This page outlines the operations of Nyaya Health as a fundraising and technical assistance international NGO. All of the operations for our INGO is stored on the wiki. Our Nepal-based clinic operations managed by Nyaya Health Nepal that are described in the Evernote.com Clinic Manual. The tasks below are the critical stuff that are required to keep the support flowing to Nepal and more than anything require dedication, conscientiousness, and reliability.
Nyaya Organizational Structure
The Nyaya Organizational chart can be found here.
Board of Directors
Functions of the Board of Directors
The function of the board of directors consist of the following:
1) to ensure the smooth day-to-day operation of Nyaya Health
2) to raise funds, network, and otherwise get human and technical resources out to Achham
3) to provide the oversight needed for excellent patient care in Nepal
4) to continuously improve upon the overall vision and strategic direction of Nyaya Health
5) to oversee and assess the effectiveness of the Executive Director and Director of Operations.
Board Structure
The size of the board of directors will vary from 8-15 depending upon the specific functions and tasks required. Given the fact that most board members do not see each other in person very often (aside from those presently working in Achham), it is important 1) that the board stays in regular contact; 2) that e-communication is conducted in a critical but respectful manner. Much of the Board discussions are conducted over the team@nyaya list, which includes many non-board key team members.
The Board conducts weekly to biweekly voice conference calls (open to all Nyaya team members), with whomever is available at that time. While the Board plays some important decision-making roles, it is important to remember that Nyaya's organizational philosophy aims to 1) emphasize local decision-making of the staff/board members currently in Achham; 2) that the extended Nyaya network should be involved in, or at least privy to, board decision-making (see board decision making below).
Board Communication
Everyone on the board must come to the (virtual) table with a mutual respect for each other, acknowledging that without other board members there can be no Nyaya Health. All board members should be cognizant of "e-etiquette". Email is a wonderful thing, but the challenge when it comes to emotionally-laden topics is that there is so much more to communication than words-- there's body language, there's tone, and most of all, there's true real-time dialogue. Without those elements, we can read too much into emails and bitterness can quickly develop. If you are upset by somebody, wait and talk with them on the phone, or, better, in person. Avoid sarcastic, offensive, or accusatory language. Before sending a nasty email or chat, take a deep breath and realize that it can be very unproductive and damaging to long-term e-communication if you say something accusatory over electronic media. In the real world, when we say something accusatory to someone, we can watch body language, we can resolve the issue through talking through, we can otherwise address concerns and criticisms productively. We can defuse our anger quickly, in person. That option is not typically available for e-communication, where there is a lag time in response, which can build stress and resentment on the other end that cannot be dealt with for a considerable amount of time. It is also important to avoid general criticisms that are likely to perceived as back-handed comments directed at individuals, particularly when they are sent out over listserves. For example, if you are frustrated with a board member's obstinancy against some policy, it is better to talk on the phone or communicate individually with that person rather than say "well i know some of us feel this is worthless..."
If we do slip and send out a poorly worded email, we all should remember a fundamental thing: that we all share a basic respect for each other and for the work we are collectively doing. As such, we should always assume that a member is meaning well and not trying to disrespect rather than the other way around. If we remember that, then we can continue to have productive, critical dialogues without worrying too much that we are potentially frustrating each other. Apologies and notes of appreciation go a long way towards maintaining the team coherence we need to fight poverty, disease, and injustice. These awful realities are far bigger than any of our individual egos.
Board Transparency
The Board conducts its business largely over two forums: 1) the team@nyaya list serve and 2) weekly conference calls, the minutes of which are submitted to team@nyaya list serve listserve. For VERY sensitive issues, largely interpersonal in nature, as well as for Board nominations, the board@nyaya listserve may be used. The reasons for using the team@ list are as follows:
1) many non-board members are very active and need to stay informed
2) all team members are often inspired by the dialogues and discussion
3) many team members have contacts and insights to contribute, ESPECIALLY on the tough decisions
4) in the long-run, this seemingly small procedural strategy will pay off dividends in keeping Nyaya a lean, open, dynamic organization even as we continue to grow in size.
The downsides of this approach, with the rebuttal as to how Nyaya overcomes them, are:
1) Some less-active board members may receive an excess volume of email. Such members easily figure out ways of selecting out emails to read or archiving.
2) There are dangers to discussing/debating sensitive matters in an open-format.
