Chief Executive Officer, FHI 360

When a catalyst is added, something special happens. In science, a catalyst ignites a chemical reaction. When applied to human development, a catalyst is the spark that transforms an idea into a solution.

In this year’s annual report, we share some of the many ways FHI 360 is working with partners to catalyze positive change in the United States and around the world. Together, we are taking on some of the toughest human development challenges: curbing the spread of HIV and tuberculosis, improving nutrition and reducing stunting, preparing students for 21st-century jobs, helping small businesses grow, and more. Each collaboration unleashes new ideas and opportunities, strengthening our collective capacity to effect change. When the momentum gets going, change is unstoppable.

While a catalyst remains unchanged by the chemical reaction it sets off, FHI 360 staff in more than 60 countries around the world are profoundly affected by the work we do. We are always learning and searching for new ways to work smarter and to ensure that solutions are relevant, responsive and owned by those involved.

As you read about people working to change their lives and the world — the beekeeper with a dream to expand her small business, the policymaker with a vision to bring good nutrition to everyone in his country, the educator committed to ensuring that students in her home state succeed — we hope you see how challenges that once seemed insurmountable are being overcome by charting new paths that accelerate results and expand opportunities.

Warm regards,

Patrick C. Fine
Chief Executive Officer, FHI 360

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Photo credit: Leanne Gray/FHI 360

As a young girl in Jordan, Samira Saeed Mouawwad loved watching her neighbors tend to their bees. Years later, when Mouawwad and her husband began to struggle financially, she transformed her childhood interest into a business. “I took many training courses before I was able to master beekeeping,” says Mouawwad. “Now I import bees from abroad, nurture them, grow them and make pure honey.”

Mouawwad, who is one of the first women in her community to earn a living from beekeeping, improved her business skills when she participated in the USAID Jordan Local Enterprise Support (LENS) home-based business training. With new skills and confidence, Mouawwad was able to take her business to the next level. The LENS project is helping entrepreneurs in Jordan grow their small, home-based businesses into formal enterprises that generate steady streams of revenue.

Mouawwad learned food safety, packaging and marketing tips to connect with customers. “The topic I found most valuable was food safety, because it’s something home-based business owners often neglect and know little about,” she says. “My products are now tested and comply with food safety standards and regulations.”

Growing small businesses

Small, family-owned businesses are a lifeline for families and communities where there are limited formal employment options. They support job creation and drive productivity.

LENS helps businesses like Mouawwad’s by focusing on specific areas of private-sector demand, including food processing, transportation and logistics, and tourism. The project provides support through grants to businesses and works to improve access to institutional financing and increase investment opportunities. Support to professional associations builds their capacity to provide services and training for their members. LENS also focuses on targeted policy reforms, such as simplifying the business registration process, that encourage the growth of small businesses.

Empowering women entrepreneurs

Many home-based businesses are run exclusively by women, yet women entrepreneurs face more challenges than their male counterparts. LENS is empowering women like Mouawwad to create their own opportunities and map a future for themselves that they might not have thought possible. “The focus on small and home-based businesses is giving women the tools they need to become more powerful and independent, and this leads to their greater contribution to the economy,” says Mouawwad. “I’ve seen the impact on me and other women, and it’s remarkable.”

Mouawwad, who hopes to export her honey to other countries, has mentored and inspired other women in Zarqa to pursue beekeeping. She offers them encouragement and assists them with turning their own ideas into stand-alone businesses.

LENS hit a milestone in 2017 by reaching more than 10,000 micro and small enterprises through grants, technical assistance, workshops and events. The project is implemented by FHI 360 and its partners, Mennonite Economic Development Associates and the International City/County Management Association.

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Project: USAID Jordan Local Enterprise Support

Funder: USAID

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Photo credit: Mohammad Magayda/FHI 360

One of the greatest barriers to ensuring that antiretroviral drugs for pre-exposure prophylaxis (PrEP) are effective in people who are at higher risk of acquiring HIV is the need to take a pill for PrEP every day consistently. Making progress on ending the global HIV epidemic hinges on providing multiple options for HIV prevention, especially options that do not require daily regimens.

