Rosann Wisman

 

At the end of MLI’s Learning Collaborative Forum, Rosann Wisman, MLI’s director, reflected on highlights from the four days of discussions. She spoke with John Donnelly about what was important, one big surprise, and what needs to happen next. This is the second of two interviews that look at the forum’s outcomes. MLI is funded by the Bill & Melinda Gates Foundation and the David and Lucile Packard Foundation. 

 

Starting Tuesday and running through this week, we also will start posting several more interviews in our `Motivators' series from the forum -- question-and-answer pieces about what motivates Ministry of Health leaders, and how they motivate others. Please check daily for updates.

Q: What are your main takeaways from the forum? 

A: I’ve been thinking about why people seemed to connect and come together so well this week. There are a lot of opportunities for Ministry officials to go to conferences and to be with their peers, and yet I think there was a spirit, and a depth of communication and sharing, that went on that was quite unusual. Some of it was good facilitation, some of it could be the combination of people we brought together, but a big part was this wasn’t a random event. We’ve been building toward this kind of forum for the last two years, or more, and many of these individuals had met before in various settings. They have gotten to know the MLI headquarters team, and we’ve been able to build credibility and trust with them and between the countries. The combination of all of that made for this very intense learning experience. 

Q: So is the lesson not to expect much in such situations until the people get to know each other well? 

A: It does take time, and south-to-south sharing and learning can’t be just a one-off event. People aren’t going to be forthcoming and able to share challenges or weaknesses unless they are with people they can trust. We’ve really worked hard to build that trust. 

Q: Any surprises from the week? 

A: The biggest one was the whole issue of negotiation training. When Nepal first said they wanted to do some negotiations training, I wondered how applicable it would be to other countries. There’s an automatic thought that negotiations means you’re trying to get something better, and probably that means more money. 

But I think it’s so much more than that. What came up in this meeting was this idea of development diplomacy. There is a real power dynamic going on between donor and recipient country. These are very poor developing countries, and they are often in somewhat of a passive role when they negotiate with donors. The reason why Nepal wanted the training – and now all the other countries are talking about it – is they want to try, in a respectful way with the donors, to level the playing field a little bit. 

They are very grateful and very dependent with donors. This is not about trying to pull the wool over the eyes of a donor. It’s about how to go into a situation with a donor that they are extremely dependent upon and feeling humble toward, and how can they feel more confident in saying what they want, what their priorities are, and what they think works best. It’s just common sense that they say these things. And so the point about negotiation skills is how can we help these countries be clearer and get their points across. I think the donors are really open to that. 

Q: Who would be against it? 

A: Right. It’s very hard for a donor or development partner not to speak favorably about country ownership. How could they possibly say it’s not what they want? And yet what does that mean? One of our challenges with MLI is to take what we’ve learned in the last few years and translate country ownership along a continuum, with stages and benchmarks. Some countries are a lot farther along than others. Ethiopia is the star that many countries want to learn from. But you also have a country like Sierra Leone, which doesn’t have anywhere near the level of experience as Ethiopia, and yet Sierra Leone has taken a really important step with free health care. How they did that and what worked, with the president taking the lead, is what MLI can help define so that we have benchmarks around country ownership.

Q: What’s next after this meeting? 

A: Officially, we have less than one year left on MLI, and with some things that came out of this week, like the interest in negotiations, we want to get scrambling and make sure some of that learning is available to some of our countries. And I really think this notion of trying to quantify our lessons and create some tools and share some things helpful to other development practitioners in other countries, that’s really a focus. The question now is how can we continue this work. 

Q: Why is that important? 

A: MLI is a four-year project, and not surprisingly it took a long time to build the level of trust and accountability in these countries. In many ways, we are finally really on a roll. We heard from the countries this week that they feel we are just getting started with them, they have developed these relationships with us, and they don’t want to stop. I feel like MLI has an obligation to help these five countries, and we hope to continue these relationships and the sharing process. I’m really determined to continue this work. I think it’s really important.

 

Live-blog from Ethiopia

Part 1: MLI Live-blog from Addis Ababa

Part 2: ‘Its Always Good to Think Big’

Part 3: Mali’s Path to Community Health Insurance

Part 4: ‘A New Dawn’ in Health Care in Sierra Leone

Part 5: Want to Bargain? The Nepalis can Help

Part 6: From Mali to Nepal: The Trail of a Negotiator

Part 7: Ethiopia’s New Plan: ‘It’s going to Really Improve this Place’

Part 8: Ethiopia and the Importance of Family Planning

Part 9: Gang of Four: Table Talk with Reproductive Health Directors

Part 10: Ethiopia’s Tedros: Four Steps to Owning Health Programs

Part 11: ‘We Want to be Led”

Part 12: ‘We Became Beggars”

Forum Wrap-up, Part 1: Marty Makinen and Amanda Folsom

Photo Credit Dominic Chavez