PLP in Building Alliances to Serve HIV and AIDS-Impacted Communities in Sub-Saharan Africa

AUTHORS: John Dada, Fantsuam Foundation; Victoria Francis, Emerging Markets Group; Mercy Isaac,
Fantsuam Foundation; Malia Mayson, Catholic Relief Services; Thomas Mensah, Sinapi Aba Trust

FACILITATORS: Stephanie Chen, The SEEP Network; Linda Jones, Independent, for The SEEP Network;
Laura Meissner, The SEEP Network

TECHNICAL NOTE
Partnership Models for Successful
Microenterprise Service Delivery to HIV
and AIDS-Affected Communities
 Copyright © 2009 The SEEP Network
Sections of this publication may be copied or adapted to meet local needs without the
permission from The SEEP Network, provided that the parts copied are distributed
for free or at cost—not for profit. Please credit the “Practitioner Learning Program in
Building Alliances to Serve HIV/AIDS-Impacted Communities in Sub-Saharan Africa”
and The SEEP Network for those sections excerpted.

SEEP would like to thank Kristen Eckert and Jared Penner, SEEP’s HAMED Working
Group Facilitators, for reviewing this document.

This study is made possible by the generous support of the American people through
the United States Agency for International Development (USAID). The contents are the
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Abstract
This technical note explores the models of partnership that can promote economic strengthening in communities af-
fected by HIV and AIDS through microenterprise development—both microfinance and enterprise development. The
information is based on the experiences and lessons learned of the participants of The SEEP Network Practitioner
Learning Program (PLP) on Building Alliances to Serve HIV and AIDS-Impacted Communities in sub-Saharan
Africa (BASICS).

In this technical note, four case studies analyze the characteristics, lessons learned, challenges, and recommendations
around four types of partnerships. The institutional partnership model is based on a long-term relationship between two
organizations. The targeted partnership model is a collaboration that focuses on fulfilling specific technical or program
needs, and may be short-term or long-term. An intermediary partnership typically involves a local or national NGO
as the connection between an international organization and community-level organizations. The commercial partner-
ship model develops a relationship between a business and producer groups with a facilitating partner that brokers the
relationship.

By the end of this document, readers will be able to understand these four types of partnerships and the specific
strengths and challenges of each, and will have gained lessons and recommendations to apply to their own partnerships.
This document is also published as an addendum to The SEEP Network Guidelines for Microenterprise Development in
HIV and AIDS-Impacted Communities at http://hamed.seepnetwork.org.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • iii

Table of Contents
Abstract iii
List of Acronyms vi
About The SEEP Network 1
About the Practitioner Learning Program 1

Introduction 1
Case Study 1: Institutional Partnership Model 3
The Context 3
The Partners 4
Partnership Objectives 4
Partnership Activities and Results 5
Lessons Learned 6
Case Study 2: Targeted Partnership Model 6
The Context 6
The Partners 7
Partnership Objectives 7
Partnership Activities and Results 7
Lessons Learned 8
Case Study 3: Intermediary Partnership Model 9
The Context 9
The Partners 9
Partnership Objectives 10
Partnership Activities and Results 10
Lessons Learned 11
Case Study 4: Commercial Partnership Model 12
The Context 12
The Partners 12
Partnership Objectives 13
Partnership Activities and Results 13
Lessons Learned 13
Conclusions and Recommendations 14
Bibliography 18

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • v

List of Acronyms

ART anti-retroviral therapy

CBO community-based organization
COPE Community-Based Orphan Care, Protection, and Empowerment project
CRS Catholic Relief Services
EASSI Economic Awareness Self Sustenance Initiative
EMG Emerging Markets Group, Ltd.
ICAP International Center for AIDS Care and Treatment Program
(Columbia University)
MDGs Millennium Development Goals
MED microfinance and enterprise development
MFI microfinance institution
MOU memorandum of understanding
NGO non-governmental organization
OVC orphans and vulnerable children
PEPFAR US President’s Emergency Plan for AIDS Relief
PLP Practitioner Learning Program
PLWHA people living with HIV and AIDS
PMTCT prevention of mother to child transmission
PPAG Planned Parenthood Association of Ghana
SAT Sinapi Aba Trust
SILC savings and internal lending communities
USAID United States Agency for International Development

vi • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

About The SEEP Network
The SEEP Network, founded in 1985 and headquartered in Washington, DC, is an association of more than 70 inter-
national NGOs that support micro- and small-enterprise development programs around the world. SEEP’s mission
is to connect microenterprise practitioners in a global learning community. As such, SEEP brings members and other
practitioners together in a peer-learning environment to produce practical, innovative solutions to key challenges in the
industry. SEEP then disseminates these solutions through training, publications, professional development, and techni-
cal assistance.

About the Practitioner Learning Program

The Practitioner Learning Program (PLP) methodology was developed by SEEP as a way to engage microenterprise
practitioners in a collaborative learning process to document and share findings and to identify effective and replicable
practices and innovations to benefit the industry as a whole. The PLP combines a small grant program with an inten-
sive small-group facilitated-learning process, usually over a period of one or more years, and utilizes workshops, email
listservs, conference calls, and distance learning. Practitioner Learning Programs focus on learning at three levels: the
individual organization, the PLP group, and the industry at large.

The objectives of the BASICS PLP are to empower microfinance and enterprise development practitioners through
peer learning to build and strengthen strategic alliances with partner organizations and to document and disseminate
the most effective models for developing these alliances for maximizing impact.

For more information on partnerships for microenterprise development in HIV and AIDS impacted communities,
please visit http://hamed.seepnetwork.org to view the other learning products in this series:

• Partnering to Achieve Economic Impact in HIV and AIDS Impacted Communities: A Partnership Toolkit for
Microenterprise Development
• Enhanced Service Provision for Economic Strengthening in HIV and AIDS Impacted Communities
• Partner Capacity Building for Economic Strengthening in HIV and AIDS Impacted Communities

Introduction
Development organizations working in microfinance or enterprise programming often work with and through local
partners. This is especially common for organizations trying to serve HIV and AIDS-affected clients and communities,
particularly when attempting to deliver or provide access to holistic services and integrated programming.1

The SEEP Guidelines for Microenterprise Development in HIV and AIDS-Impacted Communities states that “microenter-
prise development is a crucial element of a holistic approach to HIV and AIDS prevention and mitigation.” It ac-
knowledges, however, that “implementing integrated programming is challenging. It requires bringing together diverse
technical approaches, different program priorities, and—sometimes—competing institutional and professional interests.
The key to addressing these challenges is facilitating effective cross-sector partnerships among public health and MED
(microenterprise development) professionals and organizations.”2

1.  For more information on the importance of partnerships, see C. Green, “Microfinance and HIV/AIDS: Strategic Partnerships,”
AMAP Microfinance and HIV/AIDS Note 2, prepared for USAID by DAI (Washington, DC: USAID). http://www.microlinks.org/
ev.php?ID=22387_201&ID2=DO_TOPIC.