FHI 360 serves as the Leadership and Operations Center for the HIV Prevention Trials Network (HPTN), a global, collaborative, clinical trials network that develops and tests the safety and efficacy of HIV prevention interventions. HPTN launched the first global trial of cabotegravir ( HPTN 077), a long-acting injectable drug for PrEP, in 2015. HPTN 077 study data released in 2017 showed that injectable cabotegravir is safe and well-tolerated, and the study dose stays in the bloodstream at levels expected to be protective when injections are administered every eight weeks. The study and data analysis will continue until July 2018.

Long-acting injectable cabotegravir could provide an easier, more practical alternative to the current regimen of daily oral tenofovir disoproxil fumarate/emtricitabine for PrEP. This option could help bring us closer to controlling the HIV epidemic.

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Project: HIV Prevention Trials Network (HPTN), Leadership and Operations Center

Funder: U.S. National Institutes of Health (National Institute of Allergy and Infectious Diseases)

Yatin Thakur is a young Indian “serial entrepreneur” with big ambitions. Just 30 years old, he has already founded Startup India Advisory, a collective aimed at fostering entrepreneurship, and CoworkIn, a company that caters to a new generation of Indian entrepreneurs by providing affordable co-working spaces throughout New Delhi. This is in addition to founding seven other start-ups focused on wireless technology, media and bridging India’s rural-urban divide.

Thakur and five other Indian technology entrepreneurs visited the United States as part of an International Visitor Leadership Program (IVLP) called “Showcasing the American Technological Experience.” For 22 days, they traveled to six cities — Boston, Kansas City, Manchester (New Hampshire), New York City, Salt Lake City and Washington (DC) — where they took a firsthand look at e-governance initiatives, broadband access in rural areas and the use of big data in high-density U.S. cities. They also met with financiers to discuss how to gain investors and create the infrastructure for the next generation of technology tools.

Every year, IVLP brings emerging foreign leaders like Thakur to the United States for short-term visits where they can interact with U.S. counterparts to increase mutual understanding, share ideas and opportunities, and forge relationships. The leaders who participate in the IVLP program return to their home countries with energy and information that ignite new ideas and a better understanding of the United States.

New ideas, broader vision

Thakur says the knowledge he gained from the IVLP experience fundamentally changed his vision for his business as well as how he engages with government and business clients. “When you’re doing work in your country, you’re usually based in one city and you’re just thinking about your nearby surroundings and your local community,” he said. “The visit allowed me to figure out solutions from a broader lens and helped me think about how my work could be more impactful in my local state as well as the country.”

Before IVLP, Thakur operated two CoworkIn spaces in New Delhi. Now, he is in seven locations and plans to be in 20 spaces by the end of 2018. “My exposure to the U.S. environment showed me how to bring in the right people to work to achieve scale.”

Thakur, who is also the managing director for India at the Global Entrepreneurship Network, intends to do all he can to promote India’s growing culture of entrepreneurship and the fast pace of digital innovation. Already, he has given a head start to many young Indian entrepreneurs and startups. “I want to be in a key influencing position to make sure my country is moving forward and supporting all its people,” he says. “I want to make sure every Indian succeeds and that the country prospers and makes the world proud.”

IVLP impact

In 2017, FHI 360 designed programs for 543 IVLP participants from around the world on topics that included business development, human rights, investigative journalism, civic engagement, rule of law, disability inclusion and combating human trafficking.

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Project: International Visitor Leadership Program (IVLP)

Funder: U.S. Department of State, Bureau of Educational and Cultural Affairs

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Photo credit: Vivek Singh/The Verbatim Agency for FHI 360

An estimated 214 million women of reproductive age in low-income regions want to avoid pregnancy but are not using a modern contraceptive method. Hormonal contraceptive implants, introduced more than 30 years ago, are one of the most effective family planning methods available. Yet, until recently, access to implants has been limited in low-resource settings, largely because of the high cost of this method.

FHI 360 has led a decade-long initiative that has been at the forefront of increasing access to high-quality, affordable implants. In 2017, Sino-implant (II), a two-rod implant that is now marketed globally as Levoplant, was prequalified by the World Health Organization. Prequalification means that the product is recognized as meeting international standards of quality, safety and efficacy and can now be procured by donors like the U.S. Agency for International Development. As part of this process, FHI 360 partnered with Shanghai Dahua Pharmaceutical Co., Ltd. (Dahua), the manufacturer of Levoplant, to improve manufacturing quality systems, conduct clinical trials for prequalification and establish a global regulatory footprint and distribution platform.

