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Voluntary agencies in health care delivery
The document discusses the role of non-governmental organizations (NGOs) in healthcare delivery in India. It notes that there are over 20 lakh NGOs in India, with one for every 600 people. NGOs play a supplementary role to the government by providing services like health education, clinics, nutrition programs, and addressing communicable diseases. They also assist with policy formation and help communities assume responsibility for their own health. The document examines several prominent national and international NGOs working in India and their contributions to healthcare.
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Presentation led by Dr. Sandhya Rani Javalkar. Slide 2 is blank.
Defines NGOs, their history, roles, responsibilities, and differentiates from government organizations.
Describes NGO characteristics: private, self-governing, focused on public service with defined aims.
Covers NGO emergence starting from the 18th century, highlighted by significant movements, and formal recognition.
India has about 20 lakh NGOs, translating to 1 NGO for every 600 people, as compared to healthcare providers.
Breakdown of NGO focus: 26.5% in religious activities, 21.3% in social services, with low health sector engagement.
Categorizes NGOs into service and empowering types, highlighting their roles in primary health care.
Highlights cooperative conflict between NGOs and governmental organizations through Amartya Sen's perspective.
Describes NGO contributions in health education and services, focusing on targeting the poor and vulnerable.
Illustrates the need for a comprehensive health care system, including significant workforce and centers.
Describes training levels for health workers aimed at enhancing community health care delivery.
Emphasizes NGOs' role in policy formation and community development through health program assessments.
Describes collaborative frameworks, NGO schemes, and decentralization for health program implementation.
Highlights collaboration opportunities with WHO for health initiatives and policy dissemination.
Lists notable NGOs contributing to health care and social welfare.
Stresses the importance of transparency, accountability, and effective partnerships with governments.
Identifies challenges such as inequitable resources, political pressure, and the need for government cooperation.
Analyzes NGO experiences in healthcare, emphasizing advocacy and health system capacities.
Advocates for equitable health systems, highlighting NGOs' know-how and advocacy for human rights.
Discusses WHO's assessment of NGOs' engagement in governance and their isolation challenges.
Details initiatives by the Public Health Foundation of India to regulate health education standards.
Covers historical contributions of key figures and organizations in public health and maternal welfare.
Provides location details and vision of an NGO at Millennium Towers, focusing on health and development.
Lists references and resources for further understanding of NGO roles and principles in health care.
Conclusion slide is blank.
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Voluntary agencies in health care delivery
- 1. Presenter: Dr SandhyaRani Javalkar 1
- 2.
- 3. What isan NGO? History of NGO Role and responsibilities of NGO Difference in NGO and GO NGO as partner in health care delivery NGO and NRHM Leading NGOs – Nationally and Internationally Advantages of NGO in health care Few review articles Few NGOs 3
- 4. Include organizationsengaged in public service, based on ethical, social, religious. Formal/ Informal groups Following characteristics: Private, Self-governing Registered organizations/ informal groups Defined aims and objectives Do not return profits Source: NGO India website, http://ngo.india.gov.in/faq_ngo.php 4
- 5. Dates longback in history During 18th century: emergence of self help Friend-in-Need Society (1858) Prathana Samaj (1864) Satya Shodhan Samaj(1873) In 1916 : Mahatma Gandhi’s focus on Swadeshi movement,Voluntary action. 5
- 6. 1951: FirstFive-Year Plan “In any plan for social and economic regeneration, state should give them maximum cooperation in strengthening their efforts.” 1965–1966: International NGOs entered India in significant numbers 1980 :NGOs began to be formally recognized as development partners of the state 6
- 7. India witnessingNGO boom Around 20 lakh of them in states and union territories. There is 1 for every 600 people. one policeman for every 943 people. India has just one doctor for every 1,700 people. http://timesofindia.indiatimes.com/india/India-witnessing-NGO-boom-there-is-1-for- every-600-people/articleshow/30871406.cms 7
- 8. Participatory Researchin Asia, 1982 Engaged in religious activities: 26.5% Work in the area of social service: 21.3% NGOs works in education: one in five Fields of sports and culture: 17.9% Only 6.6% work in the health sector. 8
- 9. Types of NGO Service Empowering CharitableParticipatory Looking at the role of the Non-Governmental Organizations in primary health care field in India to meet the Millennium Development Goals. 9
- 10.