2.  The SEEP Network, 2008, online document. “What Kind of Microenterprise Development Strategies Work for HIV and AIDS-
Impacted Communities?” section 2.3, and “How Can We Facilitate a Cross-Sector Partnership?” section 2.5, in Guidelines for Mi-
croenterprise Development in HIV and AIDS-Impacted Communities, Book 2, For Microenterprise Development Practitioners, http://

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 1

Section 2.5 of the Guidelines sets forth guiding principles for integrated programming and discusses institutional and
technical challenges to delivering integrated programming through partnerships. The major institutional challenges and
strategies identified are:

• adoption of broader goals—and indicators—that provide stronger incentives for joint programming;
• funding streams with joint goals that require collaboration;
• incentives for institutional collaboration built into programs at all relevant levels;
• adoption of effective institutional models for implementation; and
• support for ongoing research, active communities of practice, and leadership opportunities for professionals who
advance practice in integrated programming.

The major technical challenges identified are:

• different targeting strategies (between MED programs and other organizations);

• different terminology;
• risk to MED program performance;
• need for focus and technical specialization to achieve good practices and results; and
• the small scale of some MED initiatives.3

This document furthers the dialogue by comparing and contrasting four specific partnerships (each representing a
different model) their role in serving people living with HIV and AIDS, and their individual successes and challenges
stemming from that partnership. Many of these challenges reflect the challenges identified in the Guidelines above; oth-
ers are more specific to certain types of partnerships.

The document presents four cases:

1. The institutional partnership model represents a long-term collaboration between two organizations. The case
described here is based on an ongoing relationship between an international non-governmental organization
(NGO) and a national implementing NGO partner. The international NGO provides technical support and
funding, while the national NGO is the implementer of the program at the community level.
2. The targeted partnership model focuses on fulfilling specific technical or program needs, and may be long term
or short term, depending upon the objectives of the partnership. In this technical note, one national NGO
subcontracts another national NGO to pilot the delivery of supplementary services.
3. The intermediary partnership model typically involves an international NGO, a local (national or regional)
NGO, and community-based organizations (CBO). The international NGO relies on the local NGO to
implement an overall program, while the local NGO works with CBOs, ranging from self-help groups to
small NGOs, to implement specific services needed by their clients.
4. The commercial partnership model develops a relationship between a business (lead firm) and producer groups.
A facilitating partner brokers the relationship and organizes and builds capacity of producer groups. In this
case, the producer groups are clusters of caregivers who benefit from expanded products and market access.

communities.seepnetwork.org/hamed/node/38 and http://communities.seepnetwork.org/hamed/node/40, respectively. Section 2.5

contains guiding principles for integrated programming.

3.  For a full discussion of these challenges, see SEEP, 2008, Guidelines, “Structural (Institutional) Challenges and Strategies for
Cross-Sector Collaboration,” section 2.5.2 (http://communities.seepnetwork.org/hamed/node/777) and “Technical Challenges and
Strategies for Cross-Sector Collaboration,” section 2.5.3 (http://communities.seepnetwork.org/hamed/node/778).

2 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

 PLP Participant Case Studies and Models
Institutional partnership model: Catholic Relief Services (CRS) is a large, multisectoral international NGO operating in over 100
countries. This case study examines the Lifeline project, which assists HIV and AIDS-affected households in Rwanda in devel-
oping community-managed savings and lending groups. The delivery of the service is managed by CRS’ implementing partner
Caritas Rwanda, which coordinates an extensive network of diocese, parish, and sub-parish structures at the community level
throughout the country. The activities of the Lifeline project are integrated into virtually all CRS’ HIV and AIDS programs
funded through PEPFAR.1

Targeted partnership model: Sinapi Aba Trust (SAT) and Planned Parenthood Association of Ghana (PPAG) are national NGOs
with extensive experience in their respective fields. SAT is a microfinance institution (MFI) and part of the Opportunity Inter-
national Network, and PPAG is an autonomous national body of the Planned Parenthood Network. SAT and PPAG formed an
alliance under the SEEP PLP to pilot the delivery of health services—HIV and AIDS awareness raising, voluntary testing, and
health referrals and support—to MF clients, while maintaining the privacy of clients with regard to the lending institution, loan
officers and borrower groups.

Intermediary partnership model: Fantsuam Foundation is a holistic, multisectoral NGO operating in Kaduna State in north central
Nigeria. Fantsuam works with a large number of partners, including international and local NGOs, community development
councils, and self-help groups. Through its partners, Fantsuam provides microfinance, livelihoods development, and health ser-
vices to their target populations, which include rural women, people living with HIV and AIDS (PLWHA), children, and youth.
Fantsuam frequently acts as the intermediary and implementing partner between international NGO donors and community-
based organizations.

Commercial partnership model: Emerging Markets Group (EMG) is an international development consulting firm engaged in
agribusiness and rural livelihoods, financial services, health care, private sector development, public sector and business
environment reform, and tourism. EMG works on the COPE project (Children-Community-Based Orphan Care, Protection, and
Empowerment) focused on orphans and vulnerable children in Tanzania, Uganda, Rwanda and Mozambique (funded by USAID
through PEPFAR). EMG partners with community-based caregiver associations and private-sector firms to help caregivers ac-
cess better markets, resources, and skills training. The case presented in this technical note describes the relationship with the
processing and marketing firm Fruits of the Nile.

