CATHCA STRATEGY 2020-2025

“I was sick and you took care of me” Mathew 25:36

Table of Contents

page I Process of developing strategy 1 II Context 1 III SWOT Analysis 3 IV Identity 3 V Vision 4 VI Mission 4 VII Values 4 VIII Strategic Priorities i. Priority 1: Capacity building 4 ii. Priority 2: Collaboration 5 iii. Priority 3: Communication 6 iv. Priority 4: Advocacy 7 IX Organizational implications 8

FOUNDERS OF CATHCA

Sr. Shelagh Mary Waspe Advocate Allan Shwarer I Process of developing strategy This strategy was developed after a number of consultations. Several staff meetings were held on organizational development to examine current mission, determine shared values and analyse organizational SWOT. At each of three provincial conferences, an “open session” was introduced to receive comments and criticism of CATHCA and clarify member expectations. A workshop with Caritas was also held to specifically discuss possible CATHCA strategy and joint working. At the final provincial conference in the Free State, a specific session was introduced asking members to discuss what CATHCA should prioritise in the future. A presentation by CATHCA’s former Chairperson, Dr Douglas Ross, at the 2014 National Conference fed into the writing of the section on context. All these inputs helped to develop the first draft of the strategy. A staff workshop on the draft strategy served to examine, review and improve it. A second draft was produced for consideration by the CATHCA Board, at a two-day workshop assisted by an external facilitator. Inputs and comments from this Board workshop on strategy helped produce the final version of CATHCA’s strategy for the period 2020-2025.

II Context The Church's contribution to in South has been enormous. In many parts of , the Catholic and other churches were the first to build hospitals and clinics and to provide modern medical care. Often that service was heroic, because of the difficulties of the environments in which these missionaries served, or because they cared for people in the front lines of violent conflict. Many times they defied the racial discrimination that was a norm in the region long even before the policy of apartheid was imposed. In the late nineteenth century, missionaries fanned out over the subcontinent preaching the gospel to the local peoples. They built churches, schools and hospitals and clinics. Missionaries were often the first to set up hospitals long before anyone else where successive white rulers did not bother to do so. By 1950, there were 73 Catholic hospitals in South Africa, Namibia, Zimbabwe, Swaziland (now ) and . Ten per cent of all the mission hospitals in the world were located in Southern Africa at that time. They provided not only medical services, often at nominal fees, but also trained African nurses. Over 500 African nurses were in training at several nursing colleges established by the church in 1951. As a result, for much of the 20th century, the vast majority of South Africans received health care not from the government, but from Catholic mission hospitals—until the apartheid regime expropriated almost all of them in the 1970s. In many areas, the Catholic health mission continued with increasingly lay-run clinics. ______CATHCA Strategy 2020 - 2025 Page | 1