3) Some board members may not feel comfortable debating certain items-- be they because a) they are perceived as minutiae or b) because they are thought to be controversial-- in an open format. Nyaya as institution must work to encourage them that a) health as human rights can only happen through the minutiae of logistics, supply chains, and staff management; b) the more controversial topics, the all the more reason for all members to be aware of the debates, the thinking, and the dialogue. Addressing controversies, when debated in a productive and respectful manner, helps to drive our work forward and to make tough decisions.
4) Non-board-members may contribute less helpful comments or otherwise had inefficiency to the email threads. Nyaya organizationally and board members individually must work with such members to become more productive and efficient members of the e-dialogue, as we discuss here: collaboration
It should be emphasized that, while the business is conducted openly, on key decisions, Board members are ultimately responsible for helping to make those decisions, whereas non-Board members are not.
Board members are expected to have the foresight, leadership, and belief in Nyaya's long-term goal of a culture of openness to use the team@ list extensively, courteously, and productively.
Expectations of Board Members
All board members are expected to:
1) search out new partnerships, ideas, technologies, markets, and strategies
2) respond promptly to other board members’ requests
3) contribute to the wiki, blog, and evernote
4) be honest about their time commitments and ability to meet tasks that they take on
5) regularly email the team@nyaya list about the progress of their work
6) regularly contribute to the board@nyaya list with suggestions and critiques
7) be present, on average, to at least one of the 4 monthly conference calls
Qualifications of Board Members
The fundamental qualification of a board member is that her/his placement on the Board advances the strategic direction and management of Nyaya Health. Importantly, board membership decisions should not be made out of a desire for "fairness", e.g., as a reward because someone has put in a certain amount of time or effort or work into Nyaya Health. All Nyaya team members make contributions to advancing health and justice in Nepal with no expectation of reward or acknowledgement. As such, board placement is not to be viewed as a reward for service; rather, it is purely because that person's place on the board will help Nyaya to be more effective.
As such, there are no formal qualifications of board members; duration of work with Nyaya, academic qualifications, particular skillsets, are not going to make or break any given application. Rather, board membership should be considered on whether that member will help advance the core goals of the board (as above), and whether that is best achieved as being a board member or a regular team member:
- to ensure the smooth day-to-day operation of Nyaya Health
- to raise funds, network, and otherwise get human and technical resources out to Achham
- to provide the oversight needed for excellent patient care in Nepal
- to continuously improve upon the overall vision and strategic direction of Nyaya Health
- to oversee and assess the effectiveness of the Executive Director and Director of Operations
Nominations to Board
Any board member may nominate a new member to the Board of Directors. To do so, the nominating board member will send an email to other board members (via board@) that includes the basic biographical background of the nominee (with CV, where appropriate) and the proposed major function of the new member. For the most part, a board member is expected to have a specific role and comparative advantage. The nominating member should list, in simple (non-prose) format the pros and cons of an individual's membership onto the Board.
Other board members will respond by email within one week with a simple “Yay” or “Nay” and if they so choose provide further explanation as to their decision. A unanimous positive decision is required to accept a new member onto the board.
Subsequently, the new Board member will agree to the contract (Contracts_Board) and email team@ announcing their enthusiasm in joining the Board, as well as a very brief statement of their vision of what they (together with the entire team) hope to accomplish over the coming years with Nyaya.
Board Decision-Making
For the most part on small day-to-day issues there is no need for individual board members to email asking for approval. As a volunteer Board of Directors, efficient, lean decision-making demands that we allow for the local leadership in Achham to be empowered to make the decisions they feel necessary. For larger questions, the process is again similar via emailed proposal and a simple “Yay” or “Nay” vote within one week of receipt of proposal, or within one month if the proposal requires detailed analysis. If no response is sent by a board member within the stated timeframe, tacit approval will be presumed and the proposal can be carried forward. Note as above that, for the most part, board decisions are made over the team@ email list, i.e., in an "open" forum.
Termination of Board Tenure
A board member will typically end their tenure voluntarily, by stating honestly that s/he no longer can make the time commitment necessary to remain on the board. If a board member is underperforming, other individual board members should air their concerns and discuss openly whether it is appropriate for that member to temporarily or permanently step down. It is the job of the Executive Director to assess whether a board member has not been meeting his or her duties and request that s/he step down from the board. Former board members ideally will stay involved through team list updates, will contribute as volunteers, and will return to Nepal at some point. Former board members, as time and space permit, are encouraged to re-join the board.
