
From a Centralized to a De-Centralized Model:
Leading MSH Through a Global Transformation
Management Sciences for Health (MSH) focuses on building stronger health systems to improve outcomes related to HIV/AIDS, TB, malaria, chronic diseases, family planning, and maternal and child health. Today, MSH manages 130+ projects in more than forty developing countries.
In its thirteen-year relationship with MSH, one of Crossland's key pieces of work with the organization came in 2009, during a major inflection point in global public health funding. After decades of centralized control from wealthy funder countries, including the U.S. and nations in Europe, foundations and government donors demanded more decentralized, locally operated management, immediately putting financing for all global public health projects in jeopardy. For MSH, its nearly $100M annual budget, and all its infrastructure and projects and programs, risked disruption if it could not manage the transformation from a centralized to a decentralized global healthcare provider. MSH invited the Crossland Group to be part of their journey to make this change. What began as a two-day Senior Leadership Team strategy retreat, evolved into a committed partnership to transform the organization—from implementing strategy and building new leadership capabilities required of its senior management to redesigning the organization to meet its new decentralized needs and mobilizing leadership across all forty-two countries to co-create a new future together. At a history-making event, Crossland partnered with MSHers around the world to mobilize all the country leaders in Ghana—more than ninety in all. For twelve days, we focused on formalizing their country strategies to achieve the desired health impact, building country leadership teams to synergize their work across projects, and enabling a robust talent management system.
Funding Base Triples in Just Ten Years
The impact of Crossland's partnership with MSH has been felt across the organization. In a recent 2014 review meeting, the CEO shared that “MSH would not have been able to successfully implement its 2017 Strategic Roadmap over the past ten years without the Crossland Group."
In the midst of its most dramatic transformation in forty years, MSH has flourished. In 2012 alone, the organization trained almost 29,000 health workers (of which more than nine thousand were women)—a feat made possible by an increased focus on building capacity at the local level. In just ten years, MSH’s funding soared from $100M to $300M—a result that would have been impossible without the successful decentralization of their management model.



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