1.  The US President’s Emergency Plan for AIDS Relief.

Case Study 1: Institutional Partnership Model

The Context
Rwanda is among the least developed countries in the world, ranking 165 of 179 countries in the UNDP Human
Development Index.4 Rwanda’s 9-million people inhabit the most densely populated country in Africa, with approxi-
mately 310 inhabitants per square kilometer. The estimated adult HIV prevalence rate is 2.8 percent. In 2007, UNAIDS
reported 150,000 people living with HIV and 220,000 children orphaned by AIDS.5 Chronic and acute food insecurity
has only compounded the problem as people living with HIV and AIDS and orphans and vulnerable children (OVC)
have been most affected.

4.  UN Development Programme (UNDP), 2008, website, Human Development Reports, Update 2008, Country Fact Sheets, “2008
Statistical Update: Rwanda—Human Development Index, Going beyond Income,” http://hdrstats.undp.org/2008/countries/coun-
try_fact_sheets/cty_fs_RWA.html.

5.  UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance, 2009, “Epidemiological Fact Sheet on HIV and AIDS—
Core Data on Epidemiology and Response: Rwanda 2008 Update” (Geneva: UNAIDS and WHO) 5, 7. http://apps.who.int/globalatlas/
predefinedReports/EFS2008/full/EFS2008_RW.pdf.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 3

The population of Rwanda is overwhelmingly rural; 90 percent of the country depends on agriculture. Poor soil fertility
and climatic shocks contribute to chronic and acute food insecurity and affect a significant portion of the population.6
Studies have shown that Rwandan households that care for sick individuals spend less time on agricultural activities,
leading to neglect of fields, a decrease in area planted, and shifts to less labor-intensive crops.7 Some are also forced to
sell their land and livestock, decreasing their productive assets.8

The Partners
Founded in 1943, Catholic Relief Services has technical-development programming experience in more than 100
different countries across the globe. CRS has worked in Rwanda since 1963, managing projects that encourage local
communities to participate in identifying and resolving development issues. CRS was directly involved in emergency
programs after the outbreak of civil conflict in 1990, but has now transitioned back to development activities. CRS’s
programs in Rwanda focus on agriculture, microfinance, peace building, and food assistance to vulnerable populations.

Caritas Rwanda is a local, faith-based community organization offering social, health, and development activities
through a comprehensive network of dioceses, parishes, and more than 10,000 small Christian communities throughout
the country. The primary goal of Caritas Rwanda is to empower society’s most disadvantaged groups and restore human
dignity to those who have been threatened by social marginalization, ethnic divisions, and injustice.

Partnership Objectives
CRS has partnered with Caritas in Rwanda since 1963. Caritas Rwanda shares a similar mission as CRS, and also
implements a variety of social, medical, and spiritual services through a vast network of community structures and local
health centers. Caritas also possesses the drive, the means, and the credibility needed to help the poorest of the poor
access essential services. CRS’s primary role in this partnership is to support Caritas with programming, administrative,
and technical expertise. The goal is to build up Caritas’ capacity in these areas until Caritas is able to implement high-
quality programs and access external donor funding independently.

To address issues of chronic food insecurity and economic vulnerability among families and households affected by HIV
and AIDS, CRS in collaboration with Caritas Rwanda introduced the Savings and Internal Lending Communities
(SILC) methodology. SILC is a group-managed, savings-led approach that allows communities to better manage their
own resources for investing in opportunities and cushioning against shocks.

The alliance between the two organizations has resulted in dynamic programming that reaches deep into the grassroots
levels of society as illustrated in the diagram below.

6.  WFP (World Food Program), 2009, website, “Countries,” “Rwanda (2008)” http://www.wfp.org/country_brief/indexcountry.
asp?country=646.

7.  A. de Waai and J. Tumushabe, 2003, “HIV and AIDS and Food Security in Africa,” unpublished report prepared for DFID, Febru-
ary 1, 2003, 6.

8.  C. Donovan et al., (L. Bailey, E. Mpyisi, and M. Weber), 2003, “Prime-Age Adult Motility and Mortality in Rural Rwanda: Effects
on Household Income, Agricultural Production, and Food Security Strategies,” International Development Collaborative Working Pa-
pers, no. RW-FSRP-RR-12 (East Lansing, MI, USA: Michigan State University, Department of Agricultural Economics). http://www.
aec.msu.edu/fs2/rwanda/RLDS3_2003.pdf.

4 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

 CRS Rwanda

Lifeline project manager

Diocese Diocese

Caritas Lifeline Supervisor Caritas Lifeline Supervisor

Parish Parish Parish Parish

Caritas Lifeline Field Agents

SILC group SILC group SILC group SILC group

SILC group SILC group SILC group

Partnership Activities and Results

In 2006, CRS and Caritas initiated the Lifeline Project in Rwanda to scale up microfinance services offered to HIV and
AIDS-affected households. The CRS Lifeline project manager provides training, technical assistance, monitoring, and
capacity building to Caritas partners in the dioceses. Caritas employs one SILC supervisor in each diocese and seven
field agents per diocese. The field agents operate at the parish level to raise awareness about SILC and encourage the
formation of SILC groups. Once formed, the field agents train these groups in the SILC methodology and provide
them with technical assistance and supervision. Each parish field agent supports a maximum of ten SILC groups, with
approximately 20–25 members per group.

In 2008, the Lifeline project exceeded all its targets both in the number of SILC groups formed and in the training of
field agents for SILC outreach and support. Below is a summary of achievements to date:

CRS Rwanda SILC Activities Achievements

Activity Target Achieved to Date
SILC groups formed 655 769
SILC members/households 13,120 17,113
Trained diocesan SILC supervisors and field agents 56 146
Cumulative savings $50,000 $100,000
Note: As of November 2008. Figures are self-reported.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 5

Lessons Learned

Successes
1. Shared goals and values have increased the strength of the partnership. CRS and Caritas Rwanda are
long-time collaborators. The Lifeline Project supports the CRS goal of promoting social justice and reaching
the poorest of the poor with high-quality services. The project also supports the National Caritas 2005–2007
Strategic Plan objective to increase financial revenues and two of its “intermediate results” to improve access
to capital and strengthen entrepreneurial spirit among beneficiaries.
2. Beneficiary communities are actively engaged through the partner. At the community level, SILC parish
field agents are recruited from already-existing SILC groups. These community members go through intense
training and supervision from Caritas to expand their knowledge and capacity. After two years, new SILC
groups will be able to pay a small fee to the parish field agents for their technical assistance. (Parish field
agents receive only a small stipend and a bicycle.)
3. CBO-capacity building activities enable longer-lasting program results for beneficiaries. The CRS pro-
gram manager offers a training of trainers program to diocesan supervisors. Through CRS technical assistance
and monitoring, the supervisors then progressively increase their ability to independently manage and pro-
mote SILC activities. They also provide feedback and advice to CRS on the progress of implementation of
activities.

