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From:
Sam Lanfranco <[log in to unmask]>
Reply To:
Canadian Network on Health in Development <[log in to unmask]>
Date:
Tue, 26 Oct 2010 14:24:27 -0400
Content-Type:
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----- Forwarded from Claudio Schuftan <[log in to unmask]> -----
  Date: Tue, 26 Oct 2010 15:07:31 +0700
  Subject: PHM-Exch> NGOs and public health systems
  To: phm-exchange <[log in to unmask]>

What sounds to be obvious – nongovernmental organizations working in
the field of international health cooperation support and strengthen
health systems – is not taken for granted. NGOs, “if not careful and
vigilant, can undermine the public sector and even the health system
as a whole, by diverting health workers, managers and leaders into
privatized operations that create parallel structures to government
and that tend to worsen the isolation of communities from formal
health systems (…)” This assessment is, at least, the starting point
of the “NGO Code of Conduct for Health Systems Strengthening” first
published in May 2008. The code intends to offer guidance on how
international non-governmental organizations can work in host
countries in a way that respects and supports the primacy of the
government’s responsibility for organizing health system delivery.

A matter of course? Well, you can test it yourself, right now, if you
like:

How many of the following statements taken from the NGO code
correspond with your organization’s standard?

1. “In areas where trained personnel are scarce, we will make every
effort to refrain from hiring health or managerial professional staff
away from the public sector, thus depleting ministries and their
clinical operations of talent and expertise.” (yes? no? not sure? not
relevant for you?)
2. “We commit to limiting pay and benefits inequity between expatriate
and national, rural and urban, and ministry and NGO workers. We
encourage compensation structures that provide incentives for rural
service and disallow gender-related disparities.” (yes? no? not sure?
not relevant for you?)
3. “We recognize that management capacity in Ministries of Health is
often limited. Rather than building parallel or circuitous structures
around inadequate capacity, we commit to strengthening governments’
ability to operate effectively and efficiently.” (yes? no? not sure?
not relevant for you?)
4. “We strengthen the capacity of communities to take responsibility
for and ownership of their health development, and to become partners
with government in the health system, while holding governments
accountable for their human rights obligations.” (yes? no? not sure?
not relevant for you?)
5. “We actively advocate with civil society, local institutions and
donors for policies and programs that strengthen health systems
overall.” (yes? no? not sure? not relevant for you?)
6. “We commit to designing their activities and programs so that they
reinforce primary health care, foster equity and community
involvement, and are generally replicable and financially sustainable
over time.” (yes? no? not sure? not relevant for you?)

So, are you happy with your score? 6 out of 6? Congratulations! But
nevertheless, you might be interested to further discuss the task of
contributing to building public health systems and doing no harm. The
members of the MMI Network members will meet on 5th November in
Amsterdam in a workshop on "Health systems strengthening", reflecting
about the role of NGOs and of their particular organization in health
systems strengthening. Join us, if you like!

Thomas Schwarz,
Medicus Mundi International Network

----- End forwarded message -----
Forwarded by:
**********************************************
Dr Sam Lanfranco (Prof Emeritus) Econ, York U.
Toronto, Ontario, CANADA - M3J 1P3
email: [log in to unmask]   Skype: slanfranco
blog:  http://samlanfranco.blogspot.com
Phone: 613 476-0429 cell: 416-816-2852
**********************************************

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What sounds to be obvious – nongovernmental organizations working in the field of international health cooperation support and strengthen health systems – is not taken for granted. NGOs, “if not careful and vigilant, can undermine the public sector and even the health system as a whole, by diverting health workers, managers and leaders into privatized operations that create parallel structures to government and that tend to worsen the isolation of communities from formal health systems (…)” This assessment is, at least, the starting point of the “NGO Code of Conduct for Health Systems Strengthening” first published in May 2008. The code intends to offer guidance on how international non-governmental organizations can work in host countries in a way that respects and supports the primacy of the government’s responsibility for organizing health system delivery. A matter of course? Well, you can test it yourself, right now, if you like: How many of the following statements taken from the NGO code correspond with your organization’s standard? 1. “In areas where trained personnel are scarce, we will make every effort to refrain from hiring health or managerial professional staff away from the public sector, thus depleting ministries and their clinical operations of talent and expertise.” (yes? no? not sure? not relevant for you?) 2. “We commit to limiting pay and benefits inequity between expatriate and national, rural and urban, and ministry and NGO workers. We encourage compensation structures that provide incentives for rural service and disallow gender-related disparities.” (yes? no? not sure? not relevant for you?) 3. “We recognize that management capacity in Ministries of Health is often limited. Rather than building parallel or circuitous structures around inadequate capacity, we commit to strengthening governments’ ability to operate effectively and efficiently.” (yes? no? not sure? not relevant for you?) 4. “We strengthen the capacity of communities to take responsibility for and ownership of their health development, and to become partners with government in the health system, while holding governments accountable for their human rights obligations.” (yes? no? not sure? not relevant for you?) 5. “We actively advocate with civil society, local institutions and donors for policies and programs that strengthen health systems overall.” (yes? no? not sure? not relevant for you?) 6. “We commit to designing their activities and programs so that they reinforce primary health care, foster equity and community involvement, and are generally replicable and financially sustainable over time.” (yes? no? not sure? not relevant for you?) So, are you happy with your score? 6 out of 6? Congratulations! But nevertheless, you might be interested to further discuss the task of contributing to building public health systems and doing no harm. The members of the MMI Network members will meet on 5th November in Amsterdam in a workshop on "Health systems strengthening", reflecting about the role of NGOs and of their particular organization in health systems strengthening. Join us, if you like! Thomas Schwarz, Medicus Mundi International Network
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