As a public health researcher striving to make a real change, I’ve been learning invaluable lessons from working in the non-profit sector. Research outcomes may be too technical to make a direct impact on a population, however non-profit programs also may not be as straightforward as they seem. To understand the mechanisms and processes of the change, I tend to ask a few simplified questions: what to do, how to do it, for whom, and why?

Actually these simple inquires may appear to complicate the issue, but I would not underestimate the power of clarifying the core components of the “non-profit approach.”

After all, there’s always a simplified answer. For instance we can say, we are improving people’s health and closing inequality gaps, we raise funds and deliver health programs, for those who are vulnerable, under-served, and most in need; and then the “why” question seems self-evident.

In real world, things are certainly more complex, and deeper inquires, such as program monitoring and evaluation and strategic planning, become necessary in order to elaborate the answers for the above-mentioned questions. More importantly, such inquiries can ensure the healthy operation, and essentially, the financial sustainability of the organization.

Then funding becomes an interesting perspective. Often times the programs become “donor-driven”, which does not necessarily disempower the organization, as long as it can work with the donor in order to provide adequate answers to those questions. With knowledge about the community and expertise on specific health programs, non-profits are certainly in a position of providing crucial insights, and may drive  donors to make things work in a (even) better way. But surely things don’t usually work in an ideal way, and the whole process may rely on how hard we try to answer the questions – perhaps amid working hard to fulfill grant deliveries.

For the “what” question, we need to specify project aims, especially measurable outcomes. For the “how” question, a concrete, practical implementation plan with caveats and assumptions should be developed. Target population in the “whom” question can also be more carefully identified. Then the “why” question can be addressed according to the organizational strategy and evidence base that justifies the project.

In an era of unprecedented accessibility of information, my impression is that this series of inquiries is becoming increasingly important as donors learn a lot from the field and become increasingly savvy about the rationales and values of health programs. In fact this can be a good news for researchers, who would usually prefer telling a right story to telling a attractive story (or ideally both of course). While contributing to the organizational advocacy, I also wondered how we could advocate for the value of research in non-profits, especially health organizations.

I certainly believe in and care about a solid evidence base – and I think we should not assume the opposite for donors and the general public. In fact, non-profit health programs can also significantly contribute to research with valuable community data from a proper project design. The mutually beneficial linkage between non-profit programs and academic research may not be well developed presently, but I do see it as a change we should strive to make.

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