Evaluates the impact of the Better Health for Rural Women and Children project in Guatemala (1995-2002), implemented by Management Sciences for Health (MSH), on the institutional development of the Asociacion Pro-Bienestar de la Familia (APROFAM). The MSH APROFAM partnership has been highly successful, both in terms of concrete results and the processes by which these were achieved. APROFAM has reached about an 80% level of financial sustainability. Clinic services have reached a 120% level of financial sustainability as a whole. Four of the five departments have been fully re-engineered and systems and controls have been developed that provide both cost-cutting elements as well as growth potential. These findings strongly support MSH efforts and APROFAM’s willingness and ability to manage the change process in a constructive and productive manner. These joint efforts and the major diversification of clinic and laboratory services resulted in a significant degree of financial and institutional sustainability. The results of MSH activities with APROFAM are institutionalized and sustainable. Already, APROFAM has moved from a traditional NGO highly dependent on donor contributions to a viable enterprise in its own right. The process by which these achievements were accomplished generally followed sound concepts relating to institutional cooperation, communication, and participation. MSH provided expert technical support and conscientious individuals who sought and acted upon APROFAM’s needs and long-term goals. APROFAM actively managed the process and activities with full support from the Board and the Executive Director. Importantly, APROFAM knew generally what it needed to achieve and was thus in a strong position to guide the TA towards those ends. Therefore, the main tasks of MSH were to seek and provide the very specific technical and organizational means towards APROFAM’s goals. Initially, MSH took the lead with a long-term strategy for change. That strategy has now been adopted as its own by APROFAM as is documented in its strategic planning documents. This became clear in interviews with APROFAM managers and staff. Positive anecdotes about how “MSH people” provided ample opportunity for APROFAM staff to internalize and act upon proposed major changes clearly indicate the success of the MSH and APROFAM team approach in managing positive institutional change and growth.
