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Helping an NGO Get Down to Business

March 16, 2022

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Elise Deeqa Mugabo

Head of OpEx
Population Services International


Stacey Bullock

Senior Manager of OpEx
Population Services International

What if nonprofits applied business practices to model operational excellence, improve organizational processes, and manage change? Global health NGO Population Services International (PSI)’s newly formed Operational Excellence (OpEx) department was set up to find out.

We talked to this year’s Humentum OpEx awardees Elise Deeqa Mugabo, PSI’s Head of OpEx, and Stacey Bullock, PSI’s Sr. Manager of OpEx, to understand how PSI leverages private sector approaches to evolve into a global health NGO of the future.

PSI: Tell us about yourselves! What led you to, and how long have you worked at, PSI?

Elise Deeqa Mugabo: Growing up in several African countries, I saw many NGOs and nonprofits that, despite having great missions, would eventually close because they didn’t want or didn’t know how to exploit business best practices. I went to business school hoping to help similar organizations consistently deliver on their missions by keeping their lights on while other people performed the technical work. At the time, this was a bit of a weird idea. A lot of the organizations that I wanted to work for said, “That’s an interesting idea, but not here.” PSI grabbed my attention, though, because of their dedication to harnessing private sector principles to bring their work to life and sustainably. This, I thought, was the organization where I really belonged! With some persistence, I got my foot in the PSI door in Rwanda in 2004. I’ve been with PSI ever since, across different countries and holding several roles.

Stacey Bullock: Through a decade of experience in international development, I found myself regularly thinking, “there has to be a better way.” From implementing projects and programs to managing global operations, I felt passionate about finding ways to increase efficiency and effectiveness to yield greater impact. The development sector faces constant pressure to do more with less. Yet, many entities in this space struggle to develop operational strategies that incorporate business management principles and best practices that would help. I joined PSI in early 2021 as I was finishing up an Executive MBA program concentrated on strategic leadership. I was driven to bring my program knowledge back to a mission-driven context, and PSI was establishing the new Operational Excellence department. It was exciting to join an organization proactively investing in this, and an amazing opportunity to join at the beginning and partner with Elise to build out the unit.

PSI: What led to the formation of PSI’s OpEx Department? What do you aim to achieve in the next five-ten years?

Mugabo/Bullock: PSI aims to increase equitable healthcare access, improve sustainable health behaviors and outcomes, and accelerate progress toward universal healthcare coverage – all with consumers at the center. One of the three vehicles PSI has identified for arriving at that goal is “Strengthening Global Capacity.” This vehicle depends largely on fostering and scaling technical and operational excellence to ensure top value for consumers, government partners, and donors. To that end, PSI recognized a need to build a department dedicated to defining operational excellence, setting the foundation and minimum standards for operational excellence, and fostering and growing a culture of operational excellence throughout PSI and among our stakeholders. That was just over a year ago.

We want all stakeholders to agree that operational excellence is not any department’s responsibility but a concept that we embed across our collective work. For us, a culture that embraces operational excellence is one where staff at all levels and departments think about the flow of value in the organization and help continuously improve that flow. We would love for concepts like continuous improvement, risk management, time and resource efficiency, among others, to be something that all of our stakeholders consider as equally core to their job description as any other aspect of their role. And we want our OpEx department positioned as a support system to provide the resources, guidance, and expertise to implement those concepts well.

PSI: How do private-sector practices inform how you model operational excellence, improve business processes and manage change in the non-profit development sector? 

Mugabo: We are both MBAs and licensed Green Belts in Lean/Six Sigma. I started up and ran my own small private business and helped my husband establish his own, much larger private business that, at any given point, has operated in six+ countries across the African continent.

Bullock: I have experience in for-profit and non-profit operating models and have worked across a number of functions to appreciate the complexity of development.

Mugabo/Bullock: Together, we weave our real-life experiences and lessons learned into our job every single day, often gained in the very same countries where PSI’s health consumers and staff live, helping us to deliver our department’s mission to “make it easier for PSI staff to ensure high- quality results for PSI, our funders, our government partners, and our consumers in the Global South.”

Some of the key points that get us there include:

  • We ensure that our client’s voice (PSI staff) drives our work- not our own pre-conceived notions of what needs to be done, from identifying priorities and solutions to implementing and monitoring solutions for continuous results. As a result, the solutions we catalyze meet our clients’ actual needs.
  • We focus on human resources through tight collaboration with the HR department, prioritizing delivering the most effective and targeted trainings that lead to sustained behavior change. We recognize that no matter how robust the systems are, no matter what processes or technology are in place, change is contingent on PSI recruiting and motivating the right people in the right places.
  • We make data-driven decisions. We observe, listen and facilitate working groups. We also collect and analyze quantitative data, including but not limited to trends across financial performance, trends in audit performance, and trends identified through risk management registers. Combining qualitative and quantitative data, the OpEx Department objectively identifies effective priorities and solutions.
  • Similarly, the OpEx Department strives to instill a culture of continuous improvement throughout PSI. This is a critical component of ensuring that we as an organization do not stop at “just good enough,” but rather identify efficiencies that will allow us to repeatedly “do it even better next time.” Much of this hinges on making operational excellence fun (yes, fun!). We’ve found that by identifying what motivates our clients and bringing joy to their work, our department will more effectively and sustainably instill a culture of operational excellence across PSI’s global network.

PSI: OpEx supports PSI to “execute brilliantly.” How will this shape PSI into a global health NGO of the future?

Mugabo/Bullock: The OpEx Department aims to make it easier for PSIers to do their job well—all amidst a complex global landscape:

  • At least half of the world’s population lacks access to quality essential healthcare;
  • 100 million people are pushed into poverty annually due to out-of-pocket spending on health;
  • Only 60-80 percent of health spending goes where it should; the remaining 20-40 percent could be used more efficiently.

That is an almost overwhelming task; we want PSIers to focus on delivering Consumer-Powered Healthcare, and doing that well. We do not want PSIers to waste precious time looking for the basic tools and resources they need to get their job done. We do not want PSIers in one country to waste time re-creating what’s already been created in another PSI country. We do not want PSIers to waste time because they do not have the fundamental skills to get their job done. We do not want precious time, money or effort that could go toward facilitating Consumer-Powered Healthcare wasted on unnecessary tasks or inefficiencies.

We hope that by identifying areas for process improvement and increased operating efficiency, facilitating access to staff capacity-building and training, establishing the building blocks of user-friendly risk and compliance management and setting minimum standards of operational excellence, we can help PSIers get right down to business.

Photo credit: PSI

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