Private Sector Participation in Health Care in Zimbabwe: What’s the Value Added and Institutional Challenges?

This paper analyses the private healthcare sector’s role in Zimbabwe’s health delivery system, especially after economic challenges reduced in real terms fiscal support for public health system funding. This paints a sharp contrast between practicalities of achieving affordable and accessible public healthcare on one hand, and the economic and social realities of underfunded and skills-constrained health systems. Using as empirical models and analytical lenses the country’s 2009–2013 National Health Strategy and the WHO’s health system building blocks, we examine the role played by private sector health delivery actors in the last 10 years and suggest that although the private sector added value, there is a bigger challenge of weak macro-level coordination and communication within the health sector which create problems for systemic design, strategy formulation and feedback mechanisms, important for institutional innovation and timely responses to changing dynamics. Macro-level coordination can be aided by documentation and standardization of procedures, processes and approaches by different health delivery actors to align with national health delivery goals, allowing more predictable and measurable impact from interventions by different actors

Harnessing Migration for Inclusive Growth and Development in Southern Africa

The primary goal of this study is to present the results of a comprehensive scope of key opportunities and challenges for harnessing migration for inclusive growth and development at the regional level in Southern Africa. The main objectives were as follows: Provide an overview of regional migration stocks and flows identifying regional trends, drivers and impacts from existing research literature and official data; Profile migrant characteristics at the regional level including demographic composition, types of migration and occupational profile; Examine the relevance of multilateral, continental and regional migration instruments, policies, protocols, agreements and forums with a view to identifying actions required to move the regional migration management agenda forward and align with the goal of enhancing migration for inclusive growth and development in Southern Africa; Analyze the key initiatives, opportunities and obstacles to developing a coherent, integrated and rights-regarding approach to migration management including areas of common commitment and ownership, and points of actual and potential conflict and disagreement between states; Conduct a gender analysis of regional migration dynamics including gender dimensions of migration, challenges, dangers and vulnerabilities confronting migrant women and other vulnerable groups, and gender analysis of migration management in Southern Africa; Identify potential programming areas that are weak or underdeveloped. The report relies on data and information from four main sources: (a) existing research literature and data on regional migration dynamics and trends in Southern Africa; (b) official data sources, where available, to identify current patterns, trends and types of migration; (c) bilateral global migration data sets compiled by the UNDP and the World Bank; and (d) a programme of field research involving key informant interviews and consultations with stakeholders, international organizations and donors, national government departments, and representatives from civil society, business, labour and the academy. Country visits were undertaken to South Africa, Mozambique, Botswana and Zimbabwe. A total of 60 interviews were conducted with 86 interviewees. The first two sections of the report outline the objectives and methodology of the research. The third section provides a contextual analysis of regional migration in Southern Africa to demonstrate that migration is a quintessentially regional issue and development challenge. There are a number of reasons why a regional – as opposed to a purely national – conceptual and policy approach to migration is desirable and necessary: Cross-border movements of people have a long history and constitute one of the major mechanisms of regional integration in Southern Africa (along with trade and investment). Goods and capital move relatively freely and legally across the region but people still face considerable obstacles and barriers to movement; Vast differences in levels of development and employment opportunities across the region have led to extremely uneven migration flows. All countries both send and receive migrants but the balance between the two varies significantly. Zimbabwe was a major destination before 2000 but has since become the region’s single largest exporter of migrants. South Africa is the major destination; Temporary, circular migration is the norm in the region with migrants retaining close ties with home countries and communities through formal and informal transfers of cash and goods in the form of remittances. In effect, migration and remittances have become a major source of development finance across the region; The majority of migration movements within and to the Southern African region fall into the category of South-South migration. This form of migration, from one developing country to another, can have positive and simultaneous development impacts on both countries of origin and destination; From a migration management perspective, regional organizations have recognized the importance of regional harmonization and co-ordinated action. However, governments have been slower to recognize the reality of regional migration, leading to a disjuncture between initiatives to facilitate movement and co-ordinate migration for development at the continental