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Organisational Capacity of Non Profit Organisations in the Russian Federation
Jo Crotty
Salford Business School
University of Salford
Manchester
Sergej Ljubownikow
Nottingham Business School
Nottingham Trent University
Nottingham, NG1 4BU
This research was funded by the British Academy for Humanities and Social Sciences
grant SG111936
Summary
This research investigated non-profit organisations (NPOs), engaged in the
area of health and health care in the Russian Federation. The aim of the research was
to explore whether and how such organisations provide services to their clients and
the extent to which these groups are a substitute for services normally provided by the
State. The research studying twelve Russian non-profit organisations in the health
sector found that such organisations require the development of several organisational
capabilities in order to effectively deliver sustainable services alongside the Russian
State.
Specifically the research project highlighted that health NPOs in Russia need
to: i.) develop their skills and capabilities to engage with volunteers; ii.) be more
proactive in planning for organisational leadership transitions; iii.) develop their
advocacy skills in order to be more active in influencing the State’s service provision
activities; and, iv.) be more active in exploring the diversification of both income
streams and activity focus. However the research also found that NPOs with clients
with HIV/AIDS engage in commendable and innovative ways to deliver their services
drawing on both global best practices and on the most up-to-date research in their
respective field. The HIV/AIDS area was also the best organised in terms of intra-
organisational collaborations. The research also found that all of the participating
NPOs where very proficient at navigating a very difficult official environment.
Introduction
This research project set out to examine the organisational capacity of Russian
NPOs in the health area. In light of the conclusion of the literature that Russian NPOs
lack the capacity or capability to hold the State to account (Crotty & Hall, 2013;
Ljubownikow, Crotty, & Rodgers, 2013; Sundstrom, 2005; Taylor, 2006), we were
interested as to whether this is also the case in their primary activities of providing
services. This is a particularly pertinent issue in the health sector as since 1991 the
Russian State retreated from the provision of many social services (Rivkin-Fish, 1999,
2005; Sil & Chen, 2004; Thomson, 2002). This left NPOs to fill the voids often with a
fraction of the resources (Thomson, 2002). Thus exploring and understanding whether
Russian health NPOs have the relevant organisational capacity and organisational
attributes that enable them to act as service providers is important (Cairns, Harris, &
Young, 2005; Eisinger, 2002).
The Literature
Capacity and capacity building is a widely debated topic within the literature
(Aragón, 2010; Ayuk & Basil, 2005; Baser & Morgan, 2008; Brinkerhoff, 2005,
2010; Brown & Farrelly, 2009; Cairns et al., 2005; Fiszbein, 1997; Goodman,
Steckler, & Alciati, 1997; Harrow, 2001; Herman & Renz, 1998; James, 1994, 2001;
King & Bouchard, 2011; Minzner, Klerman, Markovitz, & Fink, 2013; North, 1990;
Postma, 1998; Teskey, 2005) and has received particular attention in the health and
health care sector (Corrigan & McNeill, 2009; Fredericksen & London, 2000;
Germann & Wilson, 2004; Hamel & Schrecker, 2011; Hanusaik, O’Loughlin,
Kishchuk, Paradis, & Cameron, 2010; Hawe, 2000; Klarner, Probst, & Soparnot,
2008; Liberato, Brimblecombe, Ritchie, Ferguson, & Coveney, 2011; Proudfoot et al.,
2007; Simmons, Reynolds, & Swinburn, 2011). In an organisational setting,
organisational capacity has also received some attention (Eisinger, 2002; Madden,
Duchon, Madden, & Plowman, 2012) and generally refers to the ability of an
organisations to engage in activities (Aragón, 2010; Kapucu, Healy, & Arslan, 2011;
Madden et al., 2012). Thus organisational capacity links directly to the mission of an
organisation (Austin, 1994; Letts, Ryan, & Grossman, 1998) and the effectiveness of
their activities (Baser & Morgan, 2008; Bourgeois, Hart, Townsend, & Gagné, 2011;
Sharpe, 2006; Sowa, Selden, & Sandfort, 2004). Therefore organisational capacity is
best defined as “the resources, knowledge, and processes used by the organisation to
achieve its goals and satisfy stakeholder expectations” (Madden et al., 2012, p. 692).