Challenges
1. Inconsistent policies are disruptive to institutional collaboration. CRS and Caritas, as institutional part-
ners, cooperate on many projects; however, each project comes with its own budget and structure. As a result,
this can lead to inconsistencies within both organizations and affect the quality of services offered to clients.
For example, Caritas offices at the diocesan level do not always have a pre-determined salary scale, so staff
members with the same level of responsibility might be offered different salaries, depending on the proj-
ect. The same is true for incentives offered to volunteers: projects with bigger budgets can afford to provide
volunteers with bicycles, radios, mobile phones, and access to health care, whereas others can provide only
tee-shirts. As a result, volunteers often abandon one project in favor for another that provides better incen-
tives, helping some joint projects and hurting others.
2. A two-tier administrative system can delay implementation. Caritas serves as a sub-grantee of CRS donor
funding and, as such, Caritas relies on CRS for the bulk of the programs’ financial management. Missing
receipts from Caritas or delayed advances by CRS can hold up the implementation of project activities and
engender feelings of frustration on the part of project staff from both organizations.

Case Study 2: Targeted Partnership Model

The Context
Ghana, on the west coast of Africa, is home to an estimated population of about 19 million that has been growing at 2.7
percent annually. Ghana’s human development ranking is 135 of 177 countries, putting it at the top of the rankings in Af-
rica.9 As Ghana seeks to achieve the Millennium Development Goals (MDGs) and reach middle-income status by 2015,
it has sustained a period of economic stability, with income poverty levels declining from 39.5 per cent in 1999 to around

9.  UNDP, 2008, website, Human Development Reports, Update 2008, Country Fact Sheets, “2008 Statistical Update: Ghana—
Human Development Index, Going beyond Income,” http://hdrstats.undp.org/en/2008/countries/country_fact_sheets/cty_fs_GHA.html.

6 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

28.5 per cent in 2006.10 However, while there has been steady progress in some areas, they are still facing challenges in the
areas of child health/child mortality, maternal mortality, gender equality and worsening income inequalities.11

The national HIV prevalence of Ghana is relatively low, at just under 2 percent in 2007. However, only 1 percent of
households with orphans and vulnerable children receive������������������������������������������������������������
basic external aid, and only 15 percent��������������������
���������������������������
of advanced HIV pa-
tients receive anti-retroviral therapy (ART).12

The Partners
Sinapi Aba Trust (SAT), one of the largest microfinance institutions in Ghana, is a Christian NGO established in 1994
and headquartered������������������������������������������������������������������������������������������������������
in Kumasi, the capital of the Ashanti region. SAT operates in all 10 regions of Ghana with 39 branch-
es, serving approximately 80,000 clients, 95 percent of whom are women. SAT, as a member of the Opportunity Interna-
tional Network, seeks to transform the lives of their clients holistically through microenterprise development and train-
ing, business advisory services, HIV and AIDS awareness programs, community development, and youth development.

The Planned Parenthood Association of Ghana (PPAG) was established in Ghana in 1967 and is a member of the
International Planned Parenthood Federation. Its activities include family planning and sexual and reproductive health
issues, including HIV and AIDS. Like SAT, PPAG is also a nationwide organization with regional offices throughout
Ghana. PPAG’s mission is to “provide youth with the knowledge and means to exercise their basic right to decide freely
and responsibly about their sexual and reproductive health as a means of improving quality of life.”13

Partnership Objectives
SAT recognized the seriousness of the HIV and AIDS pandemic and the associated tragic consequences for clients,
their businesses, and their communities, as well as potential consequences for SAT staff. They reached out to and formed
an alliance with PPAG, with the goal of improving clients’ well being through quality health services related to HIV
and AIDS, along with microfinance services.

Specific objectives included:

• intensifying education and awareness efforts for SAT clients;

• offering voluntary counseling and testing for HIV and AIDS;
• educating clients on stigmatization and discrimination against people living with HIV and AIDS;
• provide care and support for HIV and AIDS affected people; and
• playing a leading role in advocacy in various dimensions to support people living with HIV and AIDS.

Partnership Activities and Results

Under the BASICS PLP, SAT and PPAG conducted a range of activities to serve the clients of both organizations.
These included a three-day capacity building workshop on education and prevention, voluntary counseling, and test-
ing in four SAT branches, ongoing support for infected persons, referrals to clinics for treatment, and the creation of an
HIV-positive client support group. The training included discussions on sexually transmitted infections and associated

10.  “MDG Profile: Ghana,” MDG Monitor website, available from http://www.mdgmonitor.org/factsheets_00.cfm?c=GHA. Accessed
on August 27, 2009.

11.  Ibid.

12.  UNAIDS, 2008, 2008 Report on the global AIDS epidemic. (Geneva: Joint United Nations Programme on HIV/AIDS). http://
viewer.zmags.com/publication/ad3eab7c#/ad3eab7c/1. 214,268, 293.

13.  Planned Parenthood Association of Ghana. http://www.ppag-gh.org/vision.asp.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 7

risk, protection against infection; relationships and HIV risk; needs of people living with HIV and AIDS, effects of
ART, stigma and discrimination, and whether to undergo testing.

PPAG and SAT focused their joint activities in four cities and towns in the Ashanti and Eastern regions of Ghana
because these areas had higher HIV prevalence rates than the national average. The program’s results are outlined in the
following table.