and regional level, and national governments that tend to view migration negatively and avoid any binding commitment to regional migration processes and instruments. The analysis of migration trends and flows distinguishes between (a) migration within the Southern African region from one country to another; (b) migration to Southern Africa from other countries, especially the rest of Africa; and (c) migration from Southern Africa to other parts of the globe. Each has implications and opportunities for harnessing migration for development and inclusive growth. For example: All of the countries of Southern Africa host some migrants, with the major migration destinations being South Africa, Zimbabwe, the Democratic Republic of the Congo (DRC), Tanzania, Mozambique, Malawi and Botswana. All are also migrant-sending countries with the major intra-regional senders being Mozambique, Zimbabwe, Lesotho, Malawi and Angola. Even South Africa sends migrants to other countries in the region. In policy terms, this means that although many countries are threatened by what they view as an uncontrolled influx of migrants, they are themselves also migrant senders and beneficiaries of out-migration to other countries. Migration flows within the region have undergone major changes in the last two decades, including a significant decline in forced (refugee) migration, an equally significant increase in migration for economic and livelihood reasons, more diversity in flows including increasing female and youth migration, a decline in formal contract migration to South African mines, and a concomitant increase in unregulated, informalized migration across borders. Data and reliable information on all of these trends and their drivers are largely absent. In total, 53% of all Southern Africa-born migrants are living outside the region. The five major sending countries are South Africa, Zimbabwe, Angola, the DRC and Mauritius. The five major destinations are the United Kingdom, Australia, France, the United States and Portugal. Shared histories and common languages have resulted in the emergence of migration corridors that include South Africa-UK, South Africa-Australia, Angola-Portugal, Zimbabwe-UK and Madagascar-France. The majority of migrants who leave the region are relatively skilled, leading to claims that countries of destination are responsible for a “brain drain” from the region. This argument has largely been replaced by the realization that these migrants are actually a resource with a potentially strong development role to play. Against the backdrop of complex and shifting migration patterns and flows, the report identifies key development-related implications of these migration trends and characteristics and presents relevant information and data on each. This provides substantive context and a link to the programming recommendations later in the report. The five areas are: (a) gender and migration; (b) migrant rights and protections; (c) migration and remittances; (d) migration and informal entrepreneurship and (e) diasporas for development. Although the available information on each area is uneven across the region, evidence is marshalled to suggest that each offers important opportunities for meeting the overall goal of harnessing migration for development and inclusive growth. These areas are united by a focus on the importance and development implications of women’s migration. The major findings from the analysis of these five areas include the following: Southern Africa is undergoing a process of feminization of migration with increased independent women’s migration. The number of female migrants in SADC is now over 2 million. In the major destination country (South Africa), the proportion of female migrants has reached 40% of the total. Gender-disaggregated data on migrant flows and occupations is generally unavailable, although South African data suggests that a migrant woman has only a 56% probability of being employed compared to a migrant man. There is a growing body of case-study evidence on informal temporary migration and the low wage regime and exploitative conditions in sectors such as construction, illicit mining, commercial agriculture and domestic work. For those migrant women who are employed, many are engaged in precarious livelihoods. Some are employed in potentially exploitative conditions with weak oversight or protection of their labour rights, for example as domestic or agricultural workers. Others are engaged in inherently precarious informal occupations such as trading, hair braiding and other beauty services, or craft production and sales, often conducted in unsafe spaces. Related to their precarious working and living conditions, female migrants experience gender-based violence and other health vulnerabilities. Poor treatment of female migrants on the way to and at the workplace exercises an extremely negative impact on the migrants themselves and their households, and is also antithetical to development and inclusive growth in their home countries. Low wages and other forms of financial extortion, for example, significantly reduce the remitting ability of migrants. Precarious employment in the agricultural and domestic service sectors is highly gendered with female migrants being most vulnerable to exploitation by formal and informal labour brokers and recruiters, employers and the authorities (especially the police). There is considerable evidence that remitting is an extremely common practice in Southern Africa. However, much remitting is through informal channels, and accurate data on remittance flows at the regional level is not available. The World Bank calculates that remittance flows to the countries of Southern Africa reached USD1 billion in 2014. Only a third of remittances