How the PIH Program Management Guide is helping a young non-profit organization in Rwanda.


By Aaron Shapiro, Gardens for Health International

Just five months after college graduation I found myself standing at a health center in Rwanda, anxiously waiting for thirty mothers of malnourished children to arrive for their first training on improved nutrition. After two hours of waiting, I finally accepted that no one was going to show. And so began my humble introduction to the challenging world of program management.


Aaron Shapiro works for Gardens for Health International in Rwanda.


Participants in a Gardens for Health project.


A cooking class organized by Gardens for Health.

I moved to Rwanda three months ago and immediately began setting up a monitoring and evaluation system, training field staff, overseeing procurements, and collaborating with our health center partners over program design and sustainable exit strategies. I work for Gardens for Health International (GHI), a non-profit organization that partners with local health centers to create long-term solutions to malnutrition by helping families grow more nutritious food and providing training on the diverse causes and solutions to malnutrition. I’m here through a Global Health Corps (GHC) Fellowship, a program that matches young professionals from around the world with health-related organizations (currently operating in Rwanda, Burundi, Malawi, Uganda, and the United States) in an effort to strengthen and build the movement for global health equity.

I’m finding more and more people my age applying for jobs in international development and global health. However, global health work was always something of an enigma to me until I experienced it first hand when I started volunteering with an orphanage for HIV positive children in Tanzania four years ago. We can all be inspired by an international NGO’s website or promotional video, but when a website says that they successfully ran a women’s empowerment program in Malawi, what does that actually mean? How many people, how much money, and how much time does it actually take to complete a water sanitation project in Congo? And how do you actually get it done?

I can tell you first hand that managing a program isn’t easy. Every day, I work through language barriers, cross-cultural miscommunications, and new regulations that need to be fully understood before any implementation takes place.  The new PIH Program Management Guide took many of the complexities I work with on a day-to-day basis and pulled them together into one document.

For me, this manual not only gives a glimpse into health programming for anyone interested, but also serves as a practical guide for those of us working with these complex challenges every day. It sheds light on ways to accurately collect data, efficiently train community members, and demonstrates the critical importance and value of working collaboratively with host governments.

PIH, GHI, and GHC all strongly hold quality healthcare as a human right. Many of us working to reduce the healthcare gap are in this line of work for similar reasons. But actual change comes down to quality program implementation.

PIH, and young non-profits developing in PIH’s wake, are setting the bar for information sharing and collaboration. It’s the only way to learn from past mistakes and move forward to better serve those in need. Plain and simple: the guide helps me do my job better. 

Thank you, PIH team, for sharing such a valuable document with the rest of us. We here at GHI have already started putting together a program management guide of our own in hopes of continuing the momentum that you’ve started.

Take a look at the PIH Program Management Guide.

Some of the participants of the Gardens for Health International project in Rwanda.