More than 1.5 million units of the product have been distributed globally through this initiative. By increasing competition in the implants market, the introduction of Levoplant has also helped reduce the price of other implant products, further increasing women’s access and helping countries achieve their goals under the Family Planning 2020 (FP2020) initiative. To achieve a sustainable business model, Dahua recently formed a partnership with DKT International, a nonprofit organization, to act as Dahua’s global distributor and announced further price reductions of Levoplant in FP2020 countries. This is an important step in expanding access to highly effective and affordable implants in additional markets.

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Project: Sino-implant (II)

Funder: Bill & Melinda Gates Foundation

The Succeed 2020 project had a bold and ambitious goal: Support all North Dakota students to successfully transition from school to college and 21^st-century careers.

Although students were enrolling in postsecondary education at a rate that outpaced the national average, they were not staying in school: North Dakota’s postsecondary completion rates for both two-year and four-year institutions fell below the national averages.

Leading the charge for change were eight regional education associations that work with school districts, higher education institutions, state and local governments, businesses and community groups. To aid their efforts, Succeed 2020 provided customized technical support and tools to generate data and research that educators can use to develop targeted programs for the unique needs of differing schools.

Customized solutions

For Jennifer Carlson, the project’s resources and technical support were crucial to transforming her region’s largely rural schools into ones that provide more rigorous academic and career and technical education programs, college and career counseling and support for students needing extra help. “The project really helped us to drill down and determine the best way to achieve the most goals within the fastest time,” said Carlson, the executive director of North Dakota’s Northeast Education Services Cooperative (NESC), one of the state’s regional education associations.

NESC designed a system that consistently collects and analyzes data from both internal and external sources. The data system increased NESC’s capacity to identify gaps in services and supports and more effectively allocate resources in the region’s 22-member public, private and tribal school districts. Educators were offered professional development activities, while students had access to more rigorous curricula and college and career preparation activities, including virtual job shadowing and science, technology, engineering and math (STEM) camps.

Better student outcomes

The impact of the five-year Succeed 2020 project can be seen across North Dakota. The number of students qualifying for state scholarships increased by 9 percentage points, from 15 percent to 24 percent. Succeed 2020 also engaged North Dakota businesses: About 350 participated in career fairs during the 2016-17 school year, which informed students about career opportunities as well as the education needed to get those jobs. Among students participating in college and career readiness activities in the same academic year, 93 percent reported knowing more about careers, and 85 percent reported increased understanding of the importance of aligning course selections with career choices.

With improved infrastructure at NESC, Carlson says her regional education association, along with the others that served as the project’s change agents, is now able to move forward using a data-driven perspective. This will help to ensure that schools are meeting the needs of their students, and the people who educate them, as they transition into their next chapter.

“We’ve increased our organizational capacities, including our in-house education data system,” Carlson said. “Data is part of our culture now.”

NESC was recently awarded a grant from the U.S. Department of Education, which will enable it to partner with three districts and the Spirit Lake tribe to build on college and career readiness efforts initiated under Succeed 2020.

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Project: Succeed 2020

Funder: Hess Corporation

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Photo credit: Leanne Gray/FHI 360

Although Tanzania has seen notable improvements in nutrition over the last decade, undernutrition remains pervasive: 34 percent of children under 5 years of age are stunted and 14 percent are underweight.

Armed with this information, the Government of Tanzania and its partners have mobilized to improve nutrition and greatly reduce stunting. With support from the Food and Nutrition Technical Assistance III (FANTA) project, Tanzania has adopted an evidence-based, multisectoral, nutrition action plan that breaks new ground in the country and can serve as a model for nutrition policy globally.

Breaking silos, widening the scope

Obey Assery, a trained economist and the Director of the Coordination of Government Business Department in the Prime Minister’s Office, played a pivotal role in building support for a more comprehensive approach to improving nutrition.

“Nutrition was initially only really looked at as a health initiative,” said Assery, who worked in close collaboration with FANTA to strengthen and align government efforts on nutrition reform. “It’s now become a multisectoral issue, which requires everyone to be involved.”

