U N I V E R S I T Y
O F
B E R G E N
Global Health Priorities
Non Governmental Organizations:
potentials and limitations
Frehiwot Berhane Defaye MD, MPH, PhD fellow
Department of Public Health and Centre for International Health, Research group in Global
Health Priorities: Ethics, Evidence and Policy UIB, Bergen, Norway
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Getting stated:
• Do you have experience with NGO work? Where and
when?
• Your most striking memory and reflection
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Global Health Priorities
Outline
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Introduction
Purpose
Working areas
Types
Potentials and Limitations
Examples
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Definitions: difficult though,
• NGOs are private organizations/civil societies that pursue
activities to relieve suffering, promote the interests of the
poor, protect the environment, provide basic social
services, undertake community development
• When the scope is around the world – International NGOs
• Local NGOs, Civil Society Organizations (CSOs),
Community Based Organizations (CBOs)
• Funded by Governments, Philanthropist, Foundations,
Corporate organizations, Individuals, Volunteers
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Purpose of NGOs
• to provide relief, and developmental aid to developing countries;
• to provide services that the state is unable or unwilling to provide
for their people
• Innovation, testing new approaches
Examples:
– HIV/AIDS awareness, prevention care and treatment, clean water, and
malaria prevention …
– Education: like schools for girls and providing books to developing
countries
– Gender: awareness, empowerment, services- GBV …
– As the first responders to natural disasters (such as hurricanes and floods
…)
– Climate change/Global warming: (Intergovernmental panel on Climate
Change (IPCC)
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Working areas:
INGOs work in five areas:
1. International relief and development
2. Democracy promotion and electoral support, human
rights and good governance,
3. Conflict mitigation, management, and resolution
4. Civil society support and community-based service
5.
Education, medical, and state service replacement
(traditionally formed locally to substitute or enhance
lacking or non-existent government services)
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Types of NGOs
• Classifications of NGOS: most common focus on
'orientation' and 'level of operation‘
• orientation refers to the type of activities it takes on,
like human rights, environmental, development work
• Level of operation indicates the scale at which an
organization works: Bilateral/Multi laterals/Intergovenmental (USAID, DIFID, AusAid NORAD, CIDA, SIDA)
national/ local (SCOs, CBOs)
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cont.
Broadly, four basic types
1. Humanitarian aid:
The primary objective of humanitarian aid is to save
lives, alleviate suffering, and maintain human dignity
both in emergency response and developmental
– Examples: Norwegian Refugee Council, American Refugee
Committee, Doctors of the World, Direct Relief International,
Mercy Corps International (MCI), International Medical Corps,
CARE, Volunteers In Technical Assistance,
– Save the Children/, Rädda Barnen
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2. Advocacy groups:
Such INGOs do not supply aid per se, instead focus
on advocacy of specific issues to draw public,
national, international attention with the aim of
making a difference immediately and/or changing
policy…
Examples:
Human Rights Watch, Amnesty International, International Rescue
Committee, Refugees International, Physicians for Human/Health
Rights,
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3. Faith-based groups:
– are humanitarian aid groups originally founded on
faith principles but do not use religion as a part of the
aid given
Examples:
– Mercy Corps or International Rescue Committee, Shelter Now,
Habitat International, Cure International, World Vision, Catholic
Relief Services, Church World Service, Norwegian Church Aid
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4. Missionary aid groups:
seek to “spread the word” using humanitarian aid to
access to those who need conversion, more or less
conditional aid
Examples: of such INGOs are Samaritan’s Purse, Hope Ships,
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Examples of INGOs in Ethiopia
All the above (4) types of INGOs are found in Ethiopia.
1. Humanitarian:
a. CARE Ethiopia:
– started working in 1984 in response to severe drought and
famine
–
Trying to address the root causes of poverty and
vulnerability
– target groups of people: pastoralist girls, chronically foodinsecure rural women and poor young girls
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– works to reduced child poverty
– Micro finance to promote saving,
– Health related: Malnutrition, HIV/AIDS, Sexual Reproductive
Health, Adolescent SRH, family planning, reduce maternal
mortality,
– Right based approach: is both a fundamental human right and a
critical development issue and market access to improve poor
people's life/health
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b. Oxfam Ethiopia:
started working since 1970’s to address the underlying causes
of poverty and marginalization and it focuses on sustainable
livelihoods, water and sanitation, agriculture, climate research,
gender and humanitarian issues …
c. Marcy Crops:
Address complex natural resource and climate change
adaptation issues, with a focus on increasing resiliency in the
face of drought and other external shocks
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2. Advocacy:
could be taken as cross cutting in different interventions: child,
women, young people
Human rights watch: it defends the rights of people, works
as part of a vibrant movement to uphold human dignity and
advance the cause of human rights for all
3. Faith-based
a. World Vision: contributes to the well-being of vulnerable
groups in partnership with the church, civil society and
the government.