Consequently, the way organisations build capacity is important (Minzner et al.,
2013; Sobeck & Agius, 2007). Within an NPO setting this is often associated with
funding provision arrangements (Germann & Wilson, 2004; Kapucu et al., 2011;
Minzner et al., 2013). Minzner et al. (2013) argue that within NPOs, organisational
capacity building activities centre on organisational development, program
development, revenue development, leadership development, and community
engagement. Proactive engagement by NPOs in improving their activities in these
areas has been found to have positive effects at the organisational level with regards
to the effectiveness of their activities (Brown & Farrelly, 2009; Doherty & Cuskelly,
2012; Doherty, Misener, & Cuskelly, 2013; Glickman & Servon, 1998; Herman &
Renz, 2008; Kapucu et al., 2011; LaFond & Brown, 2003; Minzner et al., 2013;
Wing, 2004). Drawing on this background we examined three specific aspects in this
study that contribute to the advancement of knowledge about and understanding of
organisational capacity in NPOs and specifically health NPOs in Russia.
The Insights
The analysis of the collected data provides the project with good insights into
the organisational capacity of Russian NPOs. Extensive fieldwork highlighted that
health NPO did not actually engage in many activities. This indicates a lack of
organisational capacity in particular with regards to attracting resource that would
enable organisations to maintain paid staff and to ensure the scaling of their current
activities (for elaboration of lack of resources and regulatory aspects see
Ljubownikow & Crotty, 2014). Organisations did indicate that they would like to
engage in more activities but lacked the capacity or scale. However, as expected the
majority of NPOs engage, according to their narratives, in the provision of services,
which did not exist within the government service provision framework previously.
Thus health NPOs did have the ability to develop the capacity for activities relevant to
their context (see also Fröhlich, 2012). However it also indicated that they are unable
to substitute for State service provision, which might become a pertinent issue given
that respondents illustrated an increasing opportunity to work as subcontractors to the
government.
Overall when considering Russian health NPOs against Minzner’s et al.
(2013) five dimensions of capacity building in more detail we find few specific
activities and behaviours dedicated to these aspects. In particular we found little
evidence in the interview data of organisational engagement with the wider
community that is beyond the specific client groups severed. This applied to all but
one organisation, which once a year did organise a fundraising event that relied on
wider community engagement. However none of the organisations were active in
developing or establishing wider community engagement on a more regular basis.
Continuous consideration of programme development was not driven by NPOs
assessment of their activities, but often related to whether or not these program were
able to access funding. Although programme and activity development did draw on
the needs of their constituents, it was also clearly driven by the availability of
funding. A continuous and regular assessment process was only observed in one
organisation addressing the issue of HIV/AIDS, which was mainly made up of staff
with medical backgrounds.
Across all observed and examined organisations we also found little evidence
of effective revenue development. Although significantly we did find, amongst
organisations whose constituents were mainly children, some innovative ways of
cooperation with businesses that the contemporary literature of Russian NPOs has not
yet illustrated. However, these are often for specific activities or events and provide
little contribution to long-term organisational maintenance (Duer & Mateo, 2013).
NPOs also looked positively at the prospect of competing for government contracts,
in addition to the already established grant funding competitions, as part of the
expansion of social contracting introduced by regional governments. NPOs saw these
contracts as being more long-term (for up to five years) facilitating organisational
maintenance and potentially opening up opportunities to diversify revenue streams on
the back of these contracts. Even though some aspects of organisational capacity are
presented and NPOs in this study did engage in the development of parts of their
organisational capacity, we also found a total lack of leadership development.
Amongst health NPOs it was this aspect of organisational capacity that was most
neglected in particular with regards to the awareness of it and strategic planning for
long-term succession. This was demonstrated in a lack of forward planning vis-à-vis
succession and in one case has already led to the decline and de-facto ceasing of one
organisation. However this specific organisation still maintains its legal registration
(which required regular accounts and demonstration of activity submitted to the
Russian state regulatory authority) and the current leader (also the founder of the
organisations) was aware of the continuing demand the work they used to do.
The literature highlights that a system of Public Chambers has been
established by the State as channels for NPO-state interactions as well as providing
resources (Richter, 2009a, 2009b; Richter & Hatch, 2013). Surprisingly, respondents
did not indicate the Public Chamber had played a role in their day-to-day activities.
