Posts in Social Development
Why Caribbean Development Strategies Stall at Implementation (And How to Fix it)

Organizations across the Caribbean face a persistent challenge. They invest significant resources in crafting comprehensive strategic plans, secure stakeholder buy-in, and gain approval from boards and cabinets. Then the plans stall. Research shows that approximately 76% of well-informed strategies fail during execution (Carucci, 2017). This failure occurs not because the strategies are weak, but because organizations lack the systems, capacity, and coordination required to translate strategic documents into operational reality. The gap between strategy and implementation represents the single most expensive inefficiency in Caribbean development work today.

Systematic reviews of peer-reviewed literature identify consistent barriers to strategy implementation across public sector organizations (Vigfússon et al., 2021; Girma, 2022). These barriers include fragmented leadership structures, inadequate resource allocation systems, weak coordination mechanisms across organizational units, and insufficient performance monitoring frameworks. Caribbean Small Island Developing States face additional structural challenges. Limited human resource capacity, competing urgent priorities, and external shocks like hurricanes and economic volatility create an environment where even well-designed strategies struggle to gain traction. A study of public sector organizations found that those with strong organizational capabilities (including workforce skills and management systems) achieved significantly better implementation outcomes, yet many organizations rated their internal processes and incentive structures as merely adequate (Mwanza et al., 2025). The Caribbean development sector mirrors these global patterns. Organizations formulate ambitious climate resilience frameworks, food security strategies, and digital transformation roadmaps. Consultants deliver polished documents. Cabinets approve budgets. Then progress stalls because no one established the implementation architecture: the coordination mechanisms, monitoring systems, risk protocols, and capacity-building programs required to execute complex multi-year initiatives in resource-constrained environments.

The literature identifies several implementation enablers that distinguish successful organizations from those that struggle (Cândido & Santos, 2019). First, integrated leadership frameworks that align senior executives with middle management prove essential. Strategy cannot cascade through an organization when mid-level managers lack clarity on their role in execution. Second, organizations need real-time monitoring systems that surface implementation challenges early. Traditional annual reporting cycles allow problems to compound for months before becoming visible. Third, organizations require flexible structures that enable rapid decision-making when external conditions change. Caribbean SIDS cannot afford rigid bureaucratic processes when hurricanes, commodity price shocks, or pandemic disruptions demand immediate strategic adaptation. Fourth, successful implementation requires systematic attention to organizational culture and employee engagement. Research demonstrates that organizations with supportive cultures that clearly communicate strategy and explain the logic behind strategic choices achieve dramatically higher implementation success rates (Kaplan & Norton, 1996, as cited in multiple implementation studies). Finally, modern performance measurement frameworks that track leading indicators rather than only lagging financial metrics enable organizations to manage strategy execution proactively rather than reactively.

Uwàmìto Consulting specializes in building the bridge between strategy and implementation. Over the past six years, we have managed more than 20 development consultancies across the Caribbean, supporting national governments, multilateral donors, regional bodies, and civil society organizations. Our work demonstrates consistent patterns. When we design strategic plans, we simultaneously build the implementation architecture: project management systems, monitoring dashboards, risk registers, and stakeholder coordination protocols. When we support entities to refine the grant and financing applications, we do not stop at securing funding approval. We establish project management offices, train government counterparts in results-based management, and create knowledge management systems that capture lessons for future initiatives. When we developed a community-led monitoring system for HIV services, we delivered not just a framework document but a fully operational system with trained field officers, data collection tools, secure databases, and reporting templates that organizations continue to use today. This approach reflects our understanding that Caribbean development challenges demand integrated solutions. Strategy documents alone change nothing. Implementation without strategy creates chaos. Organizations need consultants who can design bankable strategies and simultaneously build the capacity and systems required to execute them.

The graphic we created illustrates this reality simply. Strategy without implementation becomes expensive shelf decoration. Implementation without strategy becomes expensive chaos. You need both, and you need the expertise to bridge them. Uwàmìto Consulting offers Caribbean governments and development organizations what they actually require: consultants who combine deep technical expertise with practical implementation capacity. We do not deliver reports and disappear. We embed systems, train teams, establish coordination mechanisms, and ensure that strategic investments generate measurable results. When you engage Uwàmìto, you partner with consultants who have managed HIV prevention programs reaching 5,000+ people, reviewed national suicide surveillance systems adopted by Ministries of Health, and built strategic frameworks that organizations use daily for fundraising and program development. Our track record demonstrates what becomes possible when strategy and implementation function as integrated disciplines rather than separate activities. This is how development consulting should work. This is how Caribbean organizations can finally close the strategy-implementation gap.

