This review seeks to detail recent initiatives by non-governmental organisations (NGOs) and civil society organisations in improving development practice. There are several attempts to provide a ‘civil society or NGO’ parallel to the Paris Declaration. These initiatives seek some form of standardisation and evidence that NGOs are as effective as they claim to be, and to counter criticism that they have not been diligent in ensuring the quality of their delivery. However, seeking to justify oneself is not the best use of time and resources. Accountability needs to be improved. The survey indicated that many of the initiatives do not go far down the route of participation, despite a theoretical (rhetorical) commitment to beneficiary participation. Improved quality control is also required. Some of the models now available seek to improve the quality of delivery rather than the quality of impact. Thus an emphasis on things like complaints procedures, transparent, consistent and shared procedures, deal with how aid is delivered not what is delivered and whether it has any real impact. Regular assessments of efficiency, effectiveness and impact should be done. However, efficiency is not the same as effectiveness or impact. Improved efficiency does not automatically lead to more effective development or greater impact.
Governance and participation in health
The 2009 edition of the Right to Food and Nutrition Watch focuses on the question: ‘Who controls the governance of the world food system?’ For the first time in history, the number of undernourished people in the world has surpassed the tragic figure of one billion. The gap between promises and reality is increasing as the international community and national governments are far from realising the World Food Summit targets to halve the proportion of chronically hungry people in the world by the year 2015. It is clear that the global governance of the world food system needs to be remodelled in order to effectively overcome hunger and its causes. As an evidence-providing monitoring tool, this book pursues two aims: to put public pressure on policy makers at national and international levels to take the human right to food seriously and to provide a systematic compilation of best practices for the realisation of the right to food, while documenting where violations take place.
This brief asserts that research relating to humanitarian crises has largely focused on what international aid agencies and donor governments do in response to disasters. Instead, this paper focuses on the role of the affected state in responding to the needs of its own citizens. It found that one of the goals of international humanitarian actors should always be to encourage and support states to fulfil their responsibilities to assist and protect their own citizens in times of disaster. Too often, aid agencies have neglected the central role of the state, and neutrality and independence have been taken as shorthand for disengagement from state structures, rather than as necessitating principled engagement with them. States should invest their own resources in assisting and protecting their citizens in disasters, both because it is the humane thing to do and because it can be politically popular and economically effective. The roles and responsibilities of states in relation to humanitarian aid are four-fold: they are responsible for 'calling' a crisis and inviting international aid; they provide assistance and protection for themselves; they are responsible for monitoring and coordinating external assistance; and they set the regulatory and legal frameworks governing assistance.
This briefing paper aims to distil the core questions which the fragile states literature and experiences in fragile states present, with the aim of structuring space for discussion of these issues in non-governmental organisation (NGO) practice and exploring directions for further research. It found that networks are not guaranteed to work better solely by having increased resources and in many cases are not a genuine solution. NGOs must work in and strive to ameliorate the environment of mistrust through building trust and social cohesion at a community level. Underlying all fragile states discussion must be a thorough and continuous contextual analysis, as cases of fragility vary greatly and are individually extremely dynamic. There is clearly a need for civil society to innovate and pursue alternative solutions in fragile states where traditional methods do not seem to be working. The challenge for civil society is to engage more effectively in policy dialogue on fragile stages, building on their programmatic experience of working directly with poor communities.
This study sought to determine the best approach of integrating community interventions for TB control. It evaluated the records of 3,110 new TB patients registered in three Local Service Areas (LSAs), from quarter 1 2004 to quarter 4 2005. It found that bacteriological coverage, smear conversion and treatment success rates dropped in the interventional LSA, while the control LSAs remained consistent. The defaulter rates dropped in all LSAs, while the proportion of unevaluated cases increased in the interventional LSA. However, patients registered in the clinics had better chance of successful treatment outcome compared to their hospital counterparts. The study concluded that community participation by itself is not adequate to improve the performance of a TB control programme. Enhancement of the program’s technical and organisational capacity is crucial, prior to engaging purely community interventions. Failure to observe this logical relationship would ultimately result in suboptimal performance. Therefore, the process of entrusting communities with more responsibility in TB control should be gradual and take cognisance of the various health system factors.