Accountability and Governance Structures
A fundamental role of the Board of Directors is to ensure accountability, responsiveness, and transparency to donors and to the communities in which Nyaya operates. These three primary objectives-- accountability, responsiveness, and transparency-- all re-enforce and depend upon each other. The primary strategies through which these aims are achieved are through:
- month-by-month updates to the wiki of de-identified patient data: Data pages
- month-by-month updates to the wiki of line-by-line expenditures: Budget page
- weekly conference calls with the current program director and Nepal-based staff and the US-based team to discuss progress and identify problems and solutions
- collaborative, online clinic manual through evernote.com software. all members can view the current status of clinical protocols
- index of all weekly meeting minutes on evernote.
- regular stories and updates that are posted to the blog.
In general, we publish online to the public any internal controls we have for improving our programs. This is more efficient for our team since it does not require a separate set of security protocols to access the essential data that describes how we are operating. It also provides additional pressure and incentive to our team to be professional about how we do each and every task, spend money, and make decisions.
Our overall communications strategy is posted here: collaboration.
Role of the Board of Advisors
The board of advisors serves the functions of providing occassional technical advice, identifying sources of funding or in-kind donations, and lending their personal prestige/cache to Nyaya. Individual board of directors are responsible for seeking out new advisors and engaging existing ones. Further details are available here: AdvisoryBoard
Organizational Culture
Even in small organizations, work-culture inertia can be a powerful force. Decisions, processes, and structures set up in the early phases of organizational development can have a long-lasting impact on the functioning of the organization. On the one hand, this is an opportunity: thoughtful action and leadership can be powerful in producing an organization that remains efficient, reflective, and effective. On the other hand, the challenge is to reflect on current practices and not allow previous decisions made at a different stage of organizational development to drive current operational culture.
Nepal-Based Leadership
Executive Director
The Executive Director is responsible for providing the overall leadership of Nyaya in Achham. This person is based in Achham and is a full-time position. His/her contract can be found here.
Other Nepal-based leadership are found on the Personnel page.
US-Based Leadership
Director of Operations
This person directs US operations, which serve to obtain protocols, recruit new volunteers, procure donated supplies, and pursue funding sources. To the extent possible, the DOO recruits a diverse team of US-based volunteers to achieve these tasks. S/he is expected to:
1) oversee all support functions of the US-based team, listed below
2) engage Achham-based staff and volunteers in a respectful and productive dialogue to continue to build the Nyaya Health team
3) together with the Executive Director, ensure the overall functioning and synergy of the board as a team
4) together with the Executive Director, discuss individually with any board member who is underperforming and propose, as necessary, that underperforming board members be removed from the board
5) together with the Executive Director, be the point-person on any issues that any other board member faces
6) actively work to expand the vision of the organization and ensure other board members are doing so
7) send out meeting minutes for the weekly conference calls with the Achham-based team
The rest of the US team functions listed below are functions either performed by the director of operations by him/herself, or, preferably, are accomplished by other volunteer directors.
Mission-Critical Functions of the US-Based Team
To the extent possible, we engage the US-based team on discrete tasks, both to decrease the burden on the Nepal-based team and to expand our network of invested volunteers and supporters. While the COO may perform many of the functions temporarily, the ultimate goal is to recruit long-term volunteers to do the role. Rarely, a Nepal-based volunteer will be responsible for one of these tasks, but that is to be avoided for the most part.
Contracts
This director of contracts is responsible for overseeing the writing of contracts and agreements for the Nepal-based team. These include those for personnel, NGO collaborations, government agreements, and corporate partnerships.
This director should have a solid understanding of the legal and government culture in Nepal and should be an excellent writer. Fluency in written Nepali would be helpful but not required.
Current persons responsible: Duncan, Aditya
Management notes: See evernote since this is an Nepal-focussed task. All the key documents pertaining to this position are housed in SharedNyaya\Clinic\Official Documents and SharedNyaya\Clinic\Personnel.
Approximate time commitment: 10 hours per month
Grants and Reports
The director of grants is responsible for the applying for grants and maintaining relationships with existing foundations.
1) search regularly for new grants and maintain an updated list
2) oversee the writing of all grants and be responsible for ensuring that all grants meet tax compliance and Nyaya standards
3) provide semi-annual brief emailed report to the team list a “Statement of Nyaya Health’s Grants” as to the status of our grants program.
