After five impactful years, USAID’s NPI EXPAND project has concluded, leaving a legacy of localized development and strengthened health systems across 11 countries. With over US$86 million in funding, NPI EXPAND (New Partnerships Initiative Expanding Health Access) worked through more than 90 local organizations to address critical health and development challenges, tailoring programs to meet each country’s needs and fostering sustainability.

One of NPI EXPAND’s primary goals was to strengthen local organizations, giving them both the resources and responsibility to lead health initiatives. Jeff Barnes, NPI EXPAND’s Project Director shares more about the structure of the project. “All of this work was under the umbrella of strengthening and empowering local NGOs, civil society organizations, and even a private sector health partner,” he adds. “Capacity strengthening was a core focus, with over 1,000 activities to help our partners grow.”

Reflecting on the program’s achievements, Barnes shares how the team adapted to each country’s unique demands. “We managed to deal with a broad range of challenges including insecurity, hyperinflation, cultural barriers in addition to the technical challenges of the work.” By working closely with USAID missions in countries that had an NPI EXPAND buy-in, the project was able to tailor activities to the unique needs of each country.

This flexible approach allowed NPI EXPAND to tackle diverse health, education, environment, and gender equity challenges, even in highly complex settings. “In Pakistan, for example, we integrated health and education, particularly focusing on getting girls into school. It was an extremely challenging area, but by combining education and primary healthcare, we improved responsiveness to the communities.”

Complex Scope and Co-Creation

In Kenya, the project faced an extensive scope that combined health, environment, and gender equity into a single activity. “I remember getting that scope of work and thinking they wanted everything under the sun,” Barnes recalls. Here, NPI EXPAND’s co-creation process became invaluable, allowing local organizations to work through challenging issues collaboratively in partnership with USAID and the county government. “Co-creation was really helpful for tackling fairly complex problems,” Barnes adds.

NPI EXPAND’s flexibility was another key to its success, allowing it to address a wide range of needs, from COVID-19 response to health system strengthening. In Kenya’s Narok County, local partners achieved significant progress in maternal health, with a 39% reduction in maternal mortality and a 10% increase in women receiving at least four antenatal visits.
This accomplishment is a testament to how localized approaches not only enhance community engagement but more importantly, save lives.

Empowering Local Organizations

A key lesson emerged regarding capacity building: “Formal training was valuable, but informal coaching during implementation was often as, or even more, impactful. Local organizations need the experience of running programs themselves.”

Local partners not only received funding through a grant making process but also led program design, a shift from typical donor-led projects. This approach helped local organizations build confidence in their ability to lead programs. “I was pleasantly surprised by some of the ideas they came up with. In Ethiopia, for instance, local NGOs identified the need for a maternity waiting room next to the clinic so women could labor comfortably with family nearby and we saw facility deliveries go way up. That’s the kind of solution only a local organization could create.”

Building Relationships and Peer Networks

Collaboration among local NGOs was another outcome of the project, despite initial reluctance. “In Kenya, one NGO told me that at first, they were hesitant to share openly with others, seeing them as competitors. But as they worked together, they realized it was in everyone’s best interest to collaborate,” Barnes shares. Building these networks became a form of capacity strengthening in itself, with country teams adopting diverse approaches to foster cooperation and knowledge sharing.

The project also helped NGOs develop skills in resource mobilization, a crucial aspect of sustainability. “Many of our partners had never received support for resource mobilization before,” he explains. “This training was a huge help for them, and some have already transitioned to new funding and partnerships.”

Looking Ahead: The Case for Continued Localization

As NPI EXPAND closes, its legacy in localisation leaves the door open for future USAID projects to prioritize local leadership. “Supporting local organizations makes foreign aid more impactful. I hope USAID will continue with initiatives like NPI EXPAND, ensuring that funding reaches local entities.”

“The most important thing is that the money gets into the hands of the local organizations, but with a project like NPI EXPAND, we can support organizations who have limited capacity to manage those resources and get the support they need to succeed.”

The project’s experience reinforced the importance of localization for self-reliance. “There’s still a lot of mindset shift needed among both local organizations and development agencies,” Barnes notes. “The true value of localization is in creating self-reliant communities, not dependencies. When local organizations are involved in identifying and addressing their own needs, the outcomes are far more sustainable.”

NPI EXPAND’s success showcases the benefits of investing in local expertise and fostering collaboration. Its story offers a blueprint for development initiatives worldwide, proving that empowering communities to lead their own development can drive lasting change.

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