This change did not come quickly. Political commitment was essential to shift mindsets, and it took a concerted effort to increase awareness of the effects of malnutrition on national development and the need for multiple sectors to address it. Not only does malnutrition lead to underperformance in school, it reduces participation in the workforce and undermines economic growth and productivity, stunting not just individuals, but a country’s overall development.

FANTA’s approach focused on supporting the Prime Minister’s Office and the Tanzania Food and Nutrition Centre to build individual and institutional capacity, mentor leaders, foster relations with community groups and strengthen coordination across sectors to increase the sustainability of nutrition programs. These efforts resulted in policy revisions and the launch of Tanzania’s first five-year Multisectoral Nutrition Action Plan (2016–2021).

“We put together technical people from different sectors with a common agenda,” says Assery. “This meant bringing in the people from agriculture, from livestock, from water, from finance — people with different thinking to widen the scope and work together.”

The FANTA project has also integrated and systematically scaled up nutrition assessment, counseling and support (NACS) into national strategies, local government plans, budgets and program guidelines; routine health service delivery; community-based programs; and HIV care and treatment, prevention of mother-to-child transmission and most-vulnerable children programs. Health managers, health care providers and community workers have been trained in the NACS approach. Training, job aids, practical assessment tools, registers, and monitoring and evaluation forms for service providers have been developed and distributed. By mid-2017, NACS services were integrated into health facilities and community services in 22 of mainland Tanzania’s 26 regions.

Healthier, more productive citizens

Using PROFILES, an evidenced-based model, FANTA led a multisectoral stakeholder process to estimate the impact of malnutrition on human capital, economic productivity and health outcomes. The estimates show that investing to reach nutrition targets over a ten-year period (2014–2025) will save hundreds of thousands of lives, reduce disabilities and result in significant economic gains in Tanzania.

Tanzania was one of the first countries to put the NACS approach into operation and to emphasize a multisectoral approach to tackling nutrition problems. Says Assery, “Other countries are now seeking Tanzania’s help in creating models they can use to address similar issues and achieve similar results.”

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Project: Food and Nutrition Technical Assistance III (FANTA)

Funder: USAID

After many years of authoritarian rule, the Southeast Asian country of Myanmar (Burma) is on a journey toward establishing a functioning democracy. Effective, sustainable and independent civil society and media organizations are vital to success.

FHI 360 is helping to build civil society and media capacity. In partnership with Internews, Voluntary Service Overseas, and the Public International Law and Policy Group, we are supporting civil society and media leaders who are laying the foundation for greater openness in their country. We support civil society and media organizations that seek to advance democratic reform through:

 

• Promoting civic action and engagement. We work with more than 30 organizations on how to promote legal and policy reform and develop advocacy campaigns by working in coalitions. As part of this work, we brought together more than 100 civil society representatives with members of parliament to discuss the rights of farmers, persons with disabilities, women’s rights and the ratification of the International Covenant on Civil and Political Rights.
• Supporting an independent media. Through a local partner organization, Mizzima, 120 state and national-level members of Parliament have been trained in the function of a free media in a democracy and how they can work with media to engage the public. Because such engagement was not possible in the past, this is new territory for both leaders and journalists.
• Reintegration and skills building. We connected 50 former political prisoners with civil society organizations, where they served as fellows in the Former Political Prisoners Fellowship Program. Participating organizations benefit from the fellows’ political knowledge and advocacy experience, while the fellows develop practical skills to succeed in the workplace.
• Leadership development. We trained more than a dozen “inclusion champions,” who will build local capacity among civil society organizations to change societal attitudes.

 

Through our work, organizations in Myanmar are on an accelerated path to effective leadership that reflects the interests of their constituents and those who advocate for positive reform.

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Project name: Civil Society and Media Project

Funder: USAID

Decades-long conflict has stunted economic growth and development in Afghanistan. To rebuild their country and fully participate in its workforce, Afghans need access to quality higher education and vocational training that responds to the needs of employers and the realities of the job market.

The University Support and Workforce Development Program (USWDP), in partnership with Purdue University, is helping to link education programs to jobs by establishing a market-oriented bachelor degree program in food technology at the Herat University Faculty of Agriculture (HUFA). In 2017, 15 third-year students from existing departments transferred into the new food technology department.