to Southern African countries come from other countries within the region. Over two-thirds of remittances to Southern African countries therefore come from outside the region. Globally, female migrants send approximately the same per capita amount of remittances as male migrants but women tend to send a higher proportion of their income. Women also usually send money more regularly and for longer periods of time than men. In Southern Africa there is some evidence of distinct gender differences in remitting amounts, frequency and means of remitting, remittance recipients and use of remittances. This suggests that data, research and policy-making on migration and remittances needs to be gender-disaggregated. The number of migrants running small and microenterprises or being employed by these businesses is considerable in towns and cities across the region. In South Africa, as many as one-third of migrants are self-employed in the informal economy. Surveys of migrant entrepreneurs show that the sector is dominated by young people and that women occupy particular niches. Informal business owners have positive development impacts in countries of destination and origin through remittance of business profits, generating employment, rental of business properties, providing cheaper services, supporting formal sector businesses and payment of operating licences to municipalities. The major challenges to business survival and expansion include difficulties of securing start-up capital and business loans from formal financial institutions, especially banks; lack of basic business training and skills; exclusion from formal banking systems; vulnerability to xenophobic attacks and destruction of stock and businesses premises; and hostile operating environments including official harassment, extortion and demands for bribes or protection money. While many governments are developing plans and policies for diaspora engagement, an important information gap concerns the attitudes of diasporas themselves to engagement in development-related activities and initiatives in their countries of origin. A study of the global Zambian diaspora showed that most are interested in making private investments in Zambia, with the greatest sectoral interest in agriculture/horticulture, import/export, manufacturing, tourism and transport. Many expressed interest in contributing to development projects in Zambia related to education, healthcare, infrastructure development, childcare and microfinance initiatives. A study of immigrants from the SADC in Canada found that many felt they have an important role to play in developing their countries of origin. The majority remit money to their country of origin. Preferred avenues of engagement include skills transfer, investing in businesses, participation in development projects, educational exchanges, volunteer work, fundraising for development projects, philanthropy, export and import of goods to and from the country of origin, investing in infrastructural development and providing distance learning. Others specifically mentioned their desire to be involved in activities that would lead to greater empowerment for women and children. The next section of the report examines the policy implications of the information about migration flows and development implications provided in the previous section. There was a considerable degree of unanimity among the stakeholders interviewed for this study on the importance of seeing migration as a regional development issue requiring a co-ordinated regional response in Southern Africa. There was some expectation of a difference in opinion between regional and national stakeholders. However, many of the latter were also willing to acknowledge that migration was not purely an issue of national importance. Where they differed was on who should be driving the agenda: national governments or regional bodies. In principle, there is significant awareness among SADC member states about the need to strengthen efforts aimed at harnessing migration for inclusive growth and development. In practice, little progress has been made on mainstreaming migration and development at the national or regional policy level. Regional efforts to forge a common approach to migration appear promising but, while states appear willing to make initial commitments to agreements, instruments and initiatives, they are generally unwilling to ratify and implement anything that appears to infringe on their national sovereignty or the perceived interests of citizens. At the regional level, there is a paucity of instruments that focus directly on migration and development. An evaluation of the SADC Secretariat’s Regional Indicative Strategic Development Plan (RISDP) has concluded that “the relationship between migration and poverty is under-represented in the plan’s proposed intervention areas and only addressed in a partial and circumscribed manner.” Freedom of intraregional movement has been a principle of the SADC since its foundation, although this is not explicitly tied to positive development outcomes. Despite this objective, unfettered free movement is very far from being a reality. The Secretariat has had no success in getting all member states to ratify its two major regional mobility policy initiatives: the 1995 Draft Protocol on the Free Movement of Persons and the 2005 Protocol on the Facilitation of Movement of Persons. Greater regional mobility initiatives are trumped by national immigration policies focused on movement control. SADC member states prefer to act bilaterally in their dealings with each other on migration through instruments such as Joint Permanent Commissions (JPCs) and Memoranda of Understanding. At the level of individual member states, the mandate and expertise