Ready to close your strategy-implementation gap? Contact Uwàmìto Consulting for a confidential consultation. We begin with a Resilience Audit to identify your organization's specific implementation barriers, then design integrated solutions that deliver measurable results. Visit www.uwamito.com or email melliot@uwamito.com to start the conversation. You can call or WhatsApp: 1.868.756.9981

Refrences:

Cândido, C. J. F., & Santos, S. P. (2019). Implementation obstacles and strategy implementation failure. Baltic Journal of Management, 14(1), 39-57. https://doi.org/10.1108/BJM-11-2017-0350

Carucci, R. (2017, November 13). Executives fail to execute strategy because they're too internally focused. Harvard Business Review. https://hbr.org/2017/11/executives-fail-to-execute-strategy-because-theyre-too-internally-focused

Girma, B. G. (2022). Pitfalls on strategy execution of an organization: A literature review. Financial Metrics in Business, 3(2), 227-237. https://doi.org/10.25082/FMB.2022.02.004

Mwanza, M., et al. (2025). The role of strategy implementation practices on performance of the public sector organisations. Africa's Public Service Delivery & Performance Review, 13(1). https://doi.org/10.4102/apsdpr.v13i1.891

Vigfússon, K., Jóhannsdóttir, L., & Ólafsson, S. (2021). Obstacles to strategy implementation and success factors: A review of empirical literature. Strategic Management, 26(2), 12-30. https://doi.org/10.5937/StraMan2102012V

Reinvesting in Community Health Workers: An Important Strategy for Strengthening Caribbean Public Health Systems

The COVID-19 pandemic has exposed the vulnerabilities of healthcare systems worldwide, particularly in the Caribbean region. It has highlighted the need for a more resilient and responsive approach to public health, one that prioritizes primary healthcare and health prevention. As countries in the Caribbean seek to build back better, reinvesting in community health workers (CHWs) presents a vital strategy for strengthening healthcare systems and improving health outcomes.

Community health workers (CHWs) often live in the community they serve and may often receive lower levels of formal education and training than professional health care workers such as nurses and doctors. According to the World Health Organization (WHO, 2021), This human resource group has enormous potential to expand the reach of the public health system especially benefitting vulnerable populations such as rural, remote, or hard-to-reach communities and marginalized people. CHWs are often impacted by the said challenges themselves and know the language, culture, and dynamics of the communities they engage which improves the performance, efficacy, and efficiency of the health system. In the Caribbean, CHWs have played a crucial role in improving access to healthcare, particularly in rural and underserved areas (Jeet et al., 2017)

At Uwàmìto Consulting, we have witnessed firsthand the impact of investing in CHWs. Through our technical assistance and capacity-building efforts, we have supported clients in Trinidad and Tobago and Suriname to strengthen their CHW programs. In Trinidad and Tobago, we engaged stakeholders, conducted community pilots, and trained individuals to implement Risk Communication and Community Engagement (RCCE) methodologies, reaching over 2,000 people with health services. In Suriname, we provided technical assistance to develop and implement a Community-Led Monitoring (CLM) system to improve the quality and accessibility of HIV services.

The evidence supporting the effectiveness of CHWs in improving health outcomes is compelling. A systematic review by Scott et al. (2018) found that CHW interventions led to significant improvements in maternal and child health, infectious diseases, and non-communicable diseases in low- and middle-income countries. Another study by Kangovi et al. (2020) found that a CHW program in the United States reduced hospital readmissions and improved patient satisfaction.

Investing in CHWs also makes economic sense. A study by Seidman and Atun (2017) estimated that scaling up CHW programs in sub-Saharan Africa could yield a return on investment of up to 10:1, with significant savings in healthcare costs and increased economic productivity. In the Caribbean, where many countries face resource constraints and increasing healthcare costs, investing in CHWs can be a cost-effective strategy for improving health outcomes.

To fully realize the potential of CHWs in strengthening Caribbean healthcare systems, there is a need for increased investment and policy support. This includes:

  1. Providing comprehensive training and certification programs for CHWs, covering a wide range of healthcare topics and skills.

  2. Integrating CHWs into the formal healthcare system, with clear roles and responsibilities, adequate compensation, and opportunities for career advancement.

  3. Allocating sufficient resources for CHW programs, including funding for salaries, training, and equipment.

  4. Developing partnerships between CHWs, healthcare facilities, and community organizations to improve coordination and referral systems.

  5. Investing in research and evaluation to better understand the impact and effectiveness of CHW programs in the Caribbean context.

Countries in the Caribbean that already have CHW programs can benefit from a boost in investment and policy support. For countries without CHW programs, there is an opportunity to learn from the experiences of other countries and invest in this vital workforce. The COVID-19 pandemic has underscored the importance of building resilient and responsive healthcare systems, and CHWs are a critical part of the solution.

At Uwàmìto Consulting, we are committed to social development, and having a strong health system is a critical element for development in the Caribbean. Through the technical assistance, we continue to see the importance of primary health care, and more importantly, the role CHWs can play in strengthening the overall health system. We therefore call on all governments, key stakeholders, and development partners to prioritize investments in this important strategy to improve the resilience and sustainability needed to secure the future of the Caribbean.

References:

  • Kangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., and Long, J.A., 2020. Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: A randomized clinical trial. JAMA Internal Medicine, 180(10), pp.1315-1324.

  • Kraef, C., Kallestrup, P., Olsen, M.H., and Bjerregaard, P., 2020. Community health workers in the era of COVID-19: A systematic review. Tropical Medicine & International Health, 25(11), pp.1327-1336.

  • Scott, K., Beckham, S.W., Gross, M., Pariyo, G., Rao, K.D., Cometto, G., and Perry, H.B., 2018. What do we know about community-based health worker programs? A systematic review of existing reviews on community health workers. Human Resources for Health, 16(1), pp.1-17.

  • Seidman, G., and Atun, R., 2017. Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15(1), pp.1-13.

  • Jeet, G., Thakur, J.S., Prinja, S. and Singh, M., 2017. Community health workers for non-communicable diseases prevention and control in developing countries: Evidence and implications. PLOS ONE, 12(7), p.e0180640. https://doi.org/10.1371/journal.pone.0180640