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Navigating the Complex World of USAID Compliance

April 16, 2024

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Hazel Reinhardt

President and CEO
Foundation for Cancer Care in Tanzania


Sarah Le Pape

Senior Manager, Marketing & Communications, IQTS, France

In a world where cancer affects millions of lives, organizations like the Foundation for Cancer Care in Tanzania (FCCT) are crucial in providing care and support in low-income countries. Prior to FCCT, Tanzania only had two cancer care facilities to serve a population of 65 million. We recently spoke with Hazel Reinhardt, the President and CEO, to gain insight into the organization’s journey from its early days to its recent collaboration with Humentum’s consulting services to enhance their compliance with USAID regulations. 

The vision  

The Foundation set out to create a comprehensive cancer care center at the Kilimanjaro Christian Medical Center (KCMC) in Moshi, Tanzania. Serving around 15-16 million people, KCMC is a referral hospital located in the foothills of Mount Kilimanjaro, making it a central hub for cancer diagnosis and treatment. This ambitious project began in 2013 after a group of physicians and a healthcare administrator supporting the development of imaging services at KCMChaving identified the need for cancer care services through those effortsformed a new organization to support cancer care beyond surgical interventions. Additional healthcare professionals in Minnesota, US were recruited to lend their expertise, and FCCT was formed. 

Navigating regulatory hurdles 

As the Foundation expanded its scope, it embarked on additional initiatives, such as constructing an inpatient ward and a radiation center, which received partial funding from the Tanzanian government. The team applied for USAID funding to get the necessary support to complete the radiation center. While the initial grant was awarded, it came with stringent requirements. FCCT had to navigate the complexities of USAID compliance, which included creating detailed policies, procedures, and manuals. A USAID auditor’s review also highlighted the need for more comprehensive documentation and processes.  

Finding the right partner 

Hazel and her team recognized the need for guidance. That’s when they turned to Humentum for support.   

“I called Alight [Humentum member], which used to be the American Refugee Committee. The Chief Financial Officer knew that Humentum offered consulting services and urged us to join so we could meet other people in the global development space, which we did. And then, while browsing the Humentum website, we discovered they had expertise in USAID compliance.”    

Hazel pointed out that they needed a solution addressing their compliance challenges. Humentum worked with the Foundation to refine the project needs, resulting in a cost-effective proposal. This approach ensured the Foundation would have what it needed to meet USAID compliance requirements.   

Working with Humentum proved to be a valuable experience for Hazel and her team. “This was the best money we have ever spent,” she said. Hazel also praised Humentum consultant Francesca Cesti-Browne for her attentive and personalized approach. The Foundation noted that Humentum was eager to understand their unique needs and created a solution that addressed those requirements. 

I can't say anything but the highest, most glowing comments about Francesca. She listened to our needs and concerns, read our materials, and came back with a proposal. And the Project Manager, Michael Thotho, set up the whole framework of the meetings, keeping everything on track.

The ripple effect of compliance  

Hazel discussed the impact of their compliance journey on the organization and how it has also enhanced its relationship with the accounting firm, which charges 50% of its time to the organization and donates 50%. Due to the consultancy, FCCT has enhanced the firm’s internal controls and increased the separation of duties among its staff in relation to their work. The new processes have also streamlined budgeting and financial management needs.  

To that end, the consultancy has laid the groundwork, equipping the Foundation with documented and formalized policies and procedures. Hazel emphasized the strategic significance of these measures by highlighting their forward-looking nature, anticipating the organization’s growth trajectory. She also shared that the Foundation’s collaboration with the Humentum team has extended beyond the initial project, fostering a long-term and supportive relationship for ongoing compliance needs.  

Reflecting on the journey, Hazel elaborated on a key recommendation that emerged—the creation of a comprehensive written policy manual spanning approximately 60 pages. Despite initial skepticism from some board members who questioned the necessity, Hazel reaffirmed the need for thorough documentation. She asserted, “Some of our board members said, ‘Isn’t this overkill?’ But we have all the I’s dotted and the T’s crossed”. The policy manual has been a proactive tool, foreseeing the organization’s growth and catering to its evolving needs. This underscores the consultancy’s commitment to meeting present requirements and laying a robust framework for the Foundation’s sustainable future. 

Aside from the consultancy, Hazel and her colleagues have also completed Humentum’s USAID Subaward Management training facilitated by Edna Chibole, who Hazel describes as a “marvelous teacher”. The comprehensive course proved a valuable addition in preparing the team to manage USAID’s strict regulatory requirements.   

Unlocking long-term success 

While compliance doesn’t always sound exciting, the Foundation’s journey is a testament to the impact it can have on an organization’s ability to get funding. By seeking external support, FCCT found a solution that equipped it to meet the rigorous standards of USAID. Having just received a second USAID award, the Foundation continues its work in expanding cancer care in Tanzania. It now stands better prepared to navigate the complex world of compliance. 

Wherever you are on your journey with USAID, Humentum consulting has the expertise and the practical experience your organization needs. From readiness to reporting, from sub-awards to systems support, from NICRA to navigating proposals, we’re here to support you. We don’t just point you in the right direction—we become your partner for achieving your goals.

Reach out today