INFECTIOUS DISEASES AND INDIGENOUS NON-GOVERNMENT ORGANIZATION MITIGATION EFFORTS: A QUALITATIVE STUDY OF POTENTIAL CAPACITY DEVELOPMENT ACTIVITIES WITHIN NIGERIA by William E. Sumner A Dissertation Submitted to the Graduate Faculty of George Mason University in Partial Fulfillment of The Requirements for the Degree of Doctor of Philosophy Public and International Affairs Committee: Director Department Chairperson Program Director Dean, College of Humanities and Social Sciences Date: Spring Semester 2014 George Mason University Fairfax, VA Infectious Diseases and Indigenous Non-Government Organization Mitigation Efforts: A Qualitative Study of Potential Capacity Development Activities within Nigeria A Dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at George Mason University by William E. Sumner Master of Science Florida State University, 1996 Director: Stefan Toepler, Professor Department of Public and International Affairs Spring Semester 2014 George Mason University Fairfax, VA This work is licensed under a creative commons attribution-noderivs 3.0 unported license. ii TABLE OF CONTENTS Page List of Tables .................................................................................................................... vii List of Figures .................................................................................................................. viii List of Abbreviations or Symbols ...................................................................................... ix Abstract .............................................................................................................................. xi Chapter One: Introduction ................................................................................................ 13 1.1 Background ............................................................................................................. 13 1.1.1 The Importance of Nigeria ............................................................................... 15 1.1.2 The Nigerian Health Care Sector...................................................................... 19 1.1.3 The Role of Corruption in the Nigerian Health Care System........................... 25 1.1.4 The Rise of Nigerian Health NGOs .................................................................. 35 1.1.5 Social Conflict .................................................................................................. 39 1.2 Problem Statement .................................................................................................. 40 1.3 Purpose of the Study ............................................................................................... 44 1.4 Definition of Terms ................................................................................................. 49 1.5 Assumptions ............................................................................................................ 54 1.6 Research Method ..................................................................................................... 57 1.7 Relevance for the Field of Biodefense .................................................................... 59 1.8 Dissertation Structure .............................................................................................. 62 1.9 Conclusion ............................................................................................................... 64 Chapter Two: Literature Review ...................................................................................... 67 2.1 Context of the Review ............................................................................................. 67 2.2 Capacity Development Background........................................................................ 70 2.3 Capacity Development Gray Literature .................................................................. 80 2.4 Capacity Development Triad .................................................................................. 93 2.4.1 Strategy Variable .............................................................................................. 99 2.4.2 Capability Variable ......................................................................................... 104 iii 2.4.3 Partnership Variable ....................................................................................... 108 2.5 Conclusions ........................................................................................................... 113 Chapter Three: Research Design and Methodology ....................................................... 116 3.1 Introduction ........................................................................................................... 116 3.2 Research Questions ............................................................................................... 118 3.3 Research Methodology .......................................................................................... 119 3.3.1 Qualitative Design .......................................................................................... 119 3.3.2 Case Study Methodology................................................................................ 122 3.3.2.1 Rationale for Using the Case Study Method. .............................................. 123 3.3.2.2 Case Study Approach .................................................................................. 126 3.3.2.3 Case Boundary and Unit of Analysis. ......................................................... 129 3.4 Research Population and Sampling Technique ..................................................... 132 3.4.1 Demographic Profile .......................................................................................... 139 3.5 Research Instrument .............................................................................................. 150 3.5.1 Questionnaire Composition ............................................................................ 152 3.5.2 Developing the Research Instrument .............................................................. 154 3.5.2.1 UNDP’s Capacity Assessment Framework ................................................. 155 3.5.2.2 Peace Corps’ Capacity Development Profile .............................................. 164 3.5.2.3 Center for the Advancement of Collaborative Strategies in Health’s Partnership Self-Assessment Tool ........................................................................... 165 3.5.3 Questionnaire and Interview Structure ........................................................... 167 3.6 Validity and Reliability ......................................................................................... 169 3.6.1 Construct Validity........................................................................................... 170 3.6.2 Internal Validity .............................................................................................. 171 3.6.3 External Validity............................................................................................. 173 3.6.4 Reliability ....................................................................................................... 175 3.6.5 Pilot Study ...................................................................................................... 176 3.7 Data Collection and Analysis ................................................................................ 177 3.7.1 Informed Consent ........................................................................................... 177 3.7.2 Confidentiality ................................................................................................ 178 3.7.3 Information Management ............................................................................... 179 3.7.4 Data Collection ............................................................................................... 180 3.7.5 Data Analysis .................................................................................................. 181 iv 3.8 Limitations ............................................................................................................ 192 3.8.1 Identification of the Sample Population ......................................................... 192 3.8.2 Mortality Threat .............................................................................................. 193 3.8.3 Researcher Bias .............................................................................................. 194 3.9 Summary ............................................................................................................... 196 Chapter Four: Research Findings.................................................................................... 199 4.1 Introduction ........................................................................................................... 199 4.2 Data Analysis Framework ..................................................................................... 201 4.2.1 Modified UNDP CAF Spreadsheet ................................................................ 202 4.2.2 Findings: Global ............................................................................................. 203 4.3 Strategy Variable ................................................................................................... 205 4.3.1 Strategic Vision and Organizational Mission ................................................. 205 4.3.2 Program Implementation