In the last several years, a democratic boom has given way to a democratic recession. Between 1985 and 1995, scores of countries made the transition to democracy, bringing widespread euphoria about democracy's future, but more recently, democracy has retreated in some. These developments, along with the growing power of China and Russia, have led many observers to argue that democracy has reached its high-water mark and is no longer on the rise. The authors argue that that conclusion is mistaken and that the underlying conditions of societies around the world point to a more complicated reality. They note that it is unrealistic to assume that democratic institutions can be set up easily, almost anywhere, at any time. The conditions conducive to democracy, it is argued, can and do emerge – and the process of ‘modernisation’ advances them. Once set in motion, it tends to penetrate all aspects of life, creating a self-reinforcing process that transforms social life and political institutions, bringing rising mass participation in politics and – in the long run – making the establishment of democratic political institutions increasingly likely.
The People’s Health Movement (PHM), a world-wide civil society network, has a series of concerns about the World Health Summit (WHS), which is being planned as an annual event. Although the summit speaks of participation of nongovernmental organisations (NGOs), the costs ranging between 290–490 Euro for NGOs will exclude those that could legitimately reflect the voices and needs of grassroots and marginalised communities. The summit is also by invitation only, which suggests that NGO participation will be hand-picked and limited. PHM believes that, rather than creating a parallel policy forum, efforts and resources should be spent strengthening the World Health Organization (WHO) as the international coordinating body for issues related to people's health. WHO is one of the United Nation organisations in which each country has a voice. WHO thus provides a reasonably democratic decision making process, despite mechanisms used by powerful member states to direct the decisions. We are concerned that the declaration of the World Health Summit is likely to preferentially represent the interests of the Global North, corporations and those who financially sponsor the Summit.
Although the South African state has shifted away from uncritical promotion of neo-liberal public management, the government continues to mesh limited welfarism with market-driven reforms. It has tried to use service delivery to win political loyalty, but this strategy has largely backfired. There is growing public awareness that the current failures and inequities in access to public services can no longer be blamed on the legacy of apartheid. According to the free basic water policy applied since 2001, poor South Africans are entitled to 6,000 litres of free water per month. Yet, according to the Department of Finance’s own numbers, most poor households use 25,000 of water per month. Consequently, most such households then fall into arrears. Free basic water, often seen as a big improvement, also has unintended effects. It is a way to increase state surveillance of citizens by requiring registration and its restrictive availability is used as a disincentive for poor people to use water. If poor people use more than their basic allocation, they are heavily penalised by higher tariffs.
The Strengthening the AIDS Response Zambia (STARZ) programme marked a cutting edge multisectoral approach to HIV in the region. Non-governmental sectors (including civil society and the private sector) tend to be poorly organised, and authority tends to rest with government ministries. Not all sectors have incentives or welcome being coordinated, particularly by relatively young commissions claiming the mandate to do so. Coordination can also mean different things to different groups – for some it signifies regulation and control, while for others the emphasis is on participation and information exchange and even access to resources. The main aim of this project was to support the national AIDS commission, known locally as the National AIDS Council (NAC), in coordinating a multisectoral response to the epidemic. The report notes that coordination is improved when the roles and rules of engagement for key stakeholders are understood, and where accessible coordination structures are in place to enable public, civil society and private sector representatives to work effectively with the NAC. The STARZ programme has supported important processes that have focused on improved relationships between the NAC and the civil society and private sectors – including internal coordination.
This guide, produced by the EuropeAid Co-operation Office, offers guidance to European Community (EC) sector specialists on how to analyse and address governance in sector operations in a more systemic and comprehensive way, without being a compulsory blueprint. It aims to strengthen understanding of governance issues at sector level. It is divided into four chapters, which provide a broad definition of governance and overall EC policy on governance, experiences in dealing with governance at sector level reasons for strengthening efforts, a focus on an overall approach in addressing sector governance, and a methodology that can guide the process of analysing governance at sector level.