CONTRIBUTIONS OF CSOs IN ATTAINMENT OF MDGs 4 & 5

By

Cecilia Senoo

Ghana Coalition of NGOs in Health (GCNH)

“It is people mobilized as you are, more than any

government initiatives or scientific breakthrough, who can overcome the

obstacle to a better world… the civil society movement continues to grow and make

its mark.”UN Secretary General Kofi Annan, Civil

Society Forum, Brazil, June 13, 2004.

OUTLINE OF PRESENTATION Introduction

Our role

Our Areas of Interest in MDG 4 &5

Some Specific Actions for MDG 4&5 in Ghana

Some Strategies and Tactics employed by NGOs

Challenges encountered

The way forward

INTRODUCTION GCNH is a reputable not-for-profit CSO

established in 2000 as an umbrella and coordinating body of activities of all registered NGOs/CBOs/FBOs in the health sector in the country

GCNH has 559 registered NGOs/CBOs/FBOs in all the 10 regions of Ghana. Coalition members work in every district of Ghana.

INTRODUCTION (Cont.) Civil Society Organisations (CSOs) are perceived as

organisations that represent the interest of the population and negotiates matters of concern in their interest.

These institutions provide a voice to a dispersed range of interests within the health sector who otherwise cannot be placed under a structured system.

CSOs may be national or international in nature and includes NGOs, community based groups

Research institutes, think tanks ,trade unions, academic institutions, the media, professional associations and faith based organisations.

WHAT IS OUR ROLE? Build social capital and enable citizens to

identify and articulate their values, beliefs, civic norms and democratic practices;

Mobilize particular constituencies, particularly the vulnerable and marginalized sections of masses, to participate more fully in health and public affairs; and

Improve the wellbeing of their own and other communities through development work

WHAT IS OUR ROLE?

NGOs are widely recognized as an essential ‘third’ sector. Our strength can have a positive influence on the state and the market.

We are increasingly an important agent for promoting good governance like transparency, effectiveness, openness, responsiveness and accountability.

WHAT IS OUR ROLE ? To further good governance,

by policy analysis and advocacy;

By regulation and monitoring of state performance and the action and behavior of public officials;

by building social capital and enabling citizens to identify and articulate their values, beliefs, civic norms and democratic practices;

by mobilizing particular constituencies, particularly the vulnerable and marginalized sections of masses, to participate more fully in health and public affairs; and

by development work to improve the wellbeing of their own and other communities

OUR AREAS OF INTEREST IN MDG 4 & 5

Maternal and Reproductive Health Matters:

Maternal mortality ratio and skilled birth attendants

Unmet need for family planning, contraceptive prevalence, adolescent birth rate and antenatal care.

Other dimensions of maternal health and well‐being Maternal morbidity HIV AIDS and maternal health Morbidity from unsafe abortion Maternal under nutrition Violence against women

OUR AREAS OF INTEREST IN MDGS 4&5 Newborn health

Before pregnancy Family planning Pregnancy Birth

Postnatal care: Care for mother and neonate neonatal health interventions skilled care at birth, early initiation of

breastfeeding,

OUR AREAS OF INTEREST IN MDG 4 & 5

Preventive child-health interventions exclusive breastfeeding during the

first six months of age, complete immunization of children aged 12–23 months),

Curative child-health interventions care-seeking for children with acute

respiratory infections (ARI), and provision of oral rehydration therapy (ORT) for children with diarrhoea.

