Healthcare organisations occupy a unique position in sustainable development. Their work contributes directly to social wellbeing, yet their operations also involve environmental responsibilities, institutional accountability, resource management and relationships with diverse stakeholders. Managing these responsibilities requires more than individual initiatives. It calls for an institutional framework that connects sustainability priorities with everyday decisions.

For organisations operating in complex development environments, environmental, social and governance (ESG) considerations increasingly influence how programmes are designed, resources are allocated and institutional performance is assessed. The challenge lies in establishing policies that reflect organisational mandates while remaining practical enough for implementation across different functions.

This was the context for an assignment undertaken by Impact Africa Consulting Limited (IACL) for Amref Health Africa in Kenya.

Developing a policy grounded in institutional realities

Between January and June 2025, IACL supported Amref Health Africa through an ESG policy development assignment. The engagement examined how environmental, social and governance considerations could be incorporated into institutional strategy, management practices, reporting and implementation processes.

The work required an understanding of existing governance arrangements, operational priorities, stakeholder expectations and institutional capabilities. Rather than approaching policy development as a documentation exercise, the assignment considered what would be required to translate sustainability commitments into practical management responsibilities.

An important consideration was ensuring that recommendations remained consistent with the organisation’s mandate, operating environment and available resources. A policy can articulate institutional expectations, but its usefulness ultimately depends on whether the organisation can apply, monitor and maintain its provisions.

Examining existing systems and identifying gaps

IACL began by reviewing relevant organisational strategies, policies, reports, operational records and performance information. The assessment also considered stakeholder perspectives and applicable sustainability standards to establish a reference point for examining existing practices.

Consultations with management representatives, technical personnel, operational teams and other relevant stakeholders helped clarify institutional priorities and implementation considerations. These engagements complemented the documentary review by examining how governance responsibilities and sustainability expectations related to existing organisational processes.

The diagnostic assessed material sustainability issues, governance arrangements, performance gaps, disclosure requirements and potential implementation barriers. It also considered institutional strengths and opportunities for improvement, recognising that effective policy development must build on existing capabilities.

This approach enabled the team to connect sustainability requirements with the organisation’s operational context, providing a foundation for developing recommendations that could inform institutional decisions.

Turning technical findings into practical guidance

The next stage involved translating diagnostic findings into ESG policy recommendations, governance measures and implementation priorities. Particular attention was given to defining responsibilities, establishing appropriate monitoring considerations and identifying actions necessary to support institutional uptake.

IACL developed recommendations covering strategy and policy considerations, reporting requirements, institutional coordination and performance management. The proposed measures were assessed against available resources, organisational responsibilities and realistic implementation requirements.

Emerging findings were subjected to review and validation, allowing stakeholder feedback to inform the refinement of recommendations. This process supported alignment between technical expectations and the practical conditions under which the policy would operate.

Implementation guidance addressed sequencing, resource considerations, performance measures and follow up responsibilities. These elements were intended to help Amref Health Africa consider how ESG requirements could be incorporated into established management and accountability processes.

Lessons for healthcare and development organisations

The assignment illustrates the importance of treating ESG policy development as an institutional management issue rather than an isolated sustainability function. Effective integration requires attention to governance structures, operational procedures, performance information and clearly assigned responsibilities.

For healthcare and development organisations, sustainability commitments become more actionable when they are connected to existing institutional systems. Stakeholder consultation, organisational diagnostics and implementation planning provide a basis for developing policies that reflect both external expectations and internal capabilities.

The documented outputs included diagnostic findings, policy recommendations, governance measures and implementation guidance. Evidence of subsequent policy adoption or measurable institutional performance changes would require separate confirmation.

The central lesson is that an ESG policy gains practical relevance when its requirements are connected to the people, processes and decisions responsible for implementation.