Some respondents did highlight that they were part of the regional Public Chamber
and saw it as a way of liaising with other NPO leaders and ‘talking at’ the
administration. They did however stop short of illustrating the Public Chamber as
platform that has stimulated the interaction and collaboration between NPOs and the
State or led to more NPO participation in policy decision-making. Thus about eight
years after the introduction of the Federal Public Chamber and subsequent set-up at
regional levels, having a State controlled channel for NPOs to interact with the
administration (Crotty, Hall, & Ljubownikow, 2014; Richter, 2009a, 2009b) has not
affected their daily activities. For most NPOs the Public Chamber was not a platform
for interaction but merely a potential source of resources. Consequently, from the
perspective of the organisations, apart from the grant competitions the Public
Chamber (both at federal as well as regional level) played little relevance to their
activities. The limited effect of the Public Chamber on the day-to-day activities of
NPOs is indicative of their pragmatic approach to dealing with their complex
institutional environment. However, the interview data from state officials setting out
the funding priorities of the Public Chamber highlighted that the chamber might not
affect the activities of NPOs directly, but the activities NPOs engage in can affect
whether or not they will be able to access the resources provided. Thus our data here
outlined the existence of specific funding priorities with little funding available to
organisations that have been negatively noticed by engaging in activities such as
demonstrations, indirect advocacy (Mosley, 2011) or embarrassing the state.
The final aspect the project explored was the perception of the service
provision offered by NPOs in contrast to the one offered by the State. This is of
particular interest as much of the basic health care services have been provided by the
Russia state in the past (Evans, 2006) and NPOs are often characterised as lacking
legitimacy with the public to provide such or similar services (Crotty, 2003; Smolar,
1996). However, NPOs did not feel that they are seen as illegitimate service
providers. Conversely, they illustrated that their constituencies were often unwilling
to access the service offered by the State. This was particularly true for service
provision in areas such as HIV/AIDS or drug use. Here NPOs highlighted that such
clients often felt uneasy about accessing services directly associated with the state for
fear of repercussions by other State authorities (such as arrest by the police). NPOs
highlighted that for these clients State service were also insufficient. In the palliative
care area, NPOs illustrated that the service provided by the state were inadequate and
lacking humanity because they were done on the cheap. Hence clients preferred what
NPOs offered but availability of such services was not widely publicised and often
relied on relationships or knowing people in proximity to the organisation. NPOs saw
themselves, because of the type of service they offered and the marginalised nature of
the groups they served, as a more legitimate service providers then the state. NPOs
highlighted that the state was also acknowledging this with the introduction of social
contracting giving them more responsibilities. The seemingly acceptance of services
provide by NPOs indicates a fundamental shift within the Russian public and state
authorities. It could lead to the improve legitimacy of such organisations in the
Russian context – at least in the social services sector.
However, apart from the NPOs active in more medical sectors such as drug
abuse, palliative care or HIV/AIDS prevention, our evidence highlights that other
NPOs in our study did not offer such essential services to clients. Nevertheless, these
NPOs did run social clubs (for example a singing club or a chess club for the
disabled), engage in some advocacy activities (for example lobbying for additional
funding to support a special treatment of a child with cancer abroad), or organise
specific events (for example clown afternoons at the children’s cancer treatment
wing). These NPOs saw themselves mainly as complementing the State’s service
provision or as in the case of one disability NPO work to affect resource allocation
preferences within State authorities. It is thus not surprising that NPOs felt that their
constituencies or clients appreciated their services. Although this group of NPOs
complement rather than substitute for State service provision, it does suggest an
increasing acceptance of the activity of such organisations, in particular by the State
run organisations that provide essential services. Thus as highlighted above this could
be indicative of a positive shift in the perception of NPOs by the state, potential
clients and the wider Russian public.
In summary despite its small scale (12 organisations across two different
Russian regions) the project has provided a coherent overview of organisational
capacity in Russian health NPOs and thus crucial advancements to our knowledge and
understanding of such organisations as well as the wider context in which they exist.
Our research points out that Russian health NPOs have some deficits in their
organisational capacity of which they are not aware and that require further
development and capacity building. It is vital for Russian health NPOs to engage in
the development of these parts of organisational capacity (mainly leadership
development, revenue development and community engagement) if they are to take
up similar roles to their counterparts in the UK in the provision of health services.
Even though we find a significant capacity deficit on the governance side (in
particular leadership development), we also find that Russian health NPOs have good
delivery capacity with regards to providing services or engaging with their clients.
Thus after the repeated conclusions of various studies that NPOs lack the capabilities
of performing key tasks (Crotty, 2009; Crotty & Hall, 2013), our project finds
positive signs of change and improvement. However, in order for Russian health
NPOs to strengthen these positive steps, ensure sustainability of their existence, and
be able to scale up their work further organisational capacity development is required.