OUR AREAS OF INTEREST IN MDG 4 & 5 Implementing effective packages of care

Strategies for implementing effective interventions

Making a Difference: Strong Health Systems Health sector governance and political

leadership Human resources for health Referral Infrastructure Essential drugs, supplies and

equipment

OUR AREA OF INTEREST IN MDG 4&5 Health financing mechanisms for maternal

health User fees ×

Social and community based health insurance

Community based emergency funds

Private health insurance

Cash transfer and Voucher schemes

Targeting

OUR AREAS OF INTEREST IN MDG 4 & 5

Making the most of the private sector Social marketing Social franchising Performance‐based Financing Approaches

The Demand Side of MNH: Equity, Access, Advocacy and Accountability Demand side barriers Social exclusion Women’s status, empowerment and

education Financial barriers

OUR AREAS OF INTEREST IN MDG 4 & 5

Physical access to maternal health services Social and cultural barriers Increasing demand through community

mobilisation and engagement

Impact on health outcomes

Mobilisation as a vehicle for participation and empowerment

Scaling up community mobilisation

OUR AREAS OF INTEREST IN MDG 4 & 5

Building political commitment through advocacy

Taking a gender and human rights perspective

Increasing accountability from below

Holding leaders to account: Citizen participation, voice and accountability

Results for Improved Outcomes

OUR AREAS OF INTEREST IN MDGS 4&5 Tracking progress in maternal and sexual

reproductive health rights and services

What should be counted for maternal health, and how?

National accounts and sub‐accounts to improve allocation of funds to maternal, neonatal and child health

What is needed to support improvements in results reporting and lesson learning

SOME SPECIFIC ACTIONS FOR MDG 4&5 IN GHANA

Advocacy, communication, and social mobilization.

Acting as watch dog to government

Training and upgrading the skills of core health providers to increase skilled deliveries

Educational program on dangers of unsafe abortion, contraceptive use • IEC materials on safe abortions, radio discussions and

peer group education at schools and communities

SOME SPECIFIC ACTIONS FOR MDG 4&5 IN GHANA

Physical infrastructure development established SRH and child welfare facilities/clinics in

all regions where some deliveries, anti-natal, post-natal and referrals are made.

R3M has renovated 60 FP units in GHS facilities, constructed 6 new RH centers and supplied health equipment (autoclaves, lamps etc.)

renovated 30 GHS facilities, constructed 2 new SHR centers and supplied office equipment

PPAG has a SHR facilities in the West Mamprusi District in Northern Ghana that provide skilled deliveries

The R3M Consortium has engaged MOH/GHS since September, 2006 and provided the commitment, financial and technical resources to enable significant expansion in women’s access to modern family planning and comprehensive abortion care in 3 regions in Ghana

Engagement of policy makers at various levels to find mutual ways of addressing the gaps in implementation of the MDGs 4&5

SOME SPECIFIC ACTIONS FOR MDG 4&5 IN GHANA

HFFG has establish reproductive health and food production centre in Mfantsiman district

Established 2 community clinics in Ajumako Enyan Essiam.

The USIAD SHARPER project has established 31 DIC centres 11 MSM/19FSW and 1 HIV

SOME SPECIFIC ACTIONS FOR MDG 4&5 IN GHANA

SOME STRATEGIES AND TACTICS EMPLOYED BY NGOs

STRATEGIES TACTICS SKILLS

Education Meetings, media, workshops, conferences, commissions

Research, information, analysis, dissemination, Communication and articulation

Collaboration Building relationships, linkages, cooperate with government and other CSOs

Communication, organization, mobilization, networking technical capability, transparency, Openness and effectives

Persuasion Meetings, workshops, coalition, lobbying, media, demonstration

Organizing, communication, motivation, negotiation, commitment and vision

Litigation Use of courts Legislation, communication

Confrontation Demonstration, public gatherings, speeches

Mobilizing, communication, motivation, lead

CHALLENGES ENCOUNTERED

Female Low literacy especially at the grassroots where maternal and child mortality is high

Low male involvement in Health especially MDGs 4&5

Inadequate resources for project implementation

Low capacity of members in certain critical skills

Inadequate implementation of PPP.

Inadequate capacity on data management to show results of our activities.

CSOs seen as competitors more than collaborators

Coalition vrs Individual NGOs

CHALLENGES ENCOUNTERED

WAY FORWARD COLLABORATION & PARTNERSHIPS

LOBBYING

DELIVERING RESULTS

SHOWING EVIDENCE

STRATEGIC INITIATIVE FUND?

RESEARCH

Some CSOs Activities in PIX

THANK YOU