required for, and resources devoted to, migration management is often limited to routine and operational capacity requirements, as opposed to a more strategic approach in which migration management is an essential component of development objectives. Little discernible progress has therefore been made with regard to the implementation of a free movement regime by the SADC Secretariat. In part, this is because there is very little data or analysis on exactly what the impact of removing border controls in the region would be. In many ways, the SADC is already a de facto free movement zone and the removal of controls would not have a massive impact on migration flows. What it would do is provide legal channels for those who want to migrate, reduce the opportunities for personal enrichment by corrupt state functionaries on both sides of borders, eliminate current high levels of corruption and abuse in the immigration system and reduce the exploitation of migrants who enjoy few rights and protections. However, free movement is likely to remain politically unpalatable to most states for the foreseeable future. One of the key components of inclusive growth strategies is poverty reduction through productive and decent employment. Given the high levels of poverty and inequality throughout Southern Africa, it is important to view migrant employment rights as an integral part of the inclusive growth agenda. The SADC Secretariat has made various efforts to put in place instruments that commit member states to protecting the rights of migrant workers. A recent study for the United Nations Research Institute for Social Development (UNRISD) examined the issue of migrant protection and rights in the Southern African region as a whole and identified the various regional-level commitments to protecting migrant rights and the obstacles to their implementation. This report examines various instruments including the UN Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, the Charter of Fundamental Social Rights in SADC, the SADC Code on Social Security, ILO Conventions 87, 100, 111 and 182, the Convention Concerning Decent Work for Domestic Workers (Domestic Workers Convention), the SADC Protocol on Employment and Labour, and the SADC Regional Labour Migration Policy Framework and concludes that, as with the effort to implement freedom of movement, ratification and implementation are proving problematical as few member states are willing to ratify the appropriate instruments. A gender analysis of the various African Union (AU) and SADC strategic instruments shows that gender and migration issues feature only in piecemeal fashion. Regional-level instruments, polices and protocols do exist, but these are barely enforced and national laws and institutions take precedence. The persistent limitations of migration governance on the continent are recognized as an obstacle to regional and continental poverty reduction. Furthermore, policies and instruments to protect migrant and gender rights are implemented within a difficult social and political context in which xenophobic and patriarchal attitudes persist. In sum, there are many challenges in advancing gender-sensitive, rights-based migration governance in the SADC region. The scale, complexity and diversity of migration, combined with incomplete and inconsistent data, make it difficult to measure and monitor the gender composition of migrant flows and stocks, or to understand the particular contributions and vulnerabilities of female migrants. A dual focus on empowerment and protection should guide programming and policy development on gender and migration in the region. The final section of the report makes specific recommendations for a future regional programme on harnessing migration for development and inclusive growth. Given the lack of progress at regional and national level in advancing a migration and development agenda, we argue that programming should focus on “demonstration” projects that provide clear evidence of the development impacts of migration for countries of origin and destination. These projects could then be scaled up. In order to establish priority entry points, the report does three things: Presents the results of the stakeholder perceptions of priorities in which knowledge and information gaps were a recurrent theme; Analyzes and categorizes the recommendations for making migration work for development in the SDGs, the Valetta Accord and various AU and SADC agreements, protocols and instruments; Develops a Programming Framework (PF) consisting of 10 core migration and development issues and 27 associated potential entry points; and This analysis leads to the identification of five major entry points in the programming framework under the general rubric of a recommended programme on Gender and Migration for Development and Inclusive Growth in Southern Africa. For each point, the report provides a detailed rationale, examples of similar programmes and likely outcomes. In summary, the five recommended entry points are as follows: Entry Point One: Building a Gendered Knowledge Base on Migration. One of the recurrent themes in the stakeholder interviews was (a) the limited public availability and utility of official data on migration; and (b) the lack of knowledge about regional migration causes, volumes, experiences and impacts. A common failing of official data and the case-study research literature is the absence of systematic and generalizable information on the gendered nature of migration. In order to provide detailed, policy-relevant, gender-disaggregated data on migration and its development impacts, a different methodological approach is needed. There is a need for the collection of national migration data at the household level in countries