In the 1990s, the appearance of HIV/AIDS changed the whole landscape. Suddenly the nation was faced with the most important health crisis in its history. The new government struggled to face it and to handle it and was beset by denialism and obfuscation. Catholic clinics became again the centres of new action, and now the activity spread also into Catholic parishes, as caregivers, mostly women but also including some men, took up the challenge of caring for the sick and the orphans. Home based care became the tool with which the church tackled the problem, and together with many of the churches and with many civic groups, the Catholic church was in the forefront of the fight against AIDS. Catholic Health Care in Southern Africa has changed in several ways over the past few decades. One trend is clear and documented: the inexorable decline of formal health care facilities controlled by Catholic institutions in the form of hospitals and clinics. These have either been taken over by the government or have been closed due to lack of funds. Patients can neither seek nor secure care in a Catholic health facility anymore. Another trend is the aging of religious health care providers, especially those whose membership is predominantly European. As members of such orders grow older and retire, the health care institutions they managed lose previously assured sources of funding and gradually reduce the scope of work before they finally close. No longer do any Catholic doctors serve institutions within the CATHCA network, with the exception of a single hospital in eSwatini. Even the number of nurses is slowly but surely dwindling. These trends started many years ago and will continue because of the reality of reducing numbers of Catholics who take up religious vocations and engage in health care. Today, CATHCA is mostly made up of members belonging to small community-based organizations (CBOs) who provide community-based services which start and stop depending on the availability of funding. Few, if any, have any independent sources of funding. Almost all are dependent on grants from government or from national and international donors in order to function. They are skilled in providing specific services to community members which no one else provides such as home-based care and HIV counselling and adherence support. For this reason, they form the backbone of community-based health care services along with trained government community health workers. Without these cadres of grassroots workers, mortality and morbidity in South Africa would soar. Their services are increasingly appreciated and acknowledged by government, especially because access to formal health care is still quite low for the poor and marginalized. CATHCA’s support is generally well appreciated by its members. Its periodic provincial and national conferences are appreciated by all as is the training it has provided in areas such as home-based care, Maternal and Child Health, HIV, TB and pastoral care. Much of this was made possible by grants from Catholic donors. Unfortunately, their support is slowly dwindling with some moving away from supporting health care and some away from supporting funding to South Africa which is considered better-off than other countries needing aid. This is a major risk to CATHCA since it has been reliant on funding from such Catholic donors since it was founded. Without assured funding streams, services such as capacity building for a Catholic health care network and pastoral care for health care workers, including psycho-social support, will be under threat. ______CATHCA Strategy 2020 - 2025 Page | 2

III SWOT Analysis

Strengths Weaknesses

• Strong teamwork among CATHCA staff • Not enough direct contact with some • Our team upholds Catholic values of our members (e.g. few visits) • Reliable and trustworthy as a team • Not exploring new donor • Good reputation with local stakeholders opportunities built up over years • Not utilizing our full social media • Good relationships with existing donors opportunities to better advantage • Strong representation of the Catholic health • Not good at marketing our services network for a fee • Are becoming more visible at Parish and • Inadequate in meeting all the needs Diocesan level (pastoral work) of our projects, especially for funding • Advocacy: a voice to the voiceless • Not sure whether some members • Support our projects’ community health continue to exist with an unreliable initiatives (subsidize their projects, database training); • CATHCA is still unknown to most rank • Recognition at provincial and national level and file members of the Catholic in the health sector: Do, DSD, other NGO’s; Church in , eSwatini and • Adaptable to change South Africa

Opportunities Threats

• To network with other civil society • CATHCA’s relevance in relation to organizations (despite past failure to build other existing health care providers an inter-faith network on health) • Government take-over of Catholic • Use Catholic spirituality and culture to keep health facilities supporting the Catholic health care • Long timeframe in obtaining MoU’s network; with other stakeholders; • Explore new funding opportunities and • Total reliance on donor funding mechanisms • Dwindling sources of Catholic funding • Greater collaboration with other stakeholders including other affiliate members of the church and government • To get in touch with members to understand their needs and address them • Evolving to the changing nature of the Catholic health network

______CATHCA Strategy 2020 - 2025 Page | 3

IV Identity CATHCA is the Catholic Church’s associate body for health in Botswana, eSwatini and South Africa. It is an affiliate of the Southern Africa Catholic Bishops’ Conference. CATHCA has more than two hundred organisations as members. Currently, members are mainly community- based organizations working on issues related to HIV, and but also include health clinics and hospices run by religious sisters and a hospital in eSwatini. CATHCA is inspired by Mathew 25: 35-40 and particularly verse 36 “…I was sick and you took care of me.” CATHCA is committed to serving the poor and the marginalised. It perseveres in providing compassionate health care in the spirit and service of Christ, even in the face of challenges and obstacles.

V Vision CATHCA envisions a world in which even the poorest individual has access to good quality and compassionate health care.

VI Mission CATHCA exists to support and strengthen an evolving health care network of members serving the poor and marginalised, in collaboration with others.