Furthermore, the pragmatic way in which NPOs behave has made them very
adaptable and able to navigate what is still as hostile (both in terms of regulation and
public perception) environment. Overall our understanding of NPOs in the Russian
context provides a more positive assessment than one could expect given the
collective conclusions of previous studies.
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Organisational capacity of non profit organisations in the Russian Federation

  • 1. Organisational Capacity of Non Profit Organisations in the Russian Federation Jo Crotty Salford Business School University of Salford Manchester Sergej Ljubownikow Nottingham Business School Nottingham Trent University Nottingham, NG1 4BU This research was funded by the British Academy for Humanities and Social Sciences grant SG111936
  • 2. Summary This research investigated non-profit organisations (NPOs), engaged in the area of health and health care in the Russian Federation. The aim of the research was to explore whether and how such organisations provide services to their clients and the extent to which these groups are a substitute for services normally provided by the State. The research studying twelve Russian non-profit organisations in the health sector found that such organisations require the development of several organisational capabilities in order to effectively deliver sustainable services alongside the Russian State. Specifically the research project highlighted that health NPOs in Russia need to: i.) develop their skills and capabilities to engage with volunteers; ii.) be more proactive in planning for organisational leadership transitions; iii.) develop their advocacy skills in order to be more active in influencing the State’s service provision activities; and, iv.) be more active in exploring the diversification of both income streams and activity focus. However the research also found that NPOs with clients with HIV/AIDS engage in commendable and innovative ways to deliver their services drawing on both global best practices and on the most up-to-date research in their respective field. The HIV/AIDS area was also the best organised in terms of intra- organisational collaborations. The research also found that all of the participating NPOs where very proficient at navigating a very difficult official environment.
  • 3. Introduction This research project set out to examine the organisational capacity of Russian NPOs in the health area. In light of the conclusion of the literature that Russian NPOs lack the capacity or capability to hold the State to account (Crotty & Hall, 2013; Ljubownikow, Crotty, & Rodgers, 2013; Sundstrom, 2005; Taylor, 2006), we were interested as to whether this is also the case in their primary activities of providing services. This is a particularly pertinent issue in the health sector as since 1991 the Russian State retreated from the provision of many social services (Rivkin-Fish, 1999, 2005; Sil & Chen, 2004; Thomson, 2002). This left NPOs to fill the voids often with a fraction of the resources (Thomson, 2002). Thus exploring and understanding whether Russian health NPOs have the relevant organisational capacity and organisational attributes that enable them to act as service providers is important (Cairns, Harris, & Young, 2005; Eisinger, 2002). The Literature Capacity and capacity building is a widely debated topic within the literature (Aragón, 2010; Ayuk & Basil, 2005; Baser & Morgan, 2008; Brinkerhoff, 2005, 2010; Brown & Farrelly, 2009; Cairns et al., 2005; Fiszbein, 1997; Goodman, Steckler, & Alciati, 1997; Harrow, 2001; Herman & Renz, 1998; James, 1994, 2001; King & Bouchard, 2011; Minzner, Klerman, Markovitz, & Fink, 2013; North, 1990; Postma, 1998; Teskey, 2005) and has received particular attention in the health and health care sector (Corrigan & McNeill, 2009; Fredericksen & London, 2000; Germann & Wilson, 2004; Hamel & Schrecker, 2011; Hanusaik, O’Loughlin, Kishchuk, Paradis, & Cameron, 2010; Hawe, 2000; Klarner, Probst, & Soparnot, 2008; Liberato, Brimblecombe, Ritchie, Ferguson, & Coveney, 2011; Proudfoot et al., 2007; Simmons, Reynolds, & Swinburn, 2011). In an organisational setting, organisational capacity has also received some attention (Eisinger, 2002; Madden, Duchon, Madden, & Plowman, 2012) and generally refers to the ability of an organisations to engage in activities (Aragón, 2010; Kapucu, Healy, & Arslan, 2011; Madden et al., 2012). Thus organisational capacity links directly to the mission of an organisation (Austin, 1994; Letts, Ryan, & Grossman, 1998) and the effectiveness of their activities (Baser & Morgan, 2008; Bourgeois, Hart, Townsend, & Gagné, 2011; Sharpe, 2006; Sowa, Selden, & Sandfort, 2004). Therefore organisational capacity is best defined as “the resources, knowledge, and processes used by the organisation to
  • 4. achieve its goals and satisfy stakeholder expectations” (Madden et al., 2012, p. 692). Consequently, the way organisations build capacity is important (Minzner et al., 2013; Sobeck & Agius, 2007). Within an NPO setting this is often associated with funding provision arrangements (Germann & Wilson, 2004; Kapucu et al., 2011; Minzner et al., 2013). Minzner et al. (2013) argue that within NPOs, organisational capacity building activities centre on organisational development, program development, revenue development, leadership development, and community engagement. Proactive engagement by NPOs in improving their activities in these areas has been found to have positive effects at the organisational level with regards to the effectiveness of their activities (Brown & Farrelly, 2009; Doherty & Cuskelly, 2012; Doherty, Misener, & Cuskelly, 2013; Glickman & Servon, 1998; Herman & Renz, 2008; Kapucu et al., 