No. 29: The New Brain Drain from Zimbabwe

All the signs point to the existence of a growing exodus of skilled Zimbabweans from the country. Although the precise dimensions and impacts of this “brain drain” have yet to be determined, the Zimbabwean government has recently sought to stem the tide with various policy measures. The education and health sectors appear to be the hardest hit although professionals in other sectors have also been leaving in numbers. The Southern African Migration Project (SAMP) has undertaken a multi-country study of the brain drain within and from the Southern African Development Community (SADC). SAMP’s primary contribution is to examine the skills base of a country and, on the basis of nationally-representative surveys, determine the future emigration potential of skilled people who remain. In other words, SAMP provides critical policy-relevant information on the likely course of the brain drain in the future and the effectiveness of policy measures that might be deployed to slow or reverse the brain drain. The Zimbabwean survey was conducted in 2001. A representative sample of 900 skilled Zimbabweans was interviewed to obtain information on personal and household economic circumstances; attitudes towards current and future economic, social and political circumstances; likelihood of emigration in the future; and attitudes towards measures designed to keep them in the country. The majority of the respondents (844) were African. Thus, the survey results are focused primarily on the emigration potential of black Zimbabweans. The white sample was too small to say anything of significance about white intentions. The respondents were drawn from a wide variety of professions and sectors and therefore represent a broad cross-section of skilled Zimbabweans. The first significant finding is that 57% of the sampled population have given a “great deal” of thought to emigrating from Zimbabwe (with another 29% having given the matter some thought). Only 13% have given it no consideration. A comparison with South Africa is germane since that country is widely believed to be undergoing a crippling brain drain. In South Africa, only 31% of the skilled population have given a great deal of thought to emigrating, with 31% having not thought about it at all. In terms of gender breakdown, more women than men have given a great deal of thought to emigrating (62% versus 54%), which is the opposite of the South African scenario. In age terms, it is Zimbabweans in the 25-35 age group who have given most thought to emigrating. Nevertheless, levels of dissatisfaction are so high that the majority in each age group have given at least some thought to leaving. As SAMP has demonstrated elsewhere, thinking about leaving and actually doing so are not the same thing. The survey therefore sought to establish the extent to which skilled Zimbabweans have made a mental commitment to leaving within a certain time frame. Respondents were therefore asked about the likelihood of their leaving within the next six months, two years, and five years. Over a quarter (27%) said it was likely or very likely that they would leave in six months. Fifty five percent were committed to emigrating within the next two years. And 67% said they were committed to emigrating within the next five years. These are sobering statistics, unmatched in any other country in the region in which SAMP has done similar research. They suggest that the pool of future emigrants in Zimbabwe remains massive. The firmest indication of migration potential, however, is whether a person has acted on their desires by applying for emigration documentation. Many emigrants do not, of course, apply until they are already overseas. However, the survey found that nearly 20% of the resident skilled population had either applied for or were in the process of applying for a work permit in another country. Another question addressed by the survey concerns the “permanence” of intended or likely emigration. This is an important issue. Are people so disillusioned that they wish to leave forever or would they return if conditions improved for them at home? The survey found that 51% expressed a strong desire to leave permanently (for longer than 2 years), compared with only 25% who have a strong wish to only leave temporarily. Again, 43% said they would prefer to stay in their most likely emigration destination for more than 5 years. This is not therefore a population that sees emigration as temporary exile. Why are so many Zimbabweans thinking seriously about leaving? The reasons for this extraordinary state of affairs can be analysed at two levels. First, it is possible to point to economic and political events over the last decade as the primary cause of emigration and high future potential. These events are too well-known to be repeated here. Instead, this survey sought to obtain the opinions of skilled Zimbabweans themselves, to statistically measure levels and forms of dissatisfaction and disillusionment and relate these to high emigration potential. The survey discovered extremely high levels of dissatisfaction with the cost of living, taxation, availability of goods, and salaries. But the dissatisfaction goes deeper than economic circumstances to include housing, medical services, education and a viable future for children. South Africans actually show similar levels of economic dissatisfaction but they are far more optimistic about the future than Zimbabweans. Asked about the future, there was deep pessimism amongst skilled Zimbabweans, with the vast majority convinced that their personal economic circumstances would only get worse. They were also convinced that social and public services would decline further. The respondents were also asked about their perceptions of political conditions in the country. Here, too, there was considerable negativity and pessimism. Ratings of government performance were extremely low. Various measures have been mooted in Zimbabwe with a view to keeping skilled people in the country, including compulsory national service and bonding. A coercive approach to the brain drain has not worked particularly well elsewhere and often have the opposite effect to that intended. The survey showed that such measures would only add to the burden of discontent and for around 70% of respondents would make absolutely no difference to their emigration intentions. Zimbabwe faces an immense challenge in stemming the exodus to other countries within Africa and oversees. The basic conclusion of this study is that coercive measures will not work and that the best way to curb the high rates of skilled labour migration lies in addressing the economic fundamentals of the country which will ultimately improve living standards. Regretably, most skilled Zimbabweans are very pessimistic that this will happen in the foreseeable future

