Authors
Abstract
BACKGROUND: Given the expanding range of health influencing factors, increasing expectations from
the health systems, and general challenges such as insufficient resources, the health services needed
by people cannot be provided completely by the governments alone. Therefore, nongovernmental
organizations (NGOs)‑government collaboration is considered a common approach in health‑care
provision for different communities. Since the NGO‑government collaboration is complicated and
usually influenced by many challenges and issues, the present study was conducted to identify
collaboration challenges between the government and NGOs in providing health‑care services.
MATERIALS AND METHODS: Using a systematic review method and searching in ISI Web of
Science, Scopus, PubMed, and Embase databases, using related keyword/terms, between March
2020 and June 2020, studies on NGO‑government collaboration in the health area were collected
without time limitation. After completing the article selection process, those articles that consistent
with the research purpose were chosen for the final analysis.
RESULTS: From 4236 initially collected studies, 16 studies were chosen for the final analysis. Based
on the content analysis of the selected articles, 70 challenges were identified in the NGO‑government
collaboration to provide health‑care services. These challenges were divided into five main themes:
structural issues, process issues, issues related to roles and responsibilities, trust and communications
issues, and control and power relation issues and 11 subthemes.
CONCLUSION: The present study provides significant challenges by NGO‑government collaboration
in providing health‑care services. Awareness of these challenges plays an important role in promoting
such collaborations and enables these organizations to highly exploit the strengths of each other,
resulting in a collaboration with win–win situation.
Keywords
- Werker E, Ahmed FZ. What do nongovernmental organizations
do?. J Econ Perspect 2008;22:73‑92.
2. Damari B, Heidarnia M, Rahbari M. Role and performance
of Iranian NGOs in community health promotion. Payesh
2014;13:541‑50.
3. Shandra JM, Shandra CL, London B. Do non‑governmental
organizations impact health? A cross‑national analysis of infant
mortality. Int J Comp Soc 2010;51:137‑64.
4. Thara R, Patel V. Role of non‑governmental organizations in
mental health in India. Indian J Psychiatry 2010;52:S389‑95.
5. Delisle H, Roberts JH, Munro M, Jones L, Gyorkos TW. The role
of NGOs in global health research for development. Health Res
Policy Syst 2005;3:3.
6. Nikkhah HA, Redzuan MB. The role of NGOs in promoting
empowerment for sustainable community development. J Hum
Ecol 2010;30:85‑92.
7. Ghorbanian H, Haratiannejadi M. The right of diseases and
the role of governmental and private departments. Med Law J
2007;1:11‑41.
8. Solana EF. Public private not‑for‑profit partnerships: Delivering
public services to developing countries. Procedia Eng
2014;78:259‑64.
9. Das A, Friedman J, Kandpal E. Does involvement of local NGOs
enhance public service delivery? Cautionary evidence from a
malaria prevention program in India. Health Econ 2018;27:172‑88
10. Rouhi N, Gorji HA, Maleki M. Nongovernmental organizations
coordination models in natural hazards: A systematic review.
J Educ Health Promot 2019;8:44.
11. Piotrowicz M, Cianciara D. The role of non‑governmental
organizations in the social and the health system. Przegl
Epidemiol 2013;67:69‑74, 151‑5.
12. Smith K. Non‑governmental organizations in the health field:
Collaboration, integration and contrasting aims. Soc Sci Med
1989;29:395‑402.
13. Galway LP, Corbett KK, Zeng L. Where are the NGOs and why?
The distribution of health and development NGOs in bolivia.
Global Health 2012;8:38.
14. Nathan S, Rotem A, Ritchie J. Closing the gap: Building the
capacity of non‑government organizations as advocates for health
equity. Health Promot Int 2002;17:69‑78.
15. Okma KG, Kay A, Hockenberry S, Liu J, Watkins S. The
changing role of health‐oriented international organizations
and nongovernmental organizations. Int J Health Plann Manage
2016;31:488‑510.
16. Damari B. Role and share of Iranian governmental organizations
in public’s health. Payesh 2015;14:511‑21.