Initiatives include education, food security, health, HIV and
AIDS, water, sanitation, and hygiene, as well as
sponsorship management.
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b. Catholic Relief Services:
it responds to natural and man-made disasters
affecting Ethiopia's most vulnerable communities
Numerous missionary INGOs which works to improve
education, health, clean water and other services in the
country
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Potentials and limitations
I. From NGOs perspectives
– The funding models of international NGOs are often not aligned
with their vision and goals and increasing administrative waste in
the organizations, financial crises
– Likelihood of profitable organization and corruption: may led to
measuring and reporting what did not happen …
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• Sustainability: continuity and contingency plan-facing
success today, failure tomorrow,
• Internal management issues: include questions of
strategic planning, budgeting, staffing, and the governing
structure of the organization, growth and change within
the organization,
• Absence of similar goals and strategies with hosting
countries government,
• Issues of accountability to citizens and hosting
government
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– Lack of proper interaction and management with hosting
government, other NGOs, private sectors, the community
Some say INGOs are politicized:
– operate in contexts in which military operations are taking place
– Despite concerted efforts, INGOs have not been able to develop
rules of engagement that sufficiently secure independence,
security and effectiveness
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II. From the hosting country perspective
• Political situation of the hosting country
• Rules, regulations and strategies of the hosting country
towards NGO
• legal constraints: revenue sources, types of personnel, and
the nature of governance
• Cultural constraints: particular set of culture and contexts
of the nation may affect implementation of the program
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• Expected relationship and reality-the advocacy role of NGOs may give
opportunity for opposing views or political parties
• Hosting governments might give priority to their politics than public benefit,
then NGOs going beyond the state and may lose their smooth relationship
• The other way round: NGOs might have hidden political agenda
• Understanding and defining of peace and development : could vary across the
region
• Effective coordination between hosting government and NGOs
• Level of Infrastructure and other facilities, knowledge of nations, beneficiaries
• Level of democracy- corruption in hosting government
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Value addition of INGOs
• NGOs should be outcome focused
• Contextualised approach –by considering hosting countries
specific needs, cultural and political context
•
Incorporate accountability and should make relationships more
transparent
• Developing similar strategies and gaols with hosting country
government
• Creating interaction NGOs with government, mass media, private
sector, financial sectors as well as other NGOs,
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• Creating conducive environment by hosting government to
make NGOs effective
• Creating long term and short term plan, contingency and
sustainability plans,
• Creating public awareness about the objective of NGOs
• Reducing administrative waste in the organization, monitoring
and evaluation
• Providing the necessary means of technical and financial
support
• NGOs working together with other NGOs -working in group
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Declarations and code of conduct
The Paris Declaration on Aid Effectiveness and the Accra
Agenda for Action:
• Ownership: Countries leadership over their development policies
and strategies and co-ordinate development actions
• Alignment: donors base their overall support on partner countries’
national development strategies, institutions and procedures by
aligning with partners’ strategies
• Harmonisation: actions are more harmonised, transparent and
collectively effective by implementing common arrangements and
simplify procedures (Governance structures, MDG Pool Fund)
• Managing for Results: Managing resources and improving
decision-making for results by strengthen the linkages between
national development strategies and budget processes
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Accordingly, Ethiopia has developed new manual in 2009
• Registration/ application of Charities with established
abroad
• Document project profile explaining the planned
activities
• including its financial break down not less than 70%
for operational activities and not more than 30% for
administration costs
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Summary:
• Result oriented: thinking, actions and linkages
• Accountability, Transparency
• Functional Monitoring and Evaluation system
• The contributions vs attribution
• Outcome mapping:
• in harmonized and aligned manner
• and increasing ownership and community participation
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Close up reflections/foods for thoughts:
What should be the way forward with NGOs contributions
as the world moves on a fair path to Universal Health
Coverage?
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Thank you
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References
•
Inger Ulleberg, (2009). The role and impact of NGOs in Capacity Development From Replacing the
State to Reinvigorating Education. UNESC
•
Haifa’ Abu Ghalaza, (1995. The role of NGO in Development. Submitted to Management Technical
Cooperation, Amman Jordan
•
Sherine Jayawickrama & Neil McCullagh, (2009). What Makes International NGOs Distinctive?
Contributions, Characteristics and Challenges. Hauser Centre for Non-profit Organizations.
Harvard University
•
WB, (1999). Nongovernmental Organizations in World Bank–Supported Projects. Edited by
Christopher Gibbs, Claudia Fumo & Thomas Kuby. A Review. The World Bank, Washington, D.C.
•
Ministry of Foreign Affairs, (2010). A Manual Prepared by the Ministry of Foreign Affairs
Regarding the Service it Renders to Charities Established Abroad and Applying for
Registration to Operate in Ethiopia Pdf Retrieve on April 08,2014
fromhttp://www.mfa.gov.et/docs/NGO_Rule_English.pdf
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