Teaming Up for Orphaned Children

In 2008, Misganaw Eticha was looking for a partner to help address the needs of children living in Ethiopia. He was leading a nascent group called Stand for Vulnerable Organization (SVO), which had been established only three years prior, employed a full-time staff of three, and had no prior experience with global partnerships.

Eticha, who grew up in poverty in Ethiopia and went on to earn a master’s degree in development studies, was referred to a team led by Kathryn Whetten, Ph.D., a Duke professor who directs the Center for Health Policy and Inequalities Research in the Duke Global Health Institute. Whetten’s group was also doing work in the country as part of the Positive Outcomes for Orphans (POFO) project, a study aimed at understanding the experiences of orphans, separated children, and their caregivers across five low- and middle-income countries.

The meeting launched a 15-year collaboration that has deepened and flourished even in the face of political upheaval, leading to joint projects that are benefitting the socioeconomic stability and physical and mental health of Ethiopian youth and their families.

“Our partnership with Duke University grounded our organization administratively, managerially, and in project implementation capacity,” says Eticha, SVO’s founder and executive director.

But even more, the Duke-SVO partnership has provided a model for how research institutions can conduct community-led work in collaboration with local organizations. In global health, where even well-intentioned collaborations often fail to benefit local communities, it stands out as a rare partnership where everyone is happy.

Building Capacity and Innovation

Duke signed an agreement to work with SVO in May 2009. Given that SVO was still relatively new, the Duke researchers put an emphasis on capacity building – providing technology, training staff on research protocols, and setting up organizational systems.

While Duke played a critical role in technical assistance, it allowed SVO to take the lead on innovation. As one example, SVO designed a microfinancing scheme aimed at preventing child poverty by empowering their guardians. SVO organized self-help groups where members foster self-sufficiency and family management skills.

When group members make a certain amount of money, SVO adds an equal amount to a joint bank account, encouraging the group to work collectively toward goals. Women in one self-help group pooled funds from their joint accounts to purchase five grain mills, which they have been using to generate income for the past few years.

Another of SVO’s innovations is the Development Village, where six children live under the care of one guardian on a mixed-use development with residential homes, a clinic, and a library. The design of both the microfinancing scheme and the Development Village were informed by findings from the Duke POFO project, which has generated nearly 20 years of evidence for interventions that support children’s health and wellbeing.

Eticha says one of the unique aspects of working with the Duke team has been its focus on knowledge transfer, while many other partners are geared primarily toward providing services. He says Duke’s work on the project has influenced policymakers to “go in the right direction” when devising services for children.

“The research being undertaken by Duke University provides evidence-based information both to policymakers and service providers to address the needs of children,” he says.

Enduring Connections

The sharpest test of Duke’s partnership with SVO, however, may have come in the past few years, as the Ethiopian government has cracked down on foreign agencies operating in the country as part of its effort to quell a rebellion in the Tigray region. In 2021, the government suspended the work of three international aid organizations, accusing them of aiding rebels.

While suspicion about foreign influence continues to make it difficult for many NGOs to operate in Ethiopia, Whetten says Duke’s focus on community-driven leadership has allowed its work with SVO to go on.

“The government kicked out all foreign NGOs and most Ethiopian NGOs because they were associated with foreigners,” she says. “They allowed us to stay because we [Duke] were clearly not in control. We were allowed to stay and help them [SVO] build, but really, it was their creativity. What we can do now is to learn from that.”

Eticha echoes this perspective. “The leadership of Duke University considers SVO as its working partner, not only as the recipient of funds,” he says.  

When asked what advice he would give future researchers coming into Ethiopia, he again stresses the two-way nature of true partnerships: “Have good intention and passion to transform the target of your research: do not focus only on the result but on the long-term impact that result would bring in transforming the lives of the research targets.”

The POFO project, which is in its last year of data collection, has influenced policies regarding the care of orphaned and separated children around the globe. Its findings have helped shape the United Nations Alternative Care Guidelines, which have been adopted by the vast majority of nations. The project has also produced guidelines to assess the quality of residential care facilities, as well as interventions to address trauma and grief among orphaned children.