Structural shake-up at Pathfinder under new CEO

LONDON — The family planning organization Pathfinder — which turns 60 this year — is undertaking a major structural shake-up, exploring unusual partnerships and expanding its work with refugees as part of its efforts to cope with the devastating changes to United States funding for reproductive health, its new chief executive officer has told Devex.

Founded in 1957, Pathfinder prides itself on being a pioneer and innovator in the family planning space and was one of the first organizations to offer contraception in the U.S. and in 60 other countries, Lois Quam — who took over as head of the NGO in January — said.

Quoting the Spanish poet, Antonio Machado, who wrote “Traveler, there is no path. Paths are made by walking,” she said: “I think that [quote] really sums up who we’ve been and who we still are — we are brave and courageous and seek to build up the capacity in the countries in which we work.”

This pioneering spirit is needed now more than ever, as NGOs grapple with the consequences of U.S. President Donald Trump’s decision to reenact an expanded version of the “global gag rule” — also known as the Mexico City Policy — which prevents foreign NGOs that receive U.S. funding from providing any abortion-related services, including referrals and counseling. The administration has also cut $32.5 million in funding to the United Nations Population Fund, the world’s largest provider of family planning products and services.

About 75 percent of Pathfinder’s funding currently comes from the U.S. government. It has asked its non-US partners to abide by the controversial gag rule, which means it can no longer subcontract to organizations providing abortion-related services. However, it has historically been, and remains today, a vocal opponent of the order, filing a successful lawsuit against it in the 1980s which enabled the U.S. Agency for International Development to fund post-abortion care services.

“Pathfinder has long been a leader in opposing harmful policies like the global gag rule… We know… it denies women access to critical health services,” Quam said.  However, she also said that “U.S.-funded work saves lives.”

Devex spoke with Quam the day after the London Family Planning Summit — a major conference held in the United Kingdom last month, which raised approximately $5 billion in new funding for the sector.

She has taken over at Pathfinder following a series of high-profile positions in the public and private sector — including head of UnitedHealth Group and The Nature Conservancy, and special adviser to the State Department under Barack Obama’s administration. Drawing on her diverse experience, Quam outlined some of the key changes she is pursuing at the organization — in response to the changing U.S. funding landscape and beyond — which she hopes will help it chart a new path while staying true to its history and mission.

Breaking down the headquarters/field divide

Pathfinder offers a range of family planning and related health services, and carries out advocacy work in 19 countries. It has a staff of more than 1,000 people, 90 percent of whom work alongside local organizations to “ensure all people have the right to decide whether and when to have children and to lead the lives they choose,” according to its website.

On the basis that working alongside the community is one of its founding principles, one of Quam’s first moves upon taking up the role of CEO earlier this year was to oversee a major restructuring effort which saw 26 U.S. staff positions closed in order to move the organization away from the “classic headquarters/field” development structure — which she described as having “colonial overlays” — and put greater power and resources in the hands of field offices.

The move to implement what the organization refers to as a ‘community-first’ model, also freed up funds to act as a “cushion” to help the organization weather U.S. funding cuts, she said.

“We made the decision to set that [structure] aside because our headquarters was just outside Boston, and we don’t provide services there,” Quam said. “If you get closer to [the] services you provide, you can be more innovative, you can understand what the barriers are and know what’s not working.”

The NGO still has offices in Washington, D.C., and Boston, and plans to open a third in the San Francisco Bay area, but Quam said their role is now primarily to support the field offices through fundraising, compliance and grant administration.

“Our American staff and offices are really important, but that’s very different from saying this is the headquarters and this place calls the shots,” she said. While it is “always difficult” to “let go of talented people,” she said, the organization is in the process of hiring new in-country staff.  

Quam’s newly-appointed second in command — Mohamed Abou Nar — has also broken with tradition by continuing to operate out of Egypt instead of moving to Boston. As the previous program director for Pathfinder’s work in Bangladesh, Egypt, India and Pakistan, it made sense for him to stay closer to the services he manages and the time-zones in which most of the organization’s staff operate, Quam said.

Working with refugees and host-country populations

Under Quam’s leadership, Pathfinder is also increasing its work with refugees, migrants and displaced people — but with an emphasis on working “in concert” with the existing health authorities, rather than in parallel. The NGO has set up an internal humanitarian strategy group to guide and develop this work, Quam said.

In Egypt, for example — which the United Nations estimates is host to more than 115,000 Syrian refugees — Pathfinder ran a one-year project between 2015 and 2016, funded by the Ford Foundation, to increase the capacity of the Egyptian health system to serve refugees in Cairo’s Sixth of October district.

“In many parts of the city the needs of Syrian refugees and the Egyptian communities were very similar, and so instead of setting up parallel systems, which may have built resentment, we worked in concert with the Egyptian health system to build up these systems to benefit both the host communities and refugees,” Quam said.

On the back of this work, Pathfinder is considering expanding into the Lake Chad Basin, which is home to thousands of people fleeing attacks by Boko Haram; working with displaced people in the Kasai region of the Democratic Republic of Congo; and with displaced Rohingya populations in Bangladesh.

Combining family planning with conservation

While in London for the Family Planning Summit, Quam took part in a side event showcasing Pathfinder’s work with conservation groups such as The Nature Conservancy in Lake Tanganyika, western Tanzania. The region is home to hundreds of fish species and chimpanzees, as well as communities who rely on the lake and its surrounding forest for their livelihoods, food and water.

Quam described the Tanzania collaboration as being “about loving people and nature,” and said that both organizations worked with communities to come up with a “definition of a model household” as one which uses natural resources “carefully” — through energy saving cooking stoves and applying sustainable farming and fishing practices — while also maintaining good health by improved sanitation and hygiene practices, and accessing family planning services.

“When that happens, the lake is not depopulated of fish, the forests are not depleted, and families avoid preventable illnesses,” she said.

Reproductive health is a key component of the project since the region has one of the highest birth rates in the world, putting huge pressure on the area’s natural resources. Marine conservation group Blue Ventures has done similar work in coastal areas of Madagascar.

Pathfinder plans to do more of this work and is currently exploring working with additional conservation partners in Mozambique and South Africa, Quam said.

Update, Aug. 8: This article was updated to clarify that the structural changes at Pathfinder were planned before the reinstatement of the global gag rule

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