6th June, 2008
Thursday, May 29
A group of leading international health development organisations today launched an ‘NGO Code of Conduct for Health Systems Strengthening’ at the 35th Global Health Council Meeting in Washington DC.
The code encourages non-governmental organisations to engage in practices that do not undermine but instead strengthen the health systems of the countries in which they are working.
“The purpose of this code of conduct is to offer guidance on how international NGOs can work in host countries in a way that supports the primacy of the government’s responsibility for organizing health system delivery,” said Wendy Johnson of Health Alliance International.
AMREF’s Dr Daraus Bukenya helped to draft the code. “We felt that it was necessary to have a code of conduct particularly at this time when there has been a proliferation of the number of NGOs working in Africa, each applying different methods and standards. At the same time, African governments have been showing a willingness to work more with communities and to bring them into the mainstream of health care. But because most of the work in the communities is carried out by a multitude of NGOs, the governments have been finding it difficult to work with them as there has been no standard way of operating, or a code to guide how they function in the community. It is important to have some guidelines for how we operate, using the health system as the platform on which we all work.”
He added: “For AMREF, the community component is extremely important because we believe that the health threats that we are facing on the African continent cannot be addressed by the public sector alone in the absence of the communities. For instance, we have had a lot of experience building human resource capacity at the community level and have noticed how much community health workers can expand the human resource base to enable communities to access services. The code must be seen to support and strengthen the entire health systems, including the communities.
Donna Berry of Partners in Health who was also involved in drafting the code said” Tremendous growth in NGOs has led to a multitude of different projects and approaches across the developing world,” she said. “NGOs can quickly hire more staff at higher salaries, acquire specialised equipment or create idealised projects serving one limited population in a small geographic area.The result is a fragmented and inequitable health system, where we can count HIV viral loads, but a woman dying in childbirth cannot get a caesarean section; where one district has a state of the art hospital while the next district has only an empty cement-block building without running water or electricity. For this reason, we have consistently aimed at strengthening government-supported pubic health clinics in all countries in which we work, leading to sustained and more equitable care.”
The new code of conduct, which had 22 signatories at the time of the launch today, has five articles for health systems strengthening:
- NGOs will engage in hiring practices that ensure long-term system sustainability
- NGOs will enact employee compensation practices that strengthen the public sector
- NGOs pledge to create and maintain human resources training and support systems that are good for the countries where they work
- NGOs will minimise the NGO management burden for ministries
- NGOs will support Ministries of Health as they engage with communities
- NGOs will advocate for policies that promote and support the public sector
A website has been created to track signatories to the code and offer a forum for discussion of related issues (www.ngocodeofconduct.org)