A breakthrough in food technology education

“This department is the first food technology program in our country,” said Yosouf Jami, dean of HUFA, which is in western Afghanistan close to the border with Iran. “Graduates in this field can serve at the agriculture directorate and health department, work for companies in the food industry or go into other food-related areas.”

Food technologists use science to create and improve food products. The HUFA curriculum covers the fundamentals of food technology while teaching applied, practical skills in food processing, food safety and product development. Upon graduation, students will receive help finding jobs. More than half of this year’s students are female, and the university is making plans to ensure that the next group of students has a similar gender balance.

HUFA, Purdue University and USWDP developed the food technology program in close consultation with representatives of the food processing industry. The curriculum takes into account the unique challenges faced by Afghan companies and the skills graduates need to support food production and processing.

“A lack of skilled employees is our biggest challenge in this sector,” explained Jami. Until now, people outside Afghanistan were needed for technical assistance. “We hope that graduates of this department will be able to meet industry needs. This is a major educational necessity in our country.”

USWDP and Purdue University have worked closely since 2015 to design and implement the program. USWDP has taught students about basic research survey methodologies and supplied materials, such as the equipment and chemicals needed to establish a teaching laboratory. Members of the Purdue food science faculty visit regularly to provide training and assistance, and HUFA’s faculty have visited Purdue twice for intensive skills building in lab techniques. USWDP and Purdue are jointly supporting four HUFA faculty to obtain master’s degrees in food technology in India. These faculty expect to complete their studies in July 2018 and will return to assume leadership and teaching responsibilities in the food technology department. Jami is optimistic about the impact of this young program. “The food industry and other organizations will benefit,” said Jami. “When students graduate and enter society, they will bring the benefits from their recent study, and the industry will benefit from their professional knowledge and skills.”

A smaller part of a larger effort

Eleven universities receive technical and financial support from USWDP, including the food technology program at Herat. Since it began four years ago, USWDP has established or supported 32 degree programs, including five newly established associate degrees, 18 bachelor’s degrees and eight master’s degrees. These programs, supported by the University of Massachusetts and other academic institutions in the U.S., provide students with some of the most sought-after degrees in Afghanistan. Examples of degree offerings include an associate’s degree in information technology, a bachelor’s degree in oil and gas and a master’s degree in education leadership and management. These programs are bringing the country closer to creating a technically qualified, professionally capable workforce.

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Project: University Support and Workforce Development Program

Funder: USAID, Government of Afghanistan

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Photo credit: Kiana Hayeri/The Verbatim Agency for FHI 360

The potential for digital technologies to transform societies for the better and address some of the world’s most pressing challenges has never been greater. In Liberia and Ghana, FHI 360 is using technology to collect data to improve the quality and timeliness of decision-making, deliver better program outcomes and increase accountability.

Mobile payments = regular salaries

FHI 360, in partnership with the Liberian government, is transforming the way its school staff and health care workers are paid. In the past, school staff needed to leave work and travel long distances to collect their salaries, costing them time and money and causing them to be away from their classrooms. In July 2016, 67 school staff began receiving their pay digitally by mobile money, an easily accessible substitute for cash. By the end of 2017, that number had climbed to more than 3,000 school staff and 800 health care workers in nearly all of Liberia’s counties. The Government of Liberia also benefits: It can distribute salaries more efficiently and transparently.

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Project: Mobile Solutions Technical Assistance and Research (mSTAR)

Funder: USAID

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Real-time data collection = better service delivery

In all ten regions of Ghana, more than 820 circuit supervisors within the Ghana Education Service have been trained to use a mobile system to collect data on an early grade reading program, twice per term from 7,278 schools. FHI 360 provided each supervisor with a tablet and a SIM card to collect and transmit the data. Collection is done by custom observation, interview and assessment forms designed to run on an open source software that allows data to be entered offline anywhere and stored on an Android device until an internet connection is available. The large volume of data feeds into three online dashboards that allow rapid analysis and visualization. With these dashboards, the Ministry of Education and the Ghana Education Service officials, district teacher support teams and the Ministry’s development partners can see what is working well and what problems need to be solved. Data verifies factors such as whether teaching and learning materials actually arrive and are used at schools and which schools are not on pace to meet teaching and learning objectives. Support and coaching is then targeted at schools where it is needed most and tailored to teachers’ needs.

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Project: USAID Ghana Partnership for Education: Learning

Funder: USAID