Indicator Number/Comment
Clients participating in a three-day workshop 564
Number of program locations 4
Number of people volunteering for testing (9 tested positive) 150
Subsequent numbers registered for support and care 15
Support group formed and registered National Association of People with HIV
Counseling, free medical care, transport allowance for meetings,
Services received by support group and nutritional support

Lessons Learned

Successes
1. Participatory planning leads to stronger results. The SAT-PPAG alliance ran smoothly because both part-
ners were actively involved from the outset of the program. There were consultations, roundtable discussions,
and input from the partners in drafting and finalizing the memorandum of understanding (MOU) and work
plans of the partnership.
2. Anonymity concerns around HIV are more easily addressed with a partner. Guaranteed privacy meant that
MFI clients were willing to come forward for testing and treatment. If SAT had offered the training itself,
it is unlikely that clients would have been willing to get tested, for fear that they might be turned away for
future loans if they tested positive.

Challenges
1. Providing one set of services leads to others. Awareness raising and testing services often lead to the need
for other services, such as when SAT and PPAG learned that some clients tested positive and wanted to offer
medication and support services. Thus, a partnership formed with a limited scope may find itself wanting to
offer or make linkages to further services. Sinapi Aba and PPAG have worked together to ensure that follow-
up services, such as health referrals, treatment, nutritional supplements, and support groups are available, but
this is not always possible.
2. One-off programming and funding limits opportunities for expansion. Although the partnership has been
successful, and the SAT board would like to continue the training, its efforts to reach more communities are
constrained by inadequate funding. SAT has 80,000 clients, but the targeted partnership only covered 560
clients, or less than 1 percent. If SAT and PPAG want to continue working together, they will need to find
additional funding or determine other ways to cover the cost of the program, such as subsidizing it with loan
revenues.

8 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

Case Study 3: Intermediary Partnership Model
The Context
Nigeria is Africa’s most populous country, with a population of over 140 million and more than 373 ethnic groups.
It ranks 158 of 177 countries in human development14, and the prevalence of HIV has decreased from a high of 5.8
percent in 2001 to 3.1 percent in 2007.15 Although these prevalence rates appear low, Nigeria ranks third in terms of the
actual number of people infected with HIV. Furthermore, less than 10 percent of orphans and vulnerable children under
17 receive basic external support, and less than 17 percent of adults and children with advanced HIV infection have ac-
cess to ART.16

Fantsuam operates within Kaduna State, which suffers from a lack of jobs and infrastructure, including safe housing.
Many residents do not have access to affordable, quality health-care services. Economic activity is predominantly subsis-
tence and agricultural, with extremely limited opportunities for employment. A rural-urban migration has led to a “brain
drain” of many professionals moving to the cities to seek employment, further weakening the area’s economic foundation.

The Partners
Fantsuam Foundation is a regionally-based NGO committed to making Kaduna State a successful and replicable model
of integrated rural development in Nigeria. Fantsuam’s unique, integrated services approach includes microfinance,
health (including HIV and AIDS programs), information and communications technology (ICT) training and service
provision. This model requires Fantsuam to actively engage with and coordinate the activities of both international and
national partners, NGOs, and CBOs in different fields, in pursuit of its objective.

Fantsuam Foundation works with several international partners, including Columbia University’s International Center for
AIDS Care and Treatment Program (ICAP) and Partners for Development. In turn, all three organizations have extensive
partnerships with CBOs, recognizing the important roles they play in mobilizing communities, reaching the most vulner-
able, raising awareness, and reducing stigma. This case study focuses on one international partner, ICAP; one community-
level NGO, EASSI (Economic Awareness Self-Sustenance Initiative); and selected community self-help groups.

In partnership with the Nigerian government, ICAP provides a range of HIV and AIDS services in Kaduna State and
elsewhere: technical and financial assistance to scale up comprehensive HIV and AIDS prevention, care, and treatment
services, including ART. ICAP provides funding to Fantsuam under the Multi-Country Columbia Anti-retroviral Pro-
gram cooperative agreement between ICAP and the U.S. Centers for Disease Control and Prevention. Fantsuam, for its
part, provides palliative care and referral linkages between the community and ICAP-supported facilities.

14.  UNDP, 2008, website, Human Development Reports, Update 2008, Country Fact Sheets, “2008 Statistical Update: Nigeria—
Human Development Index, Going beyond Income,” http://hdrstats.undp.org/en/2008/countries/country_fact_sheets/cty_fs_NGA.html.

15.  UNAIDS, 2008, 2008 Report on the global AIDS epidemic. (Geneva: Joint United Nations Programme on HIV/AIDS). http://
viewer.zmags.com/publication/ad3eab7c#/ad3eab7c/1. 214.

16.  UNAIDS, 2008, 2008 Report on the global AIDS epidemic. (Geneva: Joint United Nations Programme on HIV/AIDS). http://
viewer.zmags.com/publication/ad3eab7c#/ad3eab7c/1. 270.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 9

 Fantsuam’s Holistic Programming Model

Microfinance
programme
PfD

FF Clients

CBO HIV/AIDS
support
FF Clients
group programme

Fantsuam
Foundation

Community FF Clients
MF Bank
ICAP
FF Clients
CBO
support
group
CRS

EASSI was established in 2007 and regards Fantsuam as its mentor. It is a member of the network of NGOs with
which Fantsuam works on a range of projects. Fantsuam has signed an MOU with EASSI and has assisted it in an ar-
ray of activities.

Positive Concern is Fantsuam’s support group for people living with HIV and AIDS. This is the first support group of
its kind in the region, so it acts as a model for others and is able to provide guidance and support for newly-established
support groups.

Partnership Objectives
Fantsuam’s holistic goals and integrated service-delivery model allow it to create partnerships and alliances to ensure
that support activities and complementary services are delivered more efficiently. ICAP’s goal is to help Fantsuam
establish a comprehensive HIV and AIDS program, in order to effectively deliver ICAP’s home-based care and other
HIV-related services and facilities at the community level. It aims to make most or all HIV and AIDS services available
at a single access point, which is particularly important in the rural areas where Fantsuam works.

Partnership Activities and Results

ICAP provides palliative-care and home-based care services to people living with HIV and AIDS in the ten chiefdoms
where Fantsuam provides microfinance and ICT services. It also provides psychosocial support and counseling through
PLWHA-support groups, conducts referrals for counseling and testing, and engages with local communities through
networking. Further, ICAP provides capacity building to Fantsuam to help it better implement community HIV and
AIDS care and support services.

