NGOs are not making specific efforts for health-related Sustainable Development Goals (SDGs) in Pakistan, and yet there exists great potential in NGOs that can be harnessed to promote SDGs through putting in more concentrated efforts, writes Rabia Tabassum.
According to a World Bank report, non-government organisations (NGOs) can be defined as “private organisations that pursue activities to relieve suffering, promote the interests of the poor, protect the environment, provide basic social services or undertake community development”. In Pakistan, a number of NGOs are working in the form of trusts, societies, unions, and social welfare organisations with deep penetration in far-flung areas across Pakistan. Hence NGOs are one of the important stakeholders, having the advantage of working closely with the community and contributing in social development through service provision, building capacity and raising awareness among masses on different health issues. Indeed, the role that NGOs play as part of the national healthcare structure of Pakistan can be seen in figure given below (the figure has been taken from Health System Profile by the World Health Organisation).
Figure 1: National Health System of Pakistan
Source: Health System Profile of Pakistan 2007, World Health Organisation
The existence of various registration laws for NGOs and the absence of a centralised registration system make it difficult to assess the actual number of NGOs in Pakistan (DAWN 2016). According to Social Policy and Development Centre (SPDC) 2002, 2,700 NGOs are working on health out of total 45,000 NGOs in Pakistan. NGOs are actively engaged with government through public-private partnerships in service delivery of healthcare at federal and provincial level. The People’s Primary Healthcare Initiative (PPHI) is one of the examples of NGOs’ engagement with the government under which Basic Health Units (BHUs) that are being managed by the NGOs (rural support programs in respective provinces). Another example of the NGO’s engagement with government is the Leprosy Control Program that is a partnership between government and Marie-Adelaide Leprosy Centre.
In order to explore the readiness of NGOs in Pakistan for sustainable development goals (SDGs), the Sustainable Development Policy Institute (SDPI), interviewed 3 NGOs and carried out a quantitative survey with responses from 9 NGOs. According to the results of the survey and interviews, a few organisations are involved in SDGs process at a national level. The majority of NGOs responded that they are working on SDGs but they couldn’t link it properly with the targets of SDGs. This implies that there exists a knowledge gap among NGOs regarding SDGs. The same situation prevails among some NGOs in having knowledge about a multi-sectoral approach. This also results in negligence in working on social determinants of health and makes the efforts less effective (Shaikh 2008). Therefore the component of the multi-sectoral approach should be included in the awareness raising campaigns on SDGs.
According to the survey, out of 9 NGOs, 8 are working on service delivery of health, and data collection & data management; 7 NGOs are working on awareness raising and advocacy, and the rest of the activities are given in figure no.2. Thus, NGOs can play a potential role in implementation (service delivery of health), and building consortiums in context of SDGs. Moreover, they can contribute in mass mobilisation and in advocacy campaigns for bringing about meaningful change by acting as a pressure group to ensure the implementation of SDGs in Pakistan.
Figure 2: Type of Activities of NGOs in Pakistan
Source: Authors’ own calculations from the survey conducted by SDPI
The survey and interviews with NGOs highlighted some challenges that are being faced by the NGOs in order to accomplish the organisational targets. Some common and major issues include:
- Lack of financial resources to fulfil the requirements of organisations
- Lack of human resources
- Lack of capacities to work on newly set targets of SDGs
- Cultural barriers especially in case of treatment of some diseases which are associated with stigma such as mental illness. Patients with mental illness don’t seek treatment due to the social stigma associated with it
- Lack of acceptance of NGOs by general public that results in lack of coordination between public and NGOs
- Some NGOs which are involved in policy advocacy find it difficult to lobby in order to address loopholes in existing laws.
- Lack of networking and partnership opportunities
- Lack of government support for NGOs
Hence, through fulfilling their resource requirements and building their capacities in terms of implementation and advocacy for SDGs, their potential in terms of SDGs can be harnessed.
Another important aspect in terms of strengthening the role of NGOs in SDGs is the formation of thematic networks. This requires an extensive mapping exercise to identify the NGOs working on particular thematic areas in order to ensure their engagement and collaboration with each other. The networks would provide platforms to the member organizations where they can discuss the ways in which they can work together for the common and shared agenda as well as how they can collaborate to solve the issues and challenges. Hence, networking would be an effective tool that will enable NGOs to play their role in an enhanced manner.
Lack of communication, resource constraints and absence of a common agenda are the basic hindrances reported by the respondent organizations for meaningful engagement with other organizations. Therefore, resource allocation specifically for networking and engagement activities are required in order to address the aforementioned challenges in building effective partnerships/engagements. In addition to that, frequency of engagement activities with the stakeholders must be increased to reduce the communication gap and enhance the level of understanding among stakeholders.
NGOs’ representation in policy formulation is another potential role of NGOs as they are involve in service delivery and can provide the solutions to many of the problems based on their experience. Moreover, NGOs can also be part of monitoring activities for SDGs and make the government accountable for not performing well at the community level.
NGOs are not making specific efforts for health-related SDGs in Pakistan, and yet there exists great potential in NGOs that can be harnessed to promote SDGs through putting in more concentrated efforts. Special attentions are required in terms of awareness raising regarding health-related SDGs, resource facilitation, more networking opportunities and the involvement of NGOs by the government in policy formulation.
Cover image: An aid worker gives preventative medical supplies to a family as part of relief efforts in Pakistan. Image source: US Federal Government, Public Domain.
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About the Author
Rabia Tabassum is a Project Associate at Sustainable Development Policy Institute (SDPI) and has exposure of working on various research and development projects from the platform of SDPI, Ministry of Finance and Planning Commission of Pakistan. She tweets @tabassum_rabia