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Oxfam Australia’s South Africa country program, No Longer Vulnerable promotes and supports an integrated programming approach. This has been pioneered as a new and effective way to enable positive change for the people with whom Oxfam Australia (‘Oxfam’) works. The approach intends to ensure that people have access to the broadest range of services and support that they need at the shortest possible distance to where they live and work. Civil society organisations supported by Oxfam deliver programs that improve health outcomes relating to HIV and AIDS, tuberculosis and water-related infections and diseases, increase and sustain food security and livelihoods options available to households, and increase and uphold access to social protection and socio-economic rights. The integrated country program was initiated in July 2012 with forty-four partners across the KwaZulu-Natal, Limpopo, Eastern Cape and Western Cape provinces. Eighteen months into the program, a Mid Term Review was commissioned to ensure that careful reflection and analysis across a broad range of projects and partners could help Oxfam take stock of how the program was unfolding and to strengthen its implementation. The review focused on three broad questions: 1. Has the program progressed towards the intended objectives? What have been the major

learnings emerging from the work implemented thus far? What is emerging as areas of focus and what does this mean then in terms of the strategy’s objectives?

2. As this program was intended for integrated approach targeting vulnerability as a measure of programming, how well has the program responded to this factor? Based on the work done thus far, has the program addressed vulnerability (as a focus) and if not, what can be done going forward using vulnerability as the measure?

3. The framework has been aligned to the Rao and Kelleher’s “integral framework” as the base of the theory of change. How this theory has has been internalised and used by program staff?

The major limitation of the study is that it was a review and not an evaluation. As such, some of the emerging analysis cannot be seen emanating from a rigorous, scientific research process. Process was more around reflection on what has emerged – intended solely to assess progress and highlight emergent theory and understanding of concepts in the design. Nonetheless, the findings and recommendations were validated through a process of corroboration through key informant interviews, roundtable discussions and informal discussions with senior staff.

Overview

Learning note

‘No longer vulnerable’

Midterm review

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Working in an “integrated” manner “Integration” is happening across Oxfam’s work and emerging from the ‘grassroots’, that is, communities and through partner experience, through careful community facilitation, social dialogue, diagnosis and learning. This approach allows civil society partners to “identify the links” between factors underpinning social vulnerability and to prioritise these according to what beneficiaries articulate. This empowers partners and in turn, their beneficiaries and affected communities, to begin engaging the structural underpinnings of vulnerability, such as holding local government to account for non-delivery and poor services. Diversity of partner organisations brings in new skills and approaches that contribute to the integration of programming, and creates new alliances and positive tensions. Using the “Integral Framework” As seen from the complex context in which Oxfam works, facilitating change depends on working across multiple spheres. Explicit recognition of this is in the “theory of change” which draws on Rao and Kelleher’s “integral framework”.

Although staff and partners intuitively recognise the “integral framework”, it is mostly not an explicit part of programming. Many partners believe a more conscious use of the framework would strengthen strategy. For example, in instances where partners’ work does not coherently address the lower right quadrant (formal institutions – laws, policies and networks), partnerships can be established with advocacy and policy organisations. Similarly, a more explicit focus on the lower left quadrant can be used to emphasise a focus on gender and women’s empowerment. Essentially the framework helps view the whole system in which people are embedded.

Active Citizenship Examples of how active citizenship has facilitated change range from social dialogue and building accountability within communities to high-level advocacy campaigns. A multi-pronged approach that can be targeted at national level or within a particular community has proven effect. There is a clear role for Oxfam to make this more explicit in their strategy to link organisations across a particular issue. Given people are busy simply trying to survive in a very challenging environment, there is often not enough space for debate and dialogue. Oxfam needs to support different ways of creating dialogue within communities to build civil society.

What did we learn from this process?

Rao and Kelleher's Integral Framework

“I like the idea of building accountability in a constructed way through encouraging local level active citizenship, but there is always the risk of violence, particularly in South Africa where things can heat up very quickly ... We need to think through the implications of context for Oxfam and its partners, as it can throw them into greater state of vulnerability.”