- 11. GOVERNMENT ORGANISATION NON GOVERNMENT ORGANISATION Prof.Amartya Sen, the relationship between the state and NGOs is one of “cooperative conflict”. 11
- 12. Health Education Clinic Services. Water and sanitation Nutrition Communicable diseases Family planning Nearly half (42%) had targeted the poor as their main beneficiaries. Followed by Mothers, youth and general public 12
- 13. A comprehensiveand innovative health care system Primary health care to advanced surgical care Access to health was non existent in a wider radius. Today- 2500 employee and 12 centres 13
- 14. Primary group • Mostelementary course • To village women usually illiterate • Hygiene, common ailments • 1 week of training The second group • Illiterate women • Trained by GK for the government. • 1 month of training • Evaluated by a GK doctor • Gov stipend The third group • Paramedics, 5 yrs schooling • To treat diseases • How and when blood, urine, sputum and stool tests • Family planning14
- 15. Work forgreater understanding and positive attitudes Assist national policy formation in health care. Establish greater collaboration, coordination Evaluative techniques to render all new programs are accountable to real community needs 15
- 16. Particular attentionto local community development groups Conduct reviews and assessment of existing health programs Enables communities to assume greater responsibility for their own health Ensure increase in beneficiaries for existing programs Expand their training efforts, e.g., training of health workers, supervisors. 16
- 17. Supplementary orcomplementary role Selection/approval of the NGOs and overseeing implementation of the projects Key features: Decentralization of the schemes Emphasis on measurable qualitative and quantitative performance indicators. Increased interface of NGOs with Government bodies. Rationalization of the jurisdiction area serviced by the NGO to provide in depth service. 17
- 18. MOTHER NGO(MNGO) SCHEME SERVICE NGO (SNGO) SCHEME STATE NGO COORDINATORS (SNGOCS) RRCs 18
- 19. Implementing themutually agreed programme of collaboration Utilize the opportunities to disseminate information policies and programmes. Collaborate individually or collectively in WHO programmes to further health-for-all goals. 19 WHO | Principles Governing Relations with Nongovernmental Organizationshttp://www.who.int/civilsociety/relations/principles/en/ 6/6
- 20. Lepre society Uday foundation Aravind eye care system Smile foundation Udaan 20
- 21. CARE(Co operativeassistance and relief) HelpAge Rotary International 21
- 22. Flexible ,Transparent,accountable and efficient Strengthen PPP Strengthen International co operation Significant influence on national program, policies and legislations 22
- 23. Inequitable distribution Political pressure Limited resources Gov Co operation Aid providing agencies 23
- 24. By NanceUpham, Review of the NGO experiences in selected Asian countries. Looked at four aspects: Health care and socio-economic context. Global advocacy capacities Proven capacities for comprehensive primary health care Capacities to innovate and prepare health systems for the future. 24
- 25. Health Systemfor the poor need not be poor health system NGOs favour “best of” in Primary Health Care NGOs’ assets: Know-how to deliver good health care to poor Powerful advocacy capacity for health as a human right 25
- 26. WHO publicationstated that: NGOs are not ready for engagement in the governance of the national programme. No networking amongst NGOs to be able to partner and exercise voice. At present NGOs work in isolation Negative competitive orientation http://www.who.int/macrohealth/events/civil_society_asia/en/Potential_for_Governme nt_NGO_Partnership_in_Health_Care.pdf 26
- 27. PHFI: Public healthfoundation India Independent accredition body to regulate standards of health education Establishing strong research network Catalysing growth and evolution 27
- 28. Henry Dunant,buisnessman 1859 Objective: aid to the wounded without distinction Activities: Disaster management First aid Maternal and child welfare Health education 28
- 29. Working in35 states More than 400 branches Objective: promotion of health, prevention of disease and mitigation of suffering Activities : Relief Medical supplies Maternal and child welfare services, FP Blood Bank and First aid 29
- 30. Mr JohnD Rockfeller Public health and medical education India: 1920 Uniqueness: All India Institute of Hygiene and Public health, Kolkatta. Family planning, rural training centre and medical education 30
- 31. Location: GroundFloor, MillenniumTowers, Opp Highland Hospital, Falnir, Mangalore VISION STATEMENT: To reach out through humanitarian efforts and to articulate frameworks that advance conversations in health and development 31
- 32. NGO Indiawebsite, http://ngo.india.gov.in/faq_ngo.php Partnership with Non- Government Organisations, NRHM, Chapter 8.101-104 Civil Society Initiative (CSI) Principles Governing Relations with NongovernmentalOrganizations WHO and Civil Society: Linking for better health External Relations and Governing Bodies C IV I L S O C I ETY I N IT I AT IV EWorld Health OrganizationWHO/CSI/2002/DP1 Nance Upham, Making Health CareWork for the Poor Efficiency in Health Delivery Systems “Best of” in Primary Health Care Review of the NGO experiences in selected Asian countries.WHO publication Potential for Gov-NGO partnership in Health carehttp://www.who.int/macrohealth/events/civil_society_asia/en/Poten tial_for_Government_NGO_Partnership_in_Health_Care.pdf http://timesofindia.indiatimes.com/india/India-witnessing-NGO-boom- there-is-1-for-every-600-people/articleshow/30871406.cms 32
- 33.