With ICAP support, Fantsuam Foundation manages an HIV and AIDS program through its Positive Concern support
group for HIV-positive clients. Fantsuam uses ICAP’s systems to track patients in the communities who do not return

10 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

for PMTCT (prevention of mother to child transmission)-care and treatment appointments, so that they can follow up
with these patients. Fantsuam also recruits and trains volunteers in palliative care and recruits community health vol-
unteer workers. Fantsuam also helps to publicize ICAP’s home-based care and other HIV-related services and facilities
available, increasing community use of the services.

Fantsuam’s partnership with EASSI includes ICAP programming, as well as other elements:

• HIV and AIDS-awareness raising and -capacity building under the ICP program
• Training for youth in making compressed bricks, provided by Fantsuam to EASSI clients
• A national volunteer program; Fantsuam has provided EASSI with training in volunteer management and
helped them select retired agricultural and health volunteers.
• Business-services support for a variety of microenterprises

Finally, the self-help group Positive Concern works with adults, grandmothers, and children, providing psychosocial
support, hospital referrals, encouragement of drug compliance, home-based care, free medical care, and monthly sti-
pends for grandmothers taking care of orphans and vulnerable children.

Lessons Learned

Successes
1. Multiple strategic alliances facilitate support for the holistic programming that affected individuals need.
Communities affected by HIV and AIDS require a wide spectrum of services to meet their needs. Commu-
nity-based organizations generally provide such holistic services, while large organizations are generally more
targeted in what they offer. As a result, multiple partnerships with organizations with similar target clients
but different strengths can help to meet the wide range of needs.
2. A robust monitoring system helps to improve efficiency, sustainability, and roll out of the programs. Each
international organization requires a different form of reporting and attention to a variety of statistics. Fant-
suam has implemented a robust monitoring and evaluation system that helps streamline work and ensure that
needed reports are available for all partners. Fantsuam uses both qualitative (outcome mapping) and quantita-
tive evaluation methodologies to assess the impact of its services.

Challenges
1. More partners mean more chances for conflicting requirements and processes. Working with multiple part-
ners means that there is a greater potential for differences in program expectations, reporting requirements,
and other procedures. This is particularly true when functioning as an intermediary between large, well-fund-
ed, international organizations and small, community-based institutions. The intermediary organization must
be strongly outward looking, and able to anticipate and be responsive to the different needs of partners.
2. Staff can easily become overburdened. Due in part to the different expectations described above, the de-
mands of multiple partners can strain staff and cause them to be less effective. Although, in theory, more part-
ners should lead to higher budgets for staffing, often staff time is a “hidden cost” that is not fully accounted
for in a partnership.
3. The intermediary partner must take responsibility for the work of the community-level organization. The
international/funding partner does not have a direct relationship with the community organization and will
hold the intermediary partner responsible for the work implemented at the community level. However, the
intermediary organization may not be able to control the outcomes. This can result in donor dissatisfaction
with performance.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 11

Case Study 4: Commercial Partnership Model
The Context
Children who have lost a parent to AIDS are at higher risk of HIV infection, poverty, illiteracy, homelessness, and
discrimination.17 In sub-Saharan Africa, it is common practice for children orphaned by AIDS to be cared for by family
members, friends, or others in the community, which may cause financial constraints and additional burdens of poverty.
Two million of Uganda’s 31.4 million people are estimated to be orphans, 50 percent due to AIDS.

The Community-Based Orphan Care, Protection and Empowerment project, or COPE, is being implemented in
the three counties of Ntungamo District, where its implementing partners have a long history of addressing the HIV
and AIDS pandemic in collaboration with both public and private sectors. The income-generation component targets
caregivers of orphans and vulnerable children. These caregivers live in rural areas and grow bananas and pineapples,
which are particularly perishable during the harvest season. In the past, the caregivers had no connection to any external
markets and reported being cheated by middlemen. To provide clusters of clients with access to more-promising market
opportunities, Emerging Markets Group (EMG), under a subcontract with Africare, works to link clients to firms in
the value chain, such as food processors and exporters working in industries with high-growth potential. Matching
clients to well-established, stable firms in these industries affords them opportunities to sell their goods and services at
fair-market values. Over five years, COPE aims to target 20,000 orphans and vulnerable children and their caregivers,
both directly and indirectly.

The Partners
EMG, based in Brussels, London, and Washington, DC, is an international consulting firm that serves donor agencies,
governments, and private clients. For the past 25 years, EMG has applied business expertise to improving communi-
ties’ economic, social, and physical infrastructures. In 2007, EMG became a wholly-owned subsidiary of the Australian
based-firm Cardno.

In Uganda, Tanzania, Mozambique, and Rwanda, EMG implements economic empowerment activities under COPE.18
EMG’s focus in the program has been to develop a successful and sustainable approach to build up the economic capac-
ity of orphans and vulnerable children and their caregivers, effectively increasing future prospects for these children.
Other services offered to caregivers by COPE through Africare include community capacity building, access to health-
care, life skills training, and educational support. This case focuses on a specific partnership in rural Uganda to offer
insights into good practices in market-driven approaches.

In Uganda, EMG partners with clusters of OVC caregivers on economic empowerment programs. Each caregiver clus-
ter is composed of 10 groups consisting of 5–8 caregivers, each caring for an average of five orphans. These clusters are
the COPE project’s primary entry point for training, enterprise development, and other services.

Fruits of the Nile is a Ugandan business that processes and exports dried fruit to markets in the UK. Fruits of the Nile
was set up in the early 1990s as a way for Ugandan farmers to avoid wasting fresh fruit and to process and market their
fresh fruits and vegetables using affordable, easy-to-construct, and environmentally friendly materials. Fruits of the Nile
buys sun-dried produce at fair prices, as well as organizing training and maintenance services for operators of solar dry-
ers, facilitating access to finance when possible.

17.  UNAIDS, UNICEF, and WHO, 2007, “Children and AIDS: A Stocktaking Report, 2007,” Report of the “Unite for Children,
Unite against AIDS” program (New York: UNICEF).

18.  The Community-Based Orphan Protection and Empowerment (COPE) project is funded by PEPFAR and implemented through
USAID. Africare is the primary grantee, with EMG as its subcontractor.

12 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

Following a market analysis and identification of caregiver needs and market opportunities, EMG brought together
caregivers to build a partnership with the Fruits of the Nile. Caregivers are organized into clusters, given appropriate
training, and linked into a business relationship with the export company. In addition, the caregivers are required to
participate in a group savings program (similar to a village savings and loan association), a practice that creates further
buy-in and signifies a commitment from the group members.

Partnership Objectives
The objectives of the partnership are to reach export markets with dried fruits, bring economic benefit to the caregiver
clusters, and to realize a profit for the private-sector partner. EMG facilitates the relationship and development of the
chain as its contribution to achieving these goals.

Each partner in the alliance plays a specific role according to its capacity: EMG develops caregivers’ skills and operates
as a facilitator, the caregivers produce the dried fruit and supply the buyer, and Fruits of the Nile buys the product from
the clusters. The following diagram illustrates the partner approach to achieve these objectives:

EMG Input: Facilitated EMG Support

Business Linkages Phases Out
• Group Formation • Business Relationships
Formed
• Product Value • Producers inserted in • Product Value
Increased Value Chain Increased Again
• Producers Prepared • Producers Move Up in
for Value Chain Value Chain
EMG Input: Training EMG Input:
and Development Entrepreneurial Training

Partnership Activities and Results

In this three-way relationship, caregivers receive two types of
training. Basic training includes the importance of savings, Caregiver
governance, financial management and record keeping, and Clusters
enterprise development. Technical training includes ensur-
ing product quantity and quality, practicing good sanitation
and hygiene, learning the practical aspects of fruit drying, and Consulting Firm /
using the solar fruit dryers. The caregiver clusters enter into a Facilitator
commercial supply relationship with the exporter, which pro-
vides the equipment to construct the fruit dryers. Wherever
possible, cash and in-kind contributions are made by all parties Commercial
Enterprise
to develop the business, ensuring invested participation and
minimizing dependency on support from outside sources.
Over time, the tripartite dynamic between EMG, caregiver
clusters, and the commercial enterprise will evolve to include
Thus far, EMG has organized 853 caregivers in 15 clusters of
only the caregiver clusters and the business.
caregivers, who support 2,337 orphans and vulnerable children,
and has linked them with Fruits of the Nile. In addition to

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 13

their sales of fresh fruit in the local market, fruit drying has become a supplemental source of income for the caregiver
clusters. Caregivers have seen a steady increase in the volume of their dried fruit sales to the company over the past year
and have earned a total of $8,128 in supplemental income. They have used this income to support the children in their
care with essential basic needs and even larger purchases, as well as reinvesting a portion of proceeds into their businesses.

The commercial partnership model differs from conventional income-generating interventions, in that EMG plays a fa-
cilitating role and phases out its involvement. The project’s exit strategy includes a number of steps designed to increase
the sustainability of economic activities beyond the life of the project. First, clusters are encouraged to work directly with
Fruits of the Nile, for example, by attending company trainings and meetings. COPE also helps the clusters register as
legal entities, making it easier to form commercial relationships with buyers. In addition, the clusters have developed a
Fruit Dryers Association, made up of cluster representatives. COPE plans to build the association’s capacity for collec-
tive negotiation and administration. In the future, the association will take up EMG’s broker/facilitator role. Eventually,
COPE’s MOU with Fruits of the Nile will be replaced with a formal commercial agreement (and relationship) between
the association and Fruits of the Nile. This document would include guiding principles, as well as specific information
about price, quantity, and quality expectations.

Because the new relationship will be purely commercial, EMG’s phase-out plan includes identifying ways to reduce the
vulnerability of caregivers, orphans, and other affected children to downward swings in the market. This might include,
for example, encouraging caregivers groups to save additional money for investment or emergencies, and perhaps adding
matching savings from the project.

Lessons Learned

Successes
1. Partnerships can bridge the gap between affected communities’ needs and economically-oriented market
actors. EMG’s facilitating role was to bring economic benefits to the caregivers in a way that fit their needs
and constraints and that also met the buyer’s economic motivation. EMG understood both sides’ perspectives
and thus was well positioned to make this link.
2. Having a businesslike relationship with the commercial partner strengthened the partnership. When
initially approaching Fruits of the Nile, EMG focused on the business case for engaging the producer groups.
It was clear that the company’s interest was in obtaining a reliable source for dried fruit at a fair price. There-
fore, negotiations focused on this aspect of the relationship, rather than on charitable motivations for helping
vulnerable populations.
3. Planning an exit strategy or phase-out from the outset is critical. All three parties in the partnership play
vital roles and will be needed for some time. Eventually, however, it is important that the relationship become
a direct two-way relationship. As can be seen from the case here, phase-out may be a lengthy process. It
should happen gradually, to allow time for capacity building as needed and to figure out who will provide any
key services that the existing facilitating partner used to provide.

Challenges
1. Market dynamics can affect the stability of commercial partnerships. This can cause particular challenges
in partnerships between community organizations and businesses, as the community partner may not be fully
aware of market dynamics and the effect these have on the partnership.
2. Commercial enterprises and subsidies can mix—if it is done right. The costs of transport, storage, certifica-
tions, and other issues can eat away at businesses’ already-thin profit margins. However, a completely unsub-
sidized approach is highly challenging in a setting with abundant charitable programs. One-time subsidies,
such as building a small storage facility to serve as a demonstration model, motivated clusters to adopt the
new technology without running up high costs for the project or the buyer.

14 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

 3. Support services are critical to HIV and AIDS-affected community enterprises. However, receiving free
services (uniforms, nutrition support, or health care) does not encourage a market mindset regarding the
enterprise-development component of a project. Further, such services are not sustainable over the long run.
The facilitating organization must work hard to mitigate the mixed message and reinforce a confident, self-
reliant attitude in their dealings with a commercial business. Promotion of savings clusters can do a great deal
for self-sufficiency.

Conclusions and Recommendations

Despite the challenges discussed, there is much value in building alliances that better serve communities affected by
HIV and AIDS. The four partnership models examined here are useful in different ways. Institutional alliances are
the basis for familiar, long-term relationships with shared values and experiences. Targeted collaborations enable the
delivery of services that are limited by scope and/or time. Intermediary models facilitate flows of services and funds
between large external organizations and community groups. Finally, commercial agreements support the development
of sustainable market-focused linkages for small-scale producers.

At the same time, each partnership model brings with it various challenges. The multiple projects typical of institutional
alliances can lead to inconsistencies and management issues, whereas the longevity of targeted partnerships is often lim-
ited by funding constraints. Intermediaries can become overburdened with the competing demands of many partners,
and commercial models require rigor in business-like behavior that requires significant investment in capacity building.

Summary Table of Successes and Challenges

Partnership Type Successes Challenges
Shared goals and values increase the strength of the Inconsistent policies disrupt institutional collaboration.
partnership. A two-tier administrative system can lead to delays.
Beneficiary communities actively engage through local
Institutional
partners.
CBO capacity building enables long-term results for
beneficiaries.
Participatory planning leads to stronger results. Providing one service leads to the need for others (may
not be available with a target partnership).
Targeted Anonymity concerns around HIV are more easily ad-
dressed with a targeted partner. One-off programming and funding limits opportunities
for expansion.
Multiple alliances facilitate support for holistic pro- More partners mean more chances for conflicting
gramming. requirements and processes.
Intermediary Robust monitoring helps improve program efficiency, Staff can easily become overburdened.
sustainability, and implementation with complex alli- Intermediary partner must take responsibility for work
ances. of CBOs.
Alliance between intermediary, clients, and business Market dynamics can affect stability of the partnership.
can bridge the gap between communities’ needs and Subsidies can work, but are tricky.
market actors.
Commercial Support services are critical.
Businesslike approach strengthens client partnership
with commercial partner.
Planning for exit is critical.

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 15

Despite these and other differences among the various models, there are some common lessons that are outlined here as
brief recommendations:

Understand your partnership type and its specific advantages and challenges.
This can help all parties to anticipate and plan for potential challenges. This is particularly critical when partners have
different understandings about the type of partnership; for example, when an organization in a targeted partnership is
hoping for a longer-term institutional relationship, or when an international organization in an intermediary model
does not know about or understand the added burden of the intermediary partner.

Use a due diligence or discovery process in assessing and selecting partners.

It is critical for partners to understand each others’ values, goals, capacity, and objectives for the partnership, in order for the
collaboration to succeed. If all partners are aware of each others’ strengths and weaknesses, skills and experiences, expecta-
tions, and commitment to the partnership’s goals, it will be easier to set clear responsibilities and realistic expectations.

Clearly define roles and responsibilities to improve alliance functioning.

Roles and responsibilities can be outlined in an MOU or contract, or can be determined by a more informal process.
This delineation will provide a framework for planning activities and reduces conflict in management and implementa-
tion. Even with a formal agreement in place, regular communication and reporting reinforce the commitments made by
each partner.

CRS and Caritas signed memoranda of understanding with each diocese, outlining each partner’s roles and responsibilities. As
a result of the MOUs and the collaborative process, the various stakeholders are clear on expected roles and responsibilities,
which has enabled smooth progress and interaction among partners.

Seek management and Board support.

When each party’s key managers and board of directors understand the alliance and its objectives, and agree to its
implementation, personnel are more likely to receive needed support in terms of allocation of time, logistics, and budget.
If tension develops between the organization’s core focus and partnership activities, a committed leadership will be bet-
ter equipped to resolve the conflict.

With common goals and vision of the partners, the board, management, and staff of Sinapi Aba and PPAG were both able to
commit to the aims of the alliance. This even resulted in Sinapi Aba’s board offering additional financial resources for care and
support for people living with HIV and AIDS above and beyond the PLP-funded program.

Manage resources separately and together.

Each partner brings different assets to the table, for example funding, capacity building, specialized services, or commu-
nity contacts. These flows of resources are not always equal between partners. Partners need to discuss and agree upon
how these resources will be managed, and how reporting and monitoring of key resources will work. Each partner must
also be accountable for the resources at their disposal.

16 • SEEP NETWORK • PRACTITIONER LEARNING PROGRAM

 When constructing the dryers, the Fruits of the Nile company provided materials, EMG offered training, and caregivers contrib-
uted room and board for the carpenters. In this way, each party had a stake in the success of the activity. All parties also are
clear on who is paying for what, minimizing confusion.

Involve clients in the partnership.

Clients receive the most benefit when they are active contributors to the partnership and its objectives. This may mean
that they participate in the formation of the partnership, the design of the project, and/or project implementation.
Sometimes, as with the EMG case, they are formal partners and signatories to legal agreements. The participatory pro-
cess can build clients’ skills, increase understanding, and reduce the risk of conflict or disappointment.

Define sustainability strategies, including impact goals, up front.

In order to achieve successful outcomes, it is crucial for partners to share a long-term vision regarding the impact of the
shared initiative and how this impact will be sustained. Planning for this vision, with a predefined exit strategy, needs
to happen up front as part of the overall planning process. Using such tools as causal chains can assist in moving from
project activities to final and lasting impact.

A long-term partnership makes it easier to measure long-term program impact. For example, several SILC groups started small
income generating projects without any assistance from Lifeline. CRS Rwanda and the Caritas diocesan partners would like to
harness this spirit and direct it into viable businesses. Given their ongoing collaboration, Caritas can readily keep CRS informed
of such developments.

Identify staff dedicated to partnership management.

A project management team in which both partners participate facilitates smoother implementation and communica-
tion. Institutional partnerships in particular have benefited from the presence of a staff person solely responsible for
managing the relationship between both organizations. He/she serves as a neutral conduit that can help tackle the
misunderstandings and unmet expectations that are bound to arise at some point in long-term relationships.

Ensure that policies and procedures are consistent and standardized.

Institutional partnerships by definition involve the joint implementation of several projects. There is, therefore, a need
to create financial, administrative, and program policies that are transparent and consistent across all projects shared
by partners to avoid feelings of frustration or unmet expectations on the part of partner staff and clients. When this is
impossible (e.g. due to donor regulations), partners should spend extra time making sure all understand the new or dif-
ferent policies.

For more recommendations, readers are invited to read other publications from this PLP and SEEP, particularly “Part-
nering to Achieve Economic Impact in HIV and AIDS Impacted Communities: A Partnership Toolkit for Microen-
terprise Development.”

PRACTITIONER LEARNING PROGRAM • SEEP NETWORK • 17

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