CONTRIBUTIONS OF CSOs IN ATTAINMENT OF MDGs 4 & 5

1. CONTRIBUTIONS OF CSOs IN ATTAINMENT OF MDGs 4 & 5 By Cecilia Senoo Ghana Coalition of NGOs in Health (GCNH)

2. “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.

3. 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

4. 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.

5. 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.

6. 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

7. 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.

8. 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

9. 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

10. 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,

11. 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.

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

19. 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

20. SOME SPECIFIC ACTIONS FOR MDG 4&5 IN GHANA • 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

21. 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

22. SOME STRATEGIES AND TACTICS EMPLOYED BY NGOs

23. 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

24. CHALLENGES ENCOUNTERED • 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

25. WAY FORWARD • COLLABORATION & PARTNERSHIPS • LOBBYING • DELIVERING RESULTS • SHOWING EVIDENCE • STRATEGIC INITIATIVE FUND? • RESEARCH

26. Some CSOs Activities in PIX

27. THANK YOU