Editor's Notes
- #5 Voluntary organizations (VOs) / Non Governmental Organizations (NGOs) include organizations engaged in public service, based on ethical, cultural, social, economic, political, religious, spiritual, philanthropic or scientific & technological considerations. VOs include formal as well as informal groups, such as: community-based organizations (CBOs); non-governmental development organizations (NGDOs); charitable organizations; support organizations; networks or federations of such organizations; as well as professional membership associations. VOs / NGOs should broadly have the following characteristics: They are private, i.e., separate from Government They do not return profits generated to their owners or directors They are self-governing, i.e., not controlled by Government They are registered organizations or informal groups, with defined aims and objectives
- #6 India has a long history of civil society based on the concepts of daana (giving) and seva (service). During the second half of the 19th century, nationalist consciousness spread across India and self-help emerged as the primary focus of sociopolitical movements. Numerous organizations were established during this period, including the Friend-in-Need Society (1858), Prathana Samaj (1864), Satya Shodhan Samaj(1873), Arya Samaj (1875), the National Council for Women in India (1875), and the Indian National Conference (1887).
- #7 Mahatma Gandhi’s return to India in 1916 shifted the focus of development activities to economic self sufficiency. His Swadeshi movement, which advocated economic self-sufficiency through small-scale local production, swept through the country. Gandhi identified the root of India’s problem as the poverty of the rural masses and held that the only way to bring the nation to prosperity was to develop the villages’ self-reliance based on locally available resources. He also believed that voluntary action, decentralized to gram panchayats (village councils), was the ideal way to stimulate India’s development. Gandhi reinvigorated civil society in India by stressing that political freedom must be accompanied by social responsibility.
- #9 This includes temples, churches, mosques, gurudwaras (Sikh place of workshop), sports associations, hospitals, educational institutions, and ganeshotsav mandals (temporary structures set up to house Ganesh festival celebrations). Most NGOs in India are small and dependent on volunteers.
- #10 NGO types can be understood by their orientation and level of cooperation as- · Charitable Orientation often involves a top-down paternalistic effort with little participation by the "beneficiaries". It includes NGOs with activities directed toward meeting the needs of the poor. · Service Orientation includes NGOs with activities such as the provision of health, family planning or education services in which the programme is designed by the NGO and people are expected to participate in its implementation and in receiving the service. · Participatory Orientation is characterized by self-help projects where local people are involved particularly in the implementation of a project by contributing cash, tools, land, materials, labour etc. In the classical community development project, participation begins with the need definition and continues into the planning and implementation stages. · Empowering Orientation aims to help poor people develop a clearer understanding of the social, political and economic factors affecting their lives, and to strengthen their awareness of their own potential power to control their lives. There is maximum involvement of the beneficiaries with NGOs acting as facilitators.[6]
- #13 the Subnational Community Level NGOs nearly half (42%) had targeted the poor as their main beneficiaries. Mothers, youth and general public (15% each) constituted the next important target groups.
- #14 GK began by providing preventive and primary health care for the villages where access to health was non existent in a wider and wider radius around its initial health center and hospital Savar, started at the time of national independence in 1971.
- #15 GK’s Human Resources development system: from education to advanced care. The most elementary course is given to the dai (midwives), village women, usually illiterate, who have learned their craft as apprentices. Their instruction, lasting only one week, is designed to fill gaps in their knowledge. After covering basic hygiene such as hand washing they are expected to treat common ailments and introduce them to family planning techniques. They receive a monthly GK supplement of Tk. 50. The second group, also illiterate, is trained by GK for the government. The women receive one month of instructions on the treatment of common ailments such as diarrhoea, skin diseases, intestinal parasites, burns, shock and poisoning, and they attend lectures where family planning is fully discussed. After they return to their villages they will be evaluated by a GK doctor or advanced paramedic and will come to Savar – the hospital- for further training twice within the next 18 months. The government gives them a stipend of Tk. 100 a month. The third category consists of GK's own paramedics. With rare exception they are required to have five years of schooling and be literate. Their training lasts from six months to a year. Lectures stressing the relationship between poverty and disease "take a big chunk out of our curriculum," Chowdhury laments, about these things, they must understand. "They are taught to treat the most prevalent diseases (70 percent of the village caseload), how to do blood, urine, sputum and stool tests, and all aspects of family planning. The Abbé Pierre group of supporters of GK recently reported from a trip to Savar’s hospital that the GK trained paramedics (over 4000 trained) are of very high quality and considered as having above average professional qualification and this has lead to constant efforts by private health care organizations to “steal” the GK trained paramedics, offering them many times the income they would make in GK. It follows that GK must always expect to loose a portion of its trainees to the private sector.