“Issues around vulnerability and marginalisation seldom adhere to strict program boundaries. The resultant impact of programming often goes unrecognised as these fall between the “silos” of differentiated programs, leaving limited options to capitalise on opportunities to consolidate learning and apply them across programs.“

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Gender No Longer Vulnerable has a strong gender analysis. Work has been done internally with staff and externally with partners and other groups to develop the skills to recognise and respond to the need to place women more centrally as both actors in development and primary beneficiaries of Oxfam’s work. This reflects the abiding concern of the program that unless the structural roots of vulnerability are addressed, any change may be temporary and illusionary. The vulnerability context is characterised by increasing poverty and inequality, alongside gender inequalities and discrimination reinforced by socio-economic inequality, therefore the aim to reduce vulnerability as essential gendered work and provide women with spaces to bring their own solutions, make their own choices and build solidarity, is pivotal for the ongoing work of the program. Working with communities Development planning often romanticises the coherence of communities and in doing so underestimates their complexity. This failure to recognise complexity often leads to inappropriate interventions and blowback from ‘beneficiaries’, as the needs of communities are not adequately addressed. Oxfam programming, especially those in the urban context, has embraced this. Given the prevalence of contestation in South Africa – whether between communities and the state or within communities themselves – it is imperative that development practice engages with conflict and contestation as a means through which to address vulnerability. Oxfam has created participatory spaces to enable communities to express disagreements, contest power and outcomes, and reach decisions. Programming Challenges facing partners include: working with health issues where “local public health services seem to be deteriorating every day”

with “no treatment available for infectious diseases, no vaccines for children and no antibiotics”. The question is how to effectively engage the public health system. Partners are increasingly integrating WASH and HIV-related services for increased impact. A central strategy is to support learners with greater understandings of hygiene, sanitation and the links to the disease burden such as HIV and other sexual and reproductive health and rights issues.

how to effectively engage with different levels of government in relation to food security, as there is

little control over the terms of engagement. Opportunities exist with the emerging policy on farmer support and extension and linkages with broader Oxfam affiliates and strategy on food sovereignty. There is a need generally to know rights at the community level, but government also needs to be aware of these for more constructive dialogues.

“It is interesting that WASH’s greatest impacts are not with AACES partners – this emphasises the integrated approach in that WASH has gone beyond its seven core partners.”

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Emerging opportunities: implementation by partners of increasingly complex strategies

for campaigning around rights, advocating for justice and advancing the voices of minorities. Partner examples have transcended different levels from national level processes such as the Traditional Courts Bill to attending ward committee meetings. The engagement of local politicians, such as Ward Councillors, often serves as an initial link between communities and local government. Risks exist that the issues raised may become politicised in a ‘party politics’ manner. Nonetheless, mobilised communities that hold local officials to account for service delivery see increased results in service quality to their communities.

the Disaster Risk Reduction (DRR) program’s exploration of urban

work, particularly in inner city and informal settlements, with an emphasis on safer spaces for vulnerable groups in communities of young women and refugees. Consciousness raising meetings have contributed to raising awareness about DRR as a rights issue. Local experiences and interpretations of this type of work have challenged international presumptions about what DRR work is, and the DRR program has reiterated the need to look beyond just the provision of facilities and support services to the physical environment and women.

Recommendations included: the need to elaborate on the concepts of ‘vulnerability’,

‘integration’, and ‘social accountability’ and share these as ways of working based on the South African experience.

ways to share lessons and raise awareness of the “integral framework” as part of programming and strategy development with both staff and partners.

the need to better articulate and support multi-pronged influencing approaches at different levels and that better link organisations across particular issues.

how to place women more centrally as both actors in development and as primary beneficiaries of Oxfam’s work, as well as considering a nuanced approach to specificity and location to account for the different forms of discrimination in urban and rural contexts for women.

Where to from here?

Reflecting on the experiences of Oxfam partners, Bela Bela and the Treatment Action Campaign (TAC), it is clear that strategies should pivot on mobilising people to demand from provincial structures an adequate and functioning service at district and local level. Bela Bela has demonstrated how effective and focused operations with better leadership and management can achieve quality health services. TAC has a proven track record of working both outside and with government to bring about change. The two entities provide an important opportunity to consolidate Oxfam’s overarching strategy to elicit change in the health sector.

“How can we start prioritising to leave the best legacy program based on this information (in light of Oxfam South Africa’s emergence) over the next 18 months?” “We need to strengthen partners and consider how best to engage and what we can we do better. We need to look at sustainable strategies for engaging government, and exploring the area of accountability.”