4) oversee the writing and production of quarterly reports
Current persons responsible: Sanjay
Management notes document: Grants, ReportsManagement
Approximate time commitment: 30 hours per month
Finance
This director is responsible for all aspects relating to the finances of the organization. Specifically, s/he is expected to:
1) with the director of operations, file all necessary tax forms
2) manage donations
3) work with the Achham team to receive quickbooks accounting text exports from Program Director and provide to the data team for uploading to the wiki
4) provide the board of directors with a simple semi-annual “Statement of Finances” that details our expenditures, our income, and the state of our financial solvency
Current persons responsible: Sanjay, Duncan, Astha
Management notes document: FinancialManagement, DonorManagement
Email streams: billing@nyaya (astha)
Approximate Time commitment: 15 hours per month
Fundraising
The role of this position is to assist members with personal fundraising. This is a critical position to meet our overall objective in engaging a broad base of people involved in resource redistribution. Additionally, our volunteers strategy is centered on the premise that most volunteers will first undertake a fundraising project to learn about the organization and make a tangible contribution prior to working on one of the more Achham-focused programs. Tasks involve:
1) when a new volunteer applicant specifically is looking to hold a fundraiser, work with this applicant on individualized materials for their campaigns
2) organize at least one fundraising event per year
Management notes document: PersonalFundraising
Approximate time commitment: 15 hours per month
Transparency and Monitoring
This position involves oversight of Nyaya's data program. S/he will work closely with the Director of Data Management. Tasks include:
1) performing regular audits of our data practices and researching new avenues to go down
2) trouble-shooting with the director of data management as problems arise
3) identifying further analytical techniques and strategies to improve our standing as a leader in the science of global health delivery
4) applying to grants specific to global health outcomes monitoring and epidemiology
Current persons responsible: Duncan
Management notes document: DataManagement
Approximate time commitment: 15 hours per month
Data Management
This position entails managing Nyaya's budgetary, pharmacy, spatial, and utilization data monitoring program that Nyaya uses to improve services and provide leadership in the science of global health delivery. S/he will work closely with the Director of Transparency and Monitoring. Specific tasks include:
1) working with Achham-based staff to develop needs assessments, surveys, and clinical databases;
2) defining clinical outcomes, indicators, and community goals;
3) coordinating databases and updating budgetary, pharmacy, and utilization charts, graphs, and spreadsheets on the wiki monthly;
4) reporting to core members utilization statistics and clinical outcome assessment results every quarter; and
5) interfacing with the grant-writing team to supply necessary statistics for proposals and follow-up reports.
Current persons responsible: Duncan
Management notes document: DataManagement
Approximate time commitment: 15 hours per month
Procurement
The role of this position is to identify medical technologies needed at the clinic. Tasks include:
1) research possible options for equipment and supplies requests from the Achham team that can be purchased in Nepal or pursued outside of Nepal.
2) pursue in-kind donations with companies for equipment and supplies
Current persons responsible: Jennifer, Duncan
Management notes document: ProcurementManagement
Approximate time commitment: 20 hours per month
Technology
The director of technology is responsible for the implementation of our internet presence.
1) perform the functions of, or otherwise oversee, the webmaster
2) oversee the technical aspects of Nyaya's presence on social networking sites
3) maintain the google apps accounts and member emails
4) propose and implement additional technical innovations
5) provide semi-annual reports to the board of directors a “Statement of Nyaya’s Web Presence” as to the effectiveness of our different sites, with specific statistics
Current persons responsible: Duncan, Bipul
Management notes document: WebManagement
Approximate Time commitment: 15 hours per month
Collaborative Technology
The role of this position is to ensure that we continue to innovatively utilize collaborative technologies for the purposes of marketing and collaboration.
1) manage the organizational foldershare file cabinet, keep it organized and clean, and invite new board members to foldershare; update the collaboration page as needed
2) manage wiki; update the WikiTips page as needed
3) manage the blog, request content from members, edit blog entries
4) recruit subscribers, spread the word among other blogs
5) encourage members to contact their local newspapers about their work with Nyaya
6) manage google analytics and adwords
Current persons responsible: Duncan, Shefali
Management notes document: CollabTechManagement; Marketing and Communications
Email streams: press@nyaya, blog@nyaya, wiki@nyaya (shefali)
Approximate time commitment: 20 hours per month
Volunteers Management
The role of this position is to manage the non-medical/specialist volunteers.