VII VALUES

Integrity Respect ✓ doing the right thing; honestly and ✓ for self, staff, people, communities, cultures in harmony with our other values and the environment, always upholding the sanctity and dignity of human life

Quality Accountability ✓ CATHCA sets and meets high ✓ transparency with all stakeholders including standards and ensures these are members, donors and government aligned with standards of the Church, government and donors

______CATHCA Strategy 2020 - 2025 Page | 4

VIII Strategic priorities i. Priority 1: Capacity building CATHCA is an enabling organization. It will work to increase capacities and capabilities of members through training, funding and mutual learning. This is at the core of its mission. CATHCA will provide training to improve knowledge and skills in areas prioritised by members in order to address felt needs of members. Meaningful training needs ownership by those trained and follow up via action plans and feedback on the usefulness of training. The core of training will remain topics in health such as communicable diseases, noncommunicable diseases, maternal and child health and broader primary health care. CATHCA will also deliver training in fundraising, bookkeeping, leadership, public participation, advocacy and project management, monitoring and evaluation. In addition, CATHCA will support pastoral care/psycho-social support and the conduct of retreats for those in Catholic health care ministry so they are themselves affirmed and renewed. In each area, CATHCA will sub- contract others (such as Rural Development Support Programme {RDSP}) when necessary to ensure good quality training is delivered. It will make use of Information and Communication Technologies (ICTs) as may be appropriate. While implementing projects with members, CATHCA will also emphasise on-the-job training and coaching in areas such as bookkeeping and project management. CATHCA will also consider training of trainers as a deliberate mechanism to broaden the network of trainers and expand the number of members being trained. When feasible, it will encourage peer-to- peer support and on-the-job learning with peers. This will enable projects to share resources, experience and expertise with each other directly. CATHCA will serve as a conduit of funds, to enable members to implement donor-funded projects and reach more people in need of services. CATHCA will try, as far as possible, to submit funding requests that include at least a few members as partners in implementation in each project proposal. Whenever such funding is made available, it will help build member capability to plan, implement, monitor and evaluate projects and report on progress. CATHCA will enable members to learn from each other through workshops and conferences, bringing in experts when needed but emphasizing learning from members’ own field experience of working with the poor and marginalised. It will continue to organize national, provincial and district conferences with emphasis on shared learning through group work and mutual sharing. When appropriate, it will bring in subject matter specialists to provide an overview of a topic while still ensuring sharing from direct experience as a key mechanism for learning. CATHCA’s newsletter and social media platforms will also serve to enable mutual sharing and learning between members. ______CATHCA Strategy 2020 - 2025 Page | 5 ii. Priority 2: Collaboration CATHCA will promote collaboration between its members, with dioceses and parishes, with other associate bodies of SACBC, with other NGOs and with government. The emphasis will be on doing more with less, leveraging resources of others to achieve shared objectives. With its members, CATHCA will continue to organise district, provincial and national conferences so members may get to know each other’s work better, share experiences and learn from each other. Greater emphasis will be placed on local, provincial conferences in particular to enable greater provincial dialogue on provincial policies and programmes. It will also help support improved networking between members at the provincial level and enable peer-to-peer support, mentoring and learning. When feasible, for specific projects, CATHCA will promote resource sharing in the form of physical assets and staff. CATHCA will build a database of members and their activities to develop a “map” of work being done in each province to enable such collaboration and support. National conferences every other year will remain necessary since these also include required elections of office bearers at the general body meeting. CATHCA will link members more closely to their local parishes for mutual benefit. Parish priests, parish pastoral councils and sodalities can all play an important role in promoting health education for all. CATHCA will work directly with diocesan structures and with the Bishops to provide psycho-social support and pastoral care to health providers and secure diocesan support for projects its members are implementing. It will encourage and support the establishment of parish and diocesan health committees. It will collaborate with Catholic health professionals such as nurses from the Catholic Nurses Guild who are ready and willing to support community-based health services on a voluntary basis. It will link such health professionals to parish and diocesan health committees to improve knowledge and service delivery capacity. In particular, it will encourage the holding of health screening and health education camps within church premises for early detection of noncommunicable diseases such as diabetes and hypertension and also communicable diseases like HIV and tuberculosis. CATHCA will collaborate with other associate bodies of SACBC such as Caritas, (RDSP) and the Catholic Parliamentary Liaison Office (CPLO) more proactively to yield a more efficient mode of functioning. Mapping activities to have fewer silos and better cooperation could assist everyone to be more efficient. For example, RDSP could provide training on gender-based violence or public participation or leadership on behalf of CATHCA since it already has developed materials and experience in those areas. Caritas staff who have an active presence in many parts of the country could support and supervise donor-funded projects on behalf of CATHCA. The CPLO could be engaged more actively to link with parliamentarians on CATHCA’s behalf on health-related policy matters. CATHCA will also reach out more proactively to other NGOs and faith-based organizations (FBOs) in Southern Africa, especially those with whom policy positions on health could be amplified. CATHCA will undertake a programme of “meet and greet” to introduce CATHCA and explore areas of potential collaboration. When possible, it will include the formation of district and national civil society forums on health as part of its project proposals to donors.

