NGOs and Health Sector Reform
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Source: Decentr-l list <DECENTR-L@erc.msh.org>
I had the opportunity to attend a recent Aga Khan Foundation sponsored
policy seminar on "The Role of NGOs in Health Sector Reform in East Af-
rica." The seminar was held in Dar-es-Salaam from September 9-11, and
included about 80 participants, representing NGOs, governments, aca-
demic institutions and donors. The program was structured around key
note presentations which were complemented by case studies.
The objectives of the seminar were:
1. to share information on current "best practices" of NGO involvement
in health sector reform (HSR);
2. to define the challenges that NGOs face in continuing to contribute
to HSR.
Some of the key findings of the seminar were that:
1. Locally-based NGOs are interested in contributing to health sector
reform and have much valuable experience to offer. There is, how-
ever, very little readily available information on their "best prac-
tices."
2. While interested, NGOs are often poorly informed about the specific
health sector reforms that the government is planning or implement-
ing. They also have limited human and financial resources to devote
to participating in shaping HSR policies.
3. NGOs represent a diverse and often fragmented group that does not
speak in one voice on issues. Co-ordinating mechanisms between NGOs
at country level can make them more valuable partners in health sec-
tor reform.
4. Governments state that they see NGOs as essential partners in HSR,
but neither know the contribution that NGOs make in the health sec-
tor nor have easy mechanisms for involving them in the policy de-
bates.
The seminar participants agreed that documenting and disseminating
"best practices" of NGO and government partnerships in health sector
reform would be important contributions to HSR efforts. Another impor-
tant contribution would be the development of models for strategic al-
liances between NGOs.
These were my observations from the meeting. I would be interested in
hearing from the rest of you. What role do you see for NGOs in health
sector reform? Does decentralisation open a wider space for NGOs to en-
gage in health policy formulation, as was suggested at the seminar? Do
governments genuinely welcome the NGOs to participate in designing and
implementing health sector reform in general and decentralisation in
particular?
Riitta-Liisa
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Riitta-Liisa Kolehmainen-Aitken, M.D., Dr.P.H.
Senior Program Associate
Management Sciences for Health
891 Centre Street
Boston MA 02130-2796, USA
Tel: +1-617-524-7766, ext. 301
Fax: +1-617-524-1363
mailto:rlkaitken@msh.org
http://www.msh.org
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