Five-country Study on Service and Volunteering in Southern Africa

In the context of globalization, civic service and volunteering is emerging as a growing social phenomenon and a field of inquiry internationally. This research was done to strengthen knowledge and understanding of service and to build research capacity in order to develop service as a field of inquiry and to strengthen its knowledge base and practice

Zimbabwe: The Community Foundation for the Western Region of Zimbabwe

This is a fact sheet information on community foundations in the Western Region of Zimbabw

Eccentric housing finance sources by the urban poor in Zimbabwe: case of Cowdray Park low-income self help housing scheme in Bulawayo

Zimbabwe has a sombre housing crisis in all its urban centres. All attempts by the government to vary housing delivery systems to ameliorate the problem have proved futile as the backlog it inherited from the colonial masters continues to soar. The situation has however been exacerbated by 2005 demolitions and evictions in the country’s major cities that destroyed homes and businesses leaving the majority of the poor and disadvantaged segments of society in deeper poverty, deprivation and destitution. The main challenge to housing the urban poor is housing finance. Public funds are meagre and private funds are not accessible to the poor due to lack of collateral security and inability to service the loans. Fascinatingly, the poor’s income comes from informal sector activities that absorbs a large percentage of the labour force and keeps the economy going while the large modern enterprises continue to reel under the economic downturn. Unfortunately the Zimbabwean informal sector has generally been perceived as a nuisance, a haven for criminals and a menace. Evidence shows that there is a strong relationship between the urban poor’s housing finance, informal sector activities and self-help housing strategies in Zimbabwe. In the pre-2005 Operation Murambatsvina era, the poor were making some construction progress as evidenced by the structures that had developed. This paper calls for active support and facilitation of the poor’s sources of income, and advocates for the involvement of other players such as the private sector and the international community in housing the poor. The Zimbabwe government’s plan to house the homeless and poor on its 250 000 stands countrywide through self-help programmes can only be successful if their sources of income are promoted and facilitated.urban poor, housing finance, informal sector, self-help, projects

Employment, unemployment and informality in Zimbabwe: Concepts and data for coherent policy-making

This document is part of a digital collection provided by the Martin P. Catherwood Library, ILR School, Cornell University, pertaining to the effects of globalization on the workplace worldwide. Special emphasis is placed on labor rights, working conditions, labor market changes, and union organizing.ILO_EmploymentUnemploymentandInformalityinZimbabwe.pdf: 1098 downloads, before Oct. 1, 2020

Wages Equal Productivity. Fact or Fiction?