2011; LaFond & Brown, 2003; Minzner et al., 2013; Wing, 2004). Drawing on this background we examined three specific aspects in this study that contribute to the advancement of knowledge about and understanding of organisational capacity in NPOs and specifically health NPOs in Russia. The Insights The analysis of the collected data provides the project with good insights into the organisational capacity of Russian NPOs. Extensive fieldwork highlighted that health NPO did not actually engage in many activities. This indicates a lack of organisational capacity in particular with regards to attracting resource that would enable organisations to maintain paid staff and to ensure the scaling of their current activities (for elaboration of lack of resources and regulatory aspects see Ljubownikow & Crotty, 2014). Organisations did indicate that they would like to engage in more activities but lacked the capacity or scale. However, as expected the majority of NPOs engage, according to their narratives, in the provision of services, which did not exist within the government service provision framework previously. Thus health NPOs did have the ability to develop the capacity for activities relevant to their context (see also Fröhlich, 2012). However it also indicated that they are unable to substitute for State service provision, which might become a pertinent issue given that respondents illustrated an increasing opportunity to work as subcontractors to the government. Overall when considering Russian health NPOs against Minzner’s et al. (2013) five dimensions of capacity building in more detail we find few specific
  • 5. activities and behaviours dedicated to these aspects. In particular we found little evidence in the interview data of organisational engagement with the wider community that is beyond the specific client groups severed. This applied to all but one organisation, which once a year did organise a fundraising event that relied on wider community engagement. However none of the organisations were active in developing or establishing wider community engagement on a more regular basis. Continuous consideration of programme development was not driven by NPOs assessment of their activities, but often related to whether or not these program were able to access funding. Although programme and activity development did draw on the needs of their constituents, it was also clearly driven by the availability of funding. A continuous and regular assessment process was only observed in one organisation addressing the issue of HIV/AIDS, which was mainly made up of staff with medical backgrounds. Across all observed and examined organisations we also found little evidence of effective revenue development. Although significantly we did find, amongst organisations whose constituents were mainly children, some innovative ways of cooperation with businesses that the contemporary literature of Russian NPOs has not yet illustrated. However, these are often for specific activities or events and provide little contribution to long-term organisational maintenance (Duer & Mateo, 2013). NPOs also looked positively at the prospect of competing for government contracts, in addition to the already established grant funding competitions, as part of the expansion of social contracting introduced by regional governments. NPOs saw these contracts as being more long-term (for up to five years) facilitating organisational maintenance and potentially opening up opportunities to diversify revenue streams on the back of these contracts. Even though some aspects of organisational capacity are presented and NPOs in this study did engage in the development of parts of their organisational capacity, we also found a total lack of leadership development. Amongst health NPOs it was this aspect of organisational capacity that was most neglected in particular with regards to the awareness of it and strategic planning for long-term succession. This was demonstrated in a lack of forward planning vis-à-vis succession and in one case has already led to the decline and de-facto ceasing of one organisation. However this specific organisation still maintains its legal registration (which required regular accounts and demonstration of activity submitted to the
  • 6. Russian state regulatory authority) and the current leader (also the founder of the organisations) was aware of the continuing demand the work they used to do. The literature highlights that a system of Public Chambers has been established by the State as channels for NPO-state interactions as well as providing resources (Richter, 2009a, 2009b; Richter & Hatch, 2013). Surprisingly, respondents did not indicate the Public Chamber had played a role in their day-to-day activities. Some respondents did highlight that they were part of the regional Public Chamber and saw it as a way of liaising with other NPO leaders and ‘talking at’ the administration. They did however stop short of illustrating the Public Chamber as platform that has stimulated the interaction and collaboration between NPOs and the State or led to more NPO participation in policy decision-making. Thus about eight years after the introduction of the Federal Public Chamber and subsequent set-up at regional levels, having a State controlled channel for NPOs to interact with the administration (Crotty, Hall, & Ljubownikow, 2014; Richter, 2009a, 2009b) has not affected their daily activities. For most NPOs the Public Chamber was not a platform for interaction but merely a potential source of resources. Consequently, from the perspective of the organisations, apart from the grant competitions the Public Chamber (both at federal as well as regional level) played little relevance to their activities. The limited effect of