1) manage the outside-Nepal volunteers by working with them on their tasks lists, goals, deadlines
2) manage the within-Nepal volunteers by working with them on their itineraries and trip planning
3) identify volunteers needs and recruit new volunteers
Management note document: VolunteersManagement
Current persons responsible: Duncan
Approximate time commitment: 15 hours per month
Translations
This role of this position is to provide timely translations to the Achham team
Current persons responsible: Astha, Bibhav
Management notes document: see evernote since this is an Achham-based task; also Translators
Approximate time commitment: 10 hours per month
Additional Functions of the US-based Team
E-Commerce
This person will oversee any e-commerce activities used in fundraising.
Management notes document: E-commerce
Email streams: efundraising@nyaya
Approximate time commitment: depending upon the scope of the activities
Laboratory Services
The director of lab services provides oversight regarding the overall quality of medical services provided by Nyaya Health.
Tasks include:
1) dialoguing with Achham team about the quality of the laboratory services and additional needs
2) researching appropriate laboratory technologies for our setting
3) pursuing companies, together with the director of procurement, involved in laboratory supplies
4) helping to develop the costing and projections sheets for laboratory services
Medical Services
The director of medical services ensures medical service access and quality control.
Tasks include:
1) developing and reviewing clinical protocols to ensure they are grounded in evidence-based medicine and social justice
2) reviewing clinical protocols and needs at least once weekly with Achham staff
3) investigating and pursuing avenues for expansion of services
4) reviewing the clinical data to consider how to improve services
Current persons responsible: Duncan, Aditya
Management notes document: ProtocolManagement
Approximate time commitment: 20 hours per month
Social Networking
The function of this position is to expand our social networking capacity to broaden our reach. The primary task involves:
1) Creating, updating, and managing Nyaya's social networking sites
Management note document: SocialNetworking
Current persons responsible: Shalaj, Bibhav
Email streams: networking@ (shalaj)
Approximate time commitment: Depending upon the scope of the activities
Community Outreach
Community outreach, oversight boards, and public reporting. This position requires fluency in Nepali and significant time spent in Achham.
1) Help vision for community engagement
2) Review needs for new resources and protocols to benefit Achham
3) Coordinate between program directors in Nepal and US team to ensure compliance with community needs
4) Research and provide ongoing technical assistance to Achham team for improving community accountability and governance standards
Current persons responsible: Bibhav
Approximate time commitment: 10 hours per month
Research
Ensure that any research being proposed or conducted with Nyaya meets ethical, scientific, and social justice standards
1) review all IRB submissions
2) review all research protocols and work plans prior to their being implemented
3) review all manuscripts for publication prior to submission
Management notes document:
Approximate time commitment: 3 hours per month
Telecommunications
Research opportunities, technologies, funding, and strategies for telecommunications and telemedicine
Tasks include:
1) dialogue with on-site Nyaya members to pursue telecommunications hardware, such as PDAs or mobile phones, as well as software to meet our clinical and mobile outreach needs.
2) document current innovative models for telemedicine in our scenario
3) with the grants team, identify funding sources for our telecommunications/telemedicine programs
4) if/when open architecture network's telemedicine program comes through, work with OAN and on-site Nyaya members to identify the optimal supplies to procure
Approximate time commitment: 15 hours per month for one year minimum
Health Service Financing
Research opportunities, models, and evidence for health services financing. Tasks include:
1) identifying the current health service financing models available (fee for service, community-based health insurance, etc.) and the evidence for each of them. the goal would be to create something with significant community buy-in that also can be integrated within government services and allows for external injection of needed funds.
2) dialogue with nyaya team to consider the next steps to decide how to pursue community-based financing models appropriate to our scenario
3) create short- and long-term action plans with the on-the-ground nyaya team
Relevant documents, albeit largely disorganized but provide some points of reference:
health economics survey we conducted in Achham: http://wiki.nyayahealth.org/CommunitySurveys
http://wiki.nyayahealth.org/Integrating-Microfinance-into-Clinic-Funding
http://wiki.nyayahealth.org/Health-Services-Financing
http://wiki.nyayahealth.org/Community-Based-Health-Financing
Approximate time commitment: 20 hours per month for one year minimum
Comments (0)
You don't have permission to comment on this page.