Leveraging organizational core values to navigate stakeholder ecosystems for effective community-led global health initiatives: Insights from Kisumu, Kenya

<jats:sec id="background"> <jats:title>Background</jats:title> <jats:p>As resource constraints in global health worsen, low- and middle-income countries, especially in sub-Saharan Africa, will continue to rely on international aid to achieve development and healthcare goals. However, beyond government agencies, the international donor community will need support from local civil society organizations and other non-state actors to fulfill its mandate. To meet this objective, community-based organizations (CBOs) must navigate complex, dynamic socioeconomic and political ecosystems that require coordinated decision-making and systematic approaches.</jats:p> </jats:sec> <jats:sec id="methods"> <jats:title>Methods</jats:title> <jats:p>Drawing on stakeholder coordination and service delivery by the Pamoja community-based organization in Kenya, this study employed qualitative methods to examine the strategies community-based organizations use to navigate the stakeholder landscape and ensure the effective delivery of donor-driven goals. Data were collected through in-depth interviews (n=20) and two focus group discussions (n=18) and were analysed thematically.</jats:p> </jats:sec> <jats:sec id="results"> <jats:title>Results</jats:title> <jats:p>The study found that while community organisations are essential to achieving global health goals, they require a well-coordinated stakeholder system to deliver services effectively and sustainably. Community-based organizations can achieve this coordination through their management—such as mission, vision, objectives, and values—and elements within their service suite, including empowerment, social structures, participation, and networking.</jats:p> </jats:sec> <jats:sec id="conclusions"> <jats:title>Conclusions</jats:title> <jats:p>Community-based organisations are essential to global health efforts. However, to deliver services effectively, these organizations rely on funding agencies, which strongly influence their behavior, position within the stakeholder landscape, management, and relationships with beneficiaries. These tensions lead to a loss of innovation, create mistrust, threaten sustainability, and perpetuate dependency. Therefore, fostering a robust internal ecosystem, developing capacity, encouraging participation, and building networks among community-based organisations can support independence and improve the effectiveness of global health initiatives.</jats:p> </jats:sec>