complete with graphics, in pdf format (which requires Adobe Acrobat software to read it) follow this link (file size 1.43 Mbytes).