In 2015 MSF-OCB launched a review to assess the perception, by the field teams, of an increased organisational “bureaucratic” burden. The review spanned three phases, from problem identification, to an in depth field study, to a final phase of webinars to improve the coverage and overall accuracy of the findings. The review process culminated in 2 missions agreeing to pilot a new monitoring and reporting system based on the principles coming out of the review, starting asap

In May 2016, concerns were raised at OCB HQ about the potential underestimation of the general IRFFG implementation costs. The OCB mission in Haiti had to retroactively disburse an unbudgeted 1.33M€ of severance pay to their staff, more than a year after the IRFFG implementation in the country.

In the last few years, MSF OCG has developed an Operational Policy with the ambition to increase and improve the quantity and quality of secondary health care structures (or inpatient care). This recognition has prompted the organization to take a closer look at the challenges, lessons and accomplishments in terms of hospital management to develop strategies that will enable the organization to successfully set up, govern, implement and exit inpatient projects in all types of contexts.

After a very intense and difficult one week response to support the MoH Hospital with specialised burn trauma capacity, the cell and mission brought in Stockholm Evaluation Unit to facilitate an internal Retrospect process to help the team identify key lessons and to bring closure to the project team. Note, the Retrospect does not aim to make independent judgement or analysis, only to facilitate bringing out the lessons and to help synthesize these into actionable outcomes.

This study was conducted to help identify factors for improving compliance to the programme, linkage and retention to care. The objectives included providing information and recommendations to the project team in order to support their understanding of local culture, health care perceptions and mobility patterns of the local fishing population, helping the team to formulate adapted messages and medical strategies as well as providing reports and tools to the project team to improve medical activities.

Since MSF’s return to Afghanistan in 2009, its operations on the ground have been monitored with a spyglass, unlike any other mission in this kind of environment. Consequently, OCs have been pushed to innovate but also remain critical vis-a-vis their respective strategies and the overall modus operandi of the Afghan mission. This evaluation of the single representation set up aims to analyse and learn from the current state of affairs of the Afghan mission in view of possible ways forward.

MSF OCG’s Initiative for Medical Innovation (2IM) has successfully introduced the beginnings of a change in organisational culture through a number of innovation projects. Every department has now adopted the notion of innovation and risk taking and a mindset of challenging the status quo. We have found evidence that the 2IM Initiative has, with a degree of success, started to address an identified latent risk aversion in OCG. Any form of organisational change must be expected to lead to tensions within the status quo, and to some extend this was even intended and deemed necessary.

SSP was formed in the aftermath of a high profile depot crisis in South Africa in 2012/3, with six organisations, already dealing with drug stock outs joining forces to tackle the issue. The different organisations brought different skills to the table. Largely focused on anti-retrovirals (ARVs) and TB medication, from the beginning the SSP has tasked itself to hold government accountable, to perform a watchdog role and to present the patient view on stock outs.

With the deterioration of the political context in Burundi since April 2015 more than 140,000 refugees have arrived in Tanzania. The refugees are hosted in three camps in Kigoma region, together with 83,000 Congolese refugees living in Nyarugusu camp for almost 20 years. The initial influx of Burundi refugees coincided with a cholera outbreak in Kigoma region, which triggered an immediate MSF emergency response in May 2015. This rapidly shifted with the movement of refugees from the lake shore of Tanganyika to the Nyarugusu camp.

In late 2013 and early 2014, thousands of people fled the Central African Republic (CAR) to neighbouring Cameroon. MSF OCG provided health care to the refugee population in Garoua-Boulai and Gbiti, which was characterized by high mortality rates, malnutrition rates over twice the emergency threshold and an uncontrolled measles outbreak.

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