- #18 NGOs in particular, have been assigned supplementary or complementary role to that of he Government health care According to the revised guidelines of NGO scheme, the states have been given an important role in selection/approval of the NGOs and overseeing implementation of the projects undertaken by them. An inbuilt mechanism of monitoring the working of the NGOs and various activities Key features: Decentralization of the schemes to the state and district level Emphasis on measurable qualitative and quantitative performance indicators. Increased interface of NGOs with local government bodies. Rationalization of the jurisdiction area serviced by the NGO to provide in depth service.
- #19 Mngo :The objectives of the MNGO scheme, are to improve RCH indicators in the under served and unserved areas, with specific focus on MCH, FP, Immunization, institutional delivery, RTI/STI andadolescent reproductive health care. Sngo: The Service NGOs (SNGOS) are, those, who are expected to provide clinical services and other specialized aspects such as Dai training, MTP, male involvement, covering 100,000 population, contributing to achieving the RCH objectives. Sngocs: The SNGOCs are responsible for monitoring the implementation, facilitating timely submission of NGO reports to the state government, providing government feed back to NGOs, communicating government policies and programs, and facilitating NGO dialogue with the district health system. RRCs :NGOs with expertise and experience in RCH and having national level stature are identified as RRCs
- #21 Top Healthcare Non-Profit Organisations in India lepra societyLEPRA Society LEPRA Society is involved in helping people who suffer serious diseases such as leprosy, AIDS and tuberculosis among others. The Society implements several initiatives focussed on improving women and child health. They have been awarded by various organizations for their efforts in eradicating leprosy in various states of India such as Andhra Pradesh, Orissa, Bihar, Madhya Pradesh and Jharkhand. uday foundation healthcare ngoUday Foundation Although Uday Foundation is not directly related to healthcare, it plays a very important role in this sector. The Foundation is essentially a support group that helps families with children suffering from serious illnesses such as congenital defects, growth disorders, and other syndromes. Uday Foundation has done substantial work towards strengthening child rights scenario in the country. It supports research aimed towards development of new technologies in healthcare. arvind eye care system ngoAravind Eye Care System Aravind Eye Care System is a drive against blindness. The NGO uses a special “assembly line” method for treatment. This method has increases productivity by 10 times and increases the number of cases that the NGO handles. Owing to its unique method, Aravind Eye Care System performs more than 300,000 optic surgeries every year. Also, 70 percent of its services are offered at subsidized prices or freely to the poor. smile foundation NGOSmile Foundation One of the largest non-profit organisations in India, Smile Foundation has two healthcare wings called Smile on Wheels and the Smile Health Camps. Smile on Wheels (SoW) is a national level program that focuses on providing a wide range of promotive, preventive and curative health services to the underprivileged section of the society. Smile’s vision through SoW is to provide affordable, accessible & advance health care facilities at the door steps of the underprivileged communities. Through their health camps, the organisation arranges special healthcare camps to provide preventive, curative, referral and promotive health services. In the next two years, Smiles plans to reach out to 500 districts. Deepalaya non profit organisationDeepalaya Deepalaya is one of the most popular healthcare non-profit organisations which works in improving rural healthcare in India. This NGO also deals with several other issues such as education, child rights, institutional care, care for the specially abled, and gender equality. Deepalaya has also launched a mobile service called Chameli Dewan Memorial Rural Health & Mobile Clinic. By coordinating with existing healthcare institutions, the mobile service has managed to increase immunizations and reduce infant mortality in the rural areas surrounding New Delhi. Udaan non profit organisationUdaan Udaan works with mentally handicapped and spastic persons. The foundation aims at bringing brain damaged children to the mainstream and helping them lead a more independent life. Ever since its establishment in 1994, Udaan has worked with children as well as their parents, and has succeeded in enabling these children to find gainful employment. The NGO educates parents about these diseases, home management, selecting schools and several other related works. Together, these NGOs definitely raise the standard of average health in India. If you feel for any of these, then take time out to participate in their events. A few hours in your busy life can change the life of another human being.
- #22 Care is an international ngo working in 87 countries with more than 1000 centre, areas of work are emergency relief
- #25 We have looked at four aspects: 1- Apprehending health care within a broader socio-economic context. 2- Global advocacy capacities to set health policy making and implementation 3- Proven capacities to implement efficient comprehensive primary health care 4- Capacities to innovate and prepare health systems for the future.
- #27 Study Methodology Data was gathered through An in-depth field survey of fifty NGOs, who responded to a semi-structured questionnaire. The sample was selected from a stratification of NGOs into four types, International, National Level Foreign Funded, Local Funded, and Sub-national and Community-based.
- #29 97 million volunteers