17. Bano M. Partnerships and the good‑governance agenda:
Improving service delivery through state–NGO collaborations.
Voluntas: Int J Voluntary Nonprofit Organ 2019;30:1270‑83.
18. Alonazi WB. Exploring shared risks through public‑private
partnerships in public health programs: A mixed method. BMC
Public Health 2017;17:571.
19. Sabaghpoor F, Kohan S, Aghdak P, Beigi M. Investigating the
service provision challenges by healthcare providers in selected
comprehensive health centers. J Educ Health Promot 2019;8:185.
20. Barr DA. Ethics in public health research: A research protocol
to evaluate the effectiveness of public‑private partnerships as a
means to improve health and welfare systems worldwide. Am J
Public Health 2007;97:19‑25.
21. Buse K, Waxman A. Public‑private health partnerships: A strategy
for WHO. Bull World Health Organ 2001;79:748‑54.
22. Wamai RG. Reforming Health Systems: The Role of NGOs in
Decentralization‑Lessons from Kenya and Ethiopia. Boston, USA:
Harvard School of Public Health; 2008.
23. Gulzar L, Henry B. Interorganizational collaboration for health
care between nongovernmental organizations (NGOs) in pakistan.
Soc Sci Med 2005;61:1930‑43.
24. Akukwe C. The growing influence of non governmental
organisations (NGOs) in international health: Challenges and
opportunities. J R Soc Health 1998;118:107‑15.
25. World Health Organization. Strategic Alliances: The Role of Civil
Society in Health. World Health Organization; 2001.
26. Njau RJ, Mosha FW, De Savigny D. Case studies in
public‑private‑partnership in health with the focus of enhancing
the accessibility of health interventions. Tanzan J Health Res
2009;11:235‑49.
27. Aldaba FT. Philippine NGOs and multistakeholder partnerships:
Three case studies. Voluntas: Int J Voluntary Nonprofit Organ
2002;13:179‑92.
28. Hushie M. Public‑non‑governmental organisation partnerships
for health: An exploratory study with case studies from recent
ghanaian experience. BMC Public Health 2016;16:963.
29. Mercer MA, Liskin L, Scott SJ. The role of non‑governmental
organizations in the global response to AIDS. AIDS Care
1991;3:265‑70.
30. Uwimana J, Zarowsky C, Hausler H, Jackson D. Engagement of
non‑government organisations and community care workers in
collaborative TB/HIV activities including prevention of mother to
child transmission in south africa: Opportunities and challenges.
BMC Health Serv Res 2012;12:233.
31. Numeh D, Ejike F. The role of NGOs in HIV/AIDS prevention in
Nigeria. Dialect Anthropol 2004;28:339‑52.
32. Dholakia YN. TB/HIV coordination through public private
partnership: Lessons from the field. Indian J Tuberc 2013;60:23‑7.
33. Ullah ZA, Newell JN, Ahmed JU, Hyder MK, Islam A.
Government‑NGO collaboration: The case of tuberculosis control
in Bangladesh. Health Policy Plan 2006;21:143‑55. - 34. Alam MS, Kabir MM, Hossain MS, Naher S, Ferdous NE,
Khan WA, et al. Reduction in malaria prevalence and increase
in malaria awareness in endemic districts of bangladesh. Malar
J 2016;15:552.
35. Pfeiffer J. International NGOs and primary health care in
mozambique: The need for a new model of collaboration. Soc Sci
Med 2003;56:725‑38.
36. World Health Organization. WHO and Civil Society: Linking for
Better Health. World Health Organization; 2002.
37. Piotrowicz M, Cianciara D. Associations and foundations in the
field of health care and their role in the health system of poland.
Przegl Epidemiol 2013;67:63‑8, 145‑9.
38. Aryankhesal A, Mohammadibakhsh R, Hamidi Y, Alidoost S,
Behzadifar M, Sohrabi R, et al. Interventions on reducing burnout
in physicians and nurses: A systematic review. Med J Islam Repub
Iran 2019;33:77.
39. Eftekhari MB, Mirabzadeh A, Forouzