Public Servants as Development Brokers: The Shaping of INGOs’ Reducing Teenage Pregnancy Projects in Malawi’s Primary Education Sector

Abstract

International non-governmental organisations (INGOs) play an increasingly prominent and multifaceted role in the field of global healthas policy advocates, recipients of donor funds, and implementers of donor-funded programmes. Many such NGOs and their local affiliates have become highly professionalized and oriented towards the priorities of global-level actors, with potential negative consequences for their ability to represent the grassroots and to challenge structures of power and inequality. In this thesis, I examine the dynamics around INGO project implementation in Malawi, within the broader context of overlapping development initiatives, shifting priorities, conditions of scarcity and donor dependence, and poor health outcomes. I draw on ethnographic research conducted in rural Malawi between May 2015 and August 2016, which focused on the implementation of a Save the Children project that aimed to improve maternal health by reducing teenage pregnancies, primarily by keeping girls in school and increasing their use of reproductive health services, notably contraceptives. My ethnographic gaze is on the individuals who serve as intermediaries between donors, northern (I)NGOs and local recipients, who I conceptualise as brokers. They include INGO district staff, primary school teachers, health workers, village heads, and community representatives. Through a focus on their practices, I examine how they translate global norms and aims into programmatic practice. The thesis brings together three peerreviewed articles. The first (in Forum for Development Studies) discusses how primary school teachers deal with, and implement, various overlapping NGO initiatives targeting girls, and the implications for public sector institutions. The second article (in Medical Anthropology) examines how INGOs' programmatic focus on behaviour change interventions inadvertently results in staff blaming culture for teenage pregnancies and school dropout, reinforcing ethnic stereotypes originating in historical inequalities and previous health development initiatives which targeted harmful cultural practices. The third article (in Reproductive Health Matters) analyses the responses of village heads, midwives and women to the reintroduction of userfees for maternal health services resulting from donors' suspension of budget support, shifting national priorities, and unstable service delivery contracts. Overall, I argue that examining the practices of the brokers who implement and reshape health development initiatives can shed light on policy-to-practice gaps and how unintended consequences occur. My ethnographic research thus helps to explain why initiatives might not be sustainable despite the intention of donors and INGOs to strengthen existing public and community structures. 1 This research is led by Professor Sidsel Roalkvam, Co-Investigator Katerini Storeng, and senior researchers at the University of Malawi-Professor Blessings Chinsinga, Peter Mvula and Joseph Chunga. Fieldwork in Malawi has been carried out by three Universit...

When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi

“…This draws parallels with research on "street-level bureaucrats", who manage policy implementation and "broker" project demands in the context of resource constraints. 45,46 Local actors' inability to hold powerful actors to account demonstrates that webs of accountability are uneven. Only when we analyse power relations from the global to the local level, and how these dynamically interact with policies, can we understand how inequities are shaped.…”

Moulding the teacher: factors shaping teacher enactment of comprehensive sexuality education policy in Ethiopia

“…There is no unidirectional way of implementing a new policy. Instead, enactment is an ongoing process of reflection, interpretation, and mediation in which teachers play central roles (Altinyelken 2011b;Ball, Maguire, and Braun 2012;Pot 2018). Future education policies and programmes should thus pay attention to ways to strengthen teachers' positions in and outside schools, and reflexivity in teacher professional development.…”

“…The influence of the international development actors in schools has also had its effect on teachers; Pot (2018) describes how teachers in Malawi act as 'development brokers', advocating messages from non-governmental organisations (NGOs) to wider communities. Pot (2018) revealed that selected teachers became important resources for NGOs, and enjoy a relatively higher social status in their communities due to their affiliation to international organisations. At the same time, such association with development or the 'cosmopolitan' may also lead to teachers feeling alienated from their communities (Barrett 2005).…”

From complexity to simplicity – how chasing success stories affects gendered NGO practices

“…Due to RTP's multi-sectoral approach and focus on behaviour change, it was better than other efforts aimed at reducing teenage pregnancies. Such analysis, it can also be argued, helped to legitimise the need for this specific project in a situation of many other projects addressing teenage pregnancies (Pot 2019b). In particular, it was necessary to address environmental (family, friends and institutions) and individual (risk perception, vulnerability and opportunity) barriers for the use of youth-friendly health services, with an emphasis on sociocultural factors (Save the Children Norway 2013, 5).…”

“…Further, these girls often made appearances during donor visits as testimonies of success, telling their story about how the project had helped them back to school. Although success was attributed to this specific NGO project, Pot (2019b) has shown how such testimonies and the attribution given are not always clear in a context where multiple NGOs have been implementing similar projects. Common to these testimonies was a linear cause-effect chain in line with the global discourse: the girls had dropped out due to pregnancies and were not aware of the readmission policy until project partners informed them and helped them back to school.…”