BY SIFISO NHLABATSI
MATSAPHA– The graduation of Eswatini Nazarene Health Institutions (ENHI) from the Accelerating Local Organizational Capacity for Achieving TB/HIV Epidemic Control (ALLOCATE) Project has marked what Georgetown University described as a permanent shift towards local leadership and ownership in the delivery of public health programmes.
The three-year initiative, implemented by Georgetown University in partnership with ENHI, was designed to strengthen the institution’s organisational and professional capacity and prepare it to assume greater responsibility for managing its health portfolio.
Speaking during the ALLOCATE graduation ceremony at Esibayeni Lodge in Matsapha on Thursday, Georgetown University Country Resident Director Professor Samson Haumba said the occasion was about more than the completion of a project.
He said it represented a defining milestone for ENHI and the broader public health landscape of Eswatini.
“Today is a graduation, but far more importantly, today is living, undeniable evidence that sustainable technical transition works,” Haumba said.
He said the graduation demonstrated the realisation of a shared vision of moving from capacity strengthening to country ownership.
According to Haumba, when Georgetown University and ENHI began the ALLOCATE journey in 2023, the objective was never limited to conventional classroom training.
The project sought to strengthen core systems, deepen institutional accountability, build operational confidence and establish a culture of continuous learning and improvement.
The starting point was an organisational capacity assessment conducted by ENHI in September 2023 using the Organisational Capacity Assessment Tool.
Haumba said the assessment produced a baseline score of 2.75 out of four and identified significant operational vulnerabilities, particularly in programme management, which scored 1.40 out of four.
There were also opportunities for improvement in human resources, project performance tracking and long-term organisational sustainability.
Rather than treating these gaps as a weakness, ENHI leadership used them as a roadmap for institutional improvement.
ALLOCATE subsequently adopted what Haumba described as a “learning by doing” approach, combining participatory technical assistance, targeted workshops, executive coaching, direct clinical mentorship, peer learning, twinning and buddy systems, and communities of practice.
The approach, he said, was intended to build capability that ENHI could fully own and sustain independently.
Three years later, the results showed substantial organisational improvement.
ENHI’s overall capacity assessment score rose from 2.75 in 2023 to 3.89 out of four in 2026.
Programme management, which had recorded the lowest baseline score, increased from 1.40 to a perfect four.
Human resources improved from 2.38 to 3.80, while organisational management and sustainability increased from 2.63 to 3.80.
Project performance management rose from 2.80 to 3.80, while governance and legal structure advanced from 3.00 to four.
Haumba said these figures represented more than improved scores.
“They represent stronger operational systems, more confident and capable managers, robust compliance frameworks, and an institution fully equipped to take total accountability for its clinical and administrative outcomes,” he said.
The culmination of this transformation is ENHI’s move towards assuming direct leadership as a prime awardee of international health funding.
Haumba said this was what made the graduation particularly significant.
“What makes today’s graduation so deeply significant is that it signals a permanent shift in how public health is owned and delivered,” he said.
He said ENHI was now stepping forward to assume direct leadership as a direct prime awardee of international health funding.
This transition, according to Haumba, was consistent with the trajectory envisioned by ALLOCATE, PEPFAR and the United States Centers for Disease Control and Prevention — moving away from reliance on external technical oversight towards local leadership, direct ownership and self-directed decision-making.
ENHI Chief Executive Officer Mazwi Mavuso similarly described the graduation as a transition into greater responsibility.
Accepting the graduation on behalf of ENHI, Mavuso said the certificates presented to graduates should not simply become decorations.
“A certificate should not be a wall decoration; it should be a working tool,” he said.
He said the real graduation would begin in ENHI’s clinics, wards, laboratories, offices and boardrooms, where the knowledge and skills acquired would have to be applied.
Mavuso said ENHI would integrate ALLOCATE tools, procedures and lessons into its institutional policies, workplans and standard operating procedures.
The institution would also continue mentorship, coaching and peer learning, incorporate ALLOCATE content into staff orientation and leadership development, and use monitoring, audits and performance reviews to track improvements in service delivery.
The transition comes with significant responsibilities.
Haumba cautioned that becoming a direct prime awardee would bring heightened accountability for public resources, regulatory compliance, statutory reporting, team stewardship and, most importantly, the health and lives of people relying on ENHI facilities.
“Graduation is the milestone; sustainability is the ultimate test,” he said.
He urged ENHI to maintain strong financial management, institutionalise mentorship, nurture the next generation of public health leaders and ensure that its systems remained resilient despite changing funding environments or future health threats.
Health Minister Mdududzi Matsebula also said the programme had demonstrated the importance of moving from capacity-building towards institutional ownership.
He said changing global health financing and growing population health needs required greater country ownership, accountability, innovation and domestic investment in health.
“The true measure of a programme is whether the knowledge, skills and systems it develops continue to strengthen institutions and benefit communities,” Matsebula said.
The minister said the journey should now move “from capacity-building to institutional ownership, from mentorship to leadership, and from programme implementation to lasting impact.”
He called for continued collaboration among Government, development partners, implementing organisations, civil society, communities and the private sector.
The ALLOCATE project was supported by an investment of more than US$600 000, equivalent to approximately E9.6 million, over three years through a Georgetown University sub-award under SEASEC funds supported by the US CDC.
As ENHI assumes greater responsibility, Haumba said Georgetown University’s role would not simply disappear with the graduation.
“Graduation changes the nature of our relationship; it does not end it,” he said.
He said Georgetown remained honoured to walk alongside ENHI, but not to direct its path.
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(Courtesy Pic)