______CATHCA Strategy 2020 - 2025 Page | 6

CATHCA will increase formal collaboration with government at district, provincial and national levels. All projects implemented by CATHCA will include elements of formal collaboration with local government in particular. CATHCA will also enable and empower its members to attend government-organised meetings and workshops and speak on its behalf and represent CATHCA in different locations. CATHCA will also collaborate with civil society organizations and networks internationally, joining and contributing to broader discourse on international commitments and declarations and on the policies and practices of multilateral organizations affecting health care policy and practice in the Southern Africa region.

iii. Priority 3: Communication CATHCA will strengthen its communications mechanisms so that more and better information flows to all members. It will ensure that its quarterly newsletters gain in relevance and improve in content. CATHCA’s emphasis will be on developing messages that simplify complex public policy and laws and also educate members on best practice with respect to the areas of health care they cover. It will ensure that even brief articles provide helpful links to websites with more detailed information for those wishing to learn more. It will ensure that electronic versions are better designed to decrease size so members may download relevant articles without incurring great cost. CATHCA will more actively contribute to the Southern Cross and also Radio Veritas to disseminate information about itself and its work. CATHCA will ensure that it scans funding opportunities in the external environment and periodically sends members details of such potential funding. CATHCA will make more extensive use of technology and social media including Facebook, Twitter, WhatsApp and Instagram to disseminate messages. A WhatsApp group of leaders of member organizations is one way of quickly reaching all with key messages, provided clear norms are set for the group. Enabling members to use twitter is another mechanism that could help. CATHCA will livestream events when feasible, especially lectures and seminars, to enable virtual participation. CATHCA will consider myriad possibilities to ensure communications with and between members becomes more robust and more useful, sharing valuable information and promoting advocacy. These will include the use of clusters where lead members in a geographic area undertake to communicate key messages with others in the same area. Flyers could be distributed to aid such sharing of information. This mechanism will be particularly useful in areas where electronic communications and email are still not used widely. Communications will need to be better targeted to different stakeholders using diverse media such as newsletters, radio broadcasts and social media. CATHCA will strive to ensure that all CATHCA members are contacted directly by CATHCA staff either in face-to-face meetings or through one-to-one phone calls at least once a year to hear from them about their work and issues affecting them more personally. These direct interactions will serve to affirm their value to the broader network and enable members to feel engaged with CATHCA and its small staff team.

