Participation of Civil Society Essential to Country Ownership of Health

Participation of Civil Society Essential to Country Ownership of Health

 {Photo: MSH Staff}Participants at a senior leadership training in Rwanda discuss best practices for country ownership.Photo: MSH Staff

This post originally appeared on the LMGforHealth Blog.

In discussions around the importance of country ownership of health-related activities and initiatives, both Management Sciences for Health (MSH) and the Leadership, Management, and Governance (LMG) Project are committed to making sure that the role of civil society is taken into consideration and promoted, in line with USAID Forward’s drive to engage and strengthen local capacity.

In September 2012, four organizations with shared interests in family planning, reproductive and sexual health, maternal health, and HIV and AIDS—The American Foundation for AIDS Research (amfAR); the Health Policy Project (HPP), a USAID-funded project of Futures Group; the International Planned Parenthood Federation Africa Region; and the Planned Parenthood Federation of America—joined forces to convene a multi-disciplinary consultation in Washington, D.C. on Advancing Country Ownership: Civil Society’s Role in Sustaining Global Health Investments. The meeting was convened in part and with participation from the US President’s Emergency Plan for AIDS Relief (PEPFAR) participating agencies and projects, and aimed at sharing lessons and practices to inform PEPFAR’s transition from an emergency plan to a more sustainable, country led program that strengthens local institutions and partners.

At this gathering, the organizations invited a diverse array of stakeholders to: consider the implications for civil society’s role in the ongoing transition of development aid programs to a country ownership model; and discuss ways in which civil society might participate as a partner in the country ownership paradigm in order to maximize its potential as the representative for populations disadvantaged by poverty, marginalized due to stigmatization, or vulnerable to discrimination.

A report on the consultation highlighted key points that came out of the discussions that should be considered by those who work in health and development:

  1. Donor governments and foundations have made substantial investments in global health, and civil society has played a key role in maximizing their impact. To ensure country ownership, the participation of civil society will be essential to ensure that these investments continue to pay off.
  2. As international development aid structures are transitioning toward a country ownership model, the role of civil society remains ill-defined. The role of civil society as an essential development partner must be affirmed.
  3. “Country” should not be defined as “government,” but rather must include all stakeholders, including civil society. As governments are ultimately responsible to citizens, civil society should be empowered to hold governments accountable for the delivery of health services.
  4. Above all, protecting and improving the health status and human rights of vulnerable and marginalized populations must be the priority. As the primary representative for key populations, civil society must participate at every stage of the development process, from program planning and design to resource allocation, program implementation, monitoring, and evaluation.

The full report on the findings of this important meeting on the role of civil society in advancing country ownership can be accessed on the amfAR website here.

As a post-script to these salient discussions, Chris Collins, one of the amfAR directors, authored an article with Chris Beyrer that was published by The Lancet in October 2013 entitled, “Country ownership and the turning point for HIV/AIDS”, in which he addresses the subject of transitioning of HIV and AIDS country programs. The article mentions the government of India taking over the Avahan program from the Gates Foundation as a good example of a successful transition from a donor-funded to a fully country-owned and funded program. It also counsels thoughtfulness and patience in the transition process, emphasizing the need for a clear transition plan as well as donor commitment to fill in gaps as country-owned programs work to scale up strategic services. These successes, however, and the lessons that can be learned from these processes can be used to ensure ownership of other programs and projects.

For more on country ownership perspectives from around the world, see:

Xavier Alterescu is a senior principal technical advisor at MSH and deputy director of the Leadership, Management, and Governance (LMG) Project.

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