the Public Chamber on the day-to-day activities of NPOs is indicative of their pragmatic approach to dealing with their complex institutional environment. However, the interview data from state officials setting out the funding priorities of the Public Chamber highlighted that the chamber might not affect the activities of NPOs directly, but the activities NPOs engage in can affect whether or not they will be able to access the resources provided. Thus our data here outlined the existence of specific funding priorities with little funding available to organisations that have been negatively noticed by engaging in activities such as demonstrations, indirect advocacy (Mosley, 2011) or embarrassing the state. The final aspect the project explored was the perception of the service provision offered by NPOs in contrast to the one offered by the State. This is of particular interest as much of the basic health care services have been provided by the Russia state in the past (Evans, 2006) and NPOs are often characterised as lacking legitimacy with the public to provide such or similar services (Crotty, 2003; Smolar, 1996). However, NPOs did not feel that they are seen as illegitimate service providers. Conversely, they illustrated that their constituencies were often unwilling
  • 7. to access the service offered by the State. This was particularly true for service provision in areas such as HIV/AIDS or drug use. Here NPOs highlighted that such clients often felt uneasy about accessing services directly associated with the state for fear of repercussions by other State authorities (such as arrest by the police). NPOs highlighted that for these clients State service were also insufficient. In the palliative care area, NPOs illustrated that the service provided by the state were inadequate and lacking humanity because they were done on the cheap. Hence clients preferred what NPOs offered but availability of such services was not widely publicised and often relied on relationships or knowing people in proximity to the organisation. NPOs saw themselves, because of the type of service they offered and the marginalised nature of the groups they served, as a more legitimate service providers then the state. NPOs highlighted that the state was also acknowledging this with the introduction of social contracting giving them more responsibilities. The seemingly acceptance of services provide by NPOs indicates a fundamental shift within the Russian public and state authorities. It could lead to the improve legitimacy of such organisations in the Russian context – at least in the social services sector. However, apart from the NPOs active in more medical sectors such as drug abuse, palliative care or HIV/AIDS prevention, our evidence highlights that other NPOs in our study did not offer such essential services to clients. Nevertheless, these NPOs did run social clubs (for example a singing club or a chess club for the disabled), engage in some advocacy activities (for example lobbying for additional funding to support a special treatment of a child with cancer abroad), or organise specific events (for example clown afternoons at the children’s cancer treatment wing). These NPOs saw themselves mainly as complementing the State’s service provision or as in the case of one disability NPO work to affect resource allocation preferences within State authorities. It is thus not surprising that NPOs felt that their constituencies or clients appreciated their services. Although this group of NPOs complement rather than substitute for State service provision, it does suggest an increasing acceptance of the activity of such organisations, in particular by the State run organisations that provide essential services. Thus as highlighted above this could be indicative of a positive shift in the perception of NPOs by the state, potential clients and the wider Russian public. In summary despite its small scale (12 organisations across two different Russian regions) the project has provided a coherent overview of organisational
  • 8. capacity in Russian health NPOs and thus crucial advancements to our knowledge and understanding of such organisations as well as the wider context in which they exist. Our research points out that Russian health NPOs have some deficits in their organisational capacity of which they are not aware and that require further development and capacity building. It is vital for Russian health NPOs to engage in the development of these parts of organisational capacity (mainly leadership development, revenue development and community engagement) if they are to take up similar roles to their counterparts in the UK in the provision of health services. Even though we find a significant capacity deficit on the governance side (in particular leadership development), we also find that Russian health NPOs have good delivery capacity with regards to providing services or engaging with their clients. Thus after the repeated conclusions of various studies that NPOs lack the capabilities of performing key tasks (Crotty, 2009; Crotty & Hall, 2013), our project finds positive signs of change and improvement. However, in order for Russian health NPOs to strengthen these positive steps, ensure sustainability of their existence, and be able to scale up their work further organisational capacity development is required. Furthermore, the pragmatic way in which NPOs behave has made them very adaptable and able to navigate what is still as hostile (both in terms of regulation and public perception) environment. Overall our understanding of NPOs in the Russian context provides a more positive assessment than one could expect given the collective conclusions of previous studies.
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