If labor markets operated entirely frictionless, productivity premiums associated with different worker characteristics would equal the wage premiums earned by workers possessing those characteristics. Using matched employer-employee data from the manufacturing sector of three sub-Saharan countries, we evaluate to what extent the two premiums differ for four characteristics that are clearly related to human capital: schooling, training, experience, and tenure. Equality holds strongly and even surprisingly well for firms in Zimbabwe (the most developed country in the sample), but not at all in Tanzania (the least developed country), while results in Kenya are intermediate. Where equality fails, the pattern is for general human capital characteristics (schooling, experience) to receive a wage return that exceeds the productivity return, while the reverse applies to more firm-specific human capital characteristics (training, tenure). Schooling tends to be over-rewarded, even though large productivity gains are consistently associated with formal employee training programs. Wages tend to rise with experience, while productivity gains are mostly associated with tenure. We demonstrate the remarkable robustness of the findings controlling, among other things, for sampling errors, nonlinear effects, and non-wage benefits. Localized labor markets and imperfect substitutability of different worker-types provide a partial explanations for the estimated gap between the wage and productivity premiums.sub-Saharan Africa; production function; labor market; human capital; market efficiency

Mending the Gap Between Law and Practice, Organizational Approaches for Women's Property Rights

This document presents information of how women in many countries are far less likely than men to own property and assets - key tools to gaining economic security and earning higher incomes. Though laws to protect women's property rights exist in most countries, gender and cultural constraints can prevent women from owning or inheriting property. In this series, ICRW suggests practical steps to promote, protect and fulfill women's property rights

Participatory Grant Making: A Success Story from Southern Africa

The Other Foundation (tOF) is an African trust dedicated to advancing human rights in southern Africa, with a particular focus on lesbian, gay, bisexual, transgender and intersex (LGBTI) people. Our primary purpose is to expand resources available to defend and advance the rights and wellbeing of LGBTI people in the southern African region. We do this by working both as a grant-maker and a fundraiser.The founding board of tOF was first convened in Johannesburg, South Africa, in August 2013. At that initial meeting concern was expressed about the need for the membership of the board to better reflect the diversity of the southern Africa region. However, it was also noted that the funding for the establishment of the Foundation was a generous challenge grant from Atlantic Philanthropies, that set very specific fund raising targets within specified time-frames. It was therefore agreed that the founding board would set a limited number of tasks to fulfill, leading to the establishment of a board more appropriately reflective of the community it was established to serve. The three tasks were: (a) appoint the founding CEO; (b) undertake a pilot grant making initiative; and (c) work with the incoming CEO on a strategic plan.This report outlines the work that was involved in the development and implementation of the pilot grant making initiative, as well as reporting on the first grants that were allocated by the foundation. tOF received 114 applications for funding, from seven different countries, through an open call to support work that 'advances the rights and well-being of LGBTI people in Southern Africa'. 12 peer reviewers from six different countries in southern Africa, were selected through an open call for nominations to work with the board to select the proposals to be funded. The peer reviewers worked in four teams of 3 reviewers each, facilitated by a board member, to come to a consensus about which projects to recommend for funding. The process began by each reviewer individually assessing a number of applications, and then coming together in teams to share their findings.32 proposals were recommended for funding to the Board. About R3.1 million rand was awarded in grants ranging in size from R 10,000 to R 500,000. Grants were allocated in South Africa, Botswana, Namibia, Zimbabwe, and Malawi. Work that tOF will be supporting includes: investigating how midwives deal with inter-sex babies in Botswana; a holiday camp for children of LGBT people in South Africa; research into gender non-conformity in Swaziland; a book on Queer African Theology; mainstreaming issues related to sexual orientation in religious curricula in a university in Zimbabwe; as well as supporting anchor institutions in the region that are responsible for doing ground breaking work around the region through the Out in Africa film festival, the gay and lesbian archives, and trans and gender identity based advocacy work