Study reveals successes and challenges in implementing the NGO Code of Conduct for Health Systems Strengthening – May 5, 2010

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In order to determine how organizations were putting into practice the NGO Code of Conduct for Health Systems Strengthening, Health Alliance International (HAI) conducted interviews with signatories as well as organizations that did not sign on. The purpose was to discover any best practices being used by the organizations, and to identify barriers and challenges to implementing the Code of Conduct.

HAI was one of the drafters of the Code of Conduct, and is the current coordinating organization. In all, HAI conducted 29 key informant interviews in 2009 (26 with signatories, 3 with non-signatory organizations). The study was completed by Anjali Sakhuja, and the summary was created by Erin Hurley.

Below is the executive summary, and you can find the full report here.

Executive Summary

The Non-Governmental Organization (NGO) Code of Conduct for Health Systems Strengthening was launched in 2008 to support public sector health systems by  changing industry-wide human resources practices that routinely undermine Ministries of Health in low-income countries striving to meet the Millennium Development Goals.  Health Alliance International interviewed signatories of  the NGO Code of conduct as well as some organizations that did not sign to gauge the success of the Code in practice. In all, we conducted 29 key informant interviews in 2009.

We found that all organizations, signatories and non-signatories alike, are operating in a competitive marketplace for skilled human resources.  Even when they are highly conscious of avoiding hiring practices harmful to the public sector, such as hiring health professionals away from public employment, international organizations seeking to meet their obligations to donors and demonstrate success feel they often cannot avoid selecting both clinical and programmatic personnel who could otherwise be working for Ministries of Health.  A few signatories said they have made attempts to keep salaries closer to the ones offered by the public health sector, but most found it challenging because using such policies made it difficult to recruit or retain staff.  While many signatory organizations, however, have identified other strategies to reduce the burden and contribute positively to the public sector, although they experience disadvantages because other organizations do not have the same restrictions. Most NGOs have not invested in pre-service training programs to generate new health professionals to help overcome these staffing obstacles.

One proposed strategy to level the playing field for NGOs seeking to support the public sector would be for donors and governments to create incentives for more comprehensive adoption of the NGO Code of Conduct principles. In the meantime, international NGOs and other stakeholders can move forward collectively to advocate for change, contribute to research and knowledge sharing, and build health workforce capacity.

Read the full report here.

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