______CATHCA Strategy 2020 - 2025 Page | 7 iv. Priority 4: Advocacy CATHCA will engage in advocacy more systematically through participation, collaboration, shared learning and representation. It will need to be more vocal, as a network, about issues and gaps in local, regional and national policies and practice. Its members will need to more actively assist communities to claim rights to health, particularly where access is poor or services are not being delivered, or where health-threatening situations exist. CATHCA will also educate its members about policy issues enabling them to engage as feasible within their own geographic spheres of influence. CATHCA will also work with other affiliates of SACBC such as CPLO and Justice and Peace to bring health issues to the attention of policy makers and the general public. CATHCA will work with its members to ensure greater participation at meetings to discuss health policy and practice organised by district and provincial governments and also by other civil society organizations and networks. It will seek to enhance its visibility through such presence and build credibility and respect for its work and experience. CATHCA will ensure greater collaboration with all stakeholders in health as described in Strategic Priority 2. Such collaboration can support effective advocacy since organizations that know CATHCA and its work, including government departments, are more likely to listen to its views and opinions. CATHCA will strengthen shared learning among its members through means described in Strategic Priority 1 and Strategic Priority 3. It will also join or organize specific seminars on specific topics with other NGOs to make a joint civil society voice on a topic clearer and louder. CATHCA will seek to be represented actively wherever there is discussion or deliberation on health policy or practice. It will empower its members to represent it at district and provincial levels. It will strive to be present at national events and forums. It will differentiate between its official spokespersons and those representing CATHCA at meetings simply to engage in dialogue and discussion or to hear and learn more about others’ policy and practice. It will apply for consultative status to the United Nations Economic and Social Council (ECOSOC). It will join international civil society groupings on HIV, TB and maternal and child health and engage as feasible with these networks.

“I was sick and you took care of me” Mathew 25:36

______CATHCA Strategy 2020 - 2025 Page | 8

IX Organizational Implications a) Clarification of membership: CATHCA will need to undertake an extensive exercise to review the status of its members, particularly to understand whether they continue to exist, continue to be registered as non-profit organizations and continue to enjoy the goodwill of their parish and/or diocese. The CATHCA values apply to all its members as well. It will need to ensure that minimum standards for governance are maintained. For those receiving funding from CATHCA as grant recipients, audit and financial review will also be required. CATHCA will draw up new membership lists for every district and diocese. It will send diocesan lists to the Bishop and ask that the diocese review the members and send objections, if any, to CATHCA. All others will have their membership confirmed. It will also undertake greater efforts to identify possible new members and make them aware of CATHCA and invite them to become members. It will compare member databases with other SACBC affiliates, including Caritas. It will classify members into three groups viz. fully engaged, partly engaged and unengaged and invest in reaching out to the unengaged to move them to levels of engagement with others in the network and with the CATHCA office. b) Building internal capacity: CATHCA will need to build its own capacity to deliver this strategy, particularly in terms of communications, advocacy and fundraising. It will need to review its structure and staffing to ensure these vital functions are adequately addressed. Fundraising will need an experienced and skilled person to increase the volume of proposals and improve the quality of reporting. An additional member of staff, responsible for communication and advocacy will be required over time. CATHCA will need to understand its baseline skills and future needs and find ways and means to bridge the gaps. It could outsource some of its work to other service providers and also increase the deployment of volunteers and interns to address specific tasks. It will invest in ongoing skills development for its own staff to aid their development. It will ensure at least two days are set aside each year for staff as reflection days for ongoing spiritual formation. This will also assist in reaffirming CATHCA’s core identity. c) Fundraising: CATHCA will need to approach new sources of funding to build new streams of income. Such diversification will need CATHCA to more effectively create a brand that appeals to secular donors and which emphasises strengths that are universally valued such as its broad membership and its reach and its ability to deliver measurable results. It will have to develop a broader approach to fundraising by not only proposing ideas to potential donors but also applying to calls to funding including Requests For Proposals (RFPs). It will need to pursue bilateral and multilateral funding from institutions such as USAID, DFID, European Commission, etc. besides approaching foundations and trusts. It will also need to explore securing funds directly from individuals as gifts, endowments, pledges and legacies. It will pursue the idea of institutional sponsorship for events and conferences. It will need increased capacity to undertake such fundraising and also to support effective reporting to donors.

______CATHCA Strategy 2020 - 2025 Page | 9

CATHOLIC HEALTH CARE ASSOCIATION www.cathca.org

P O Box 52015,Saxonwold

2132 Gauteng South Africa

Tel: +27 11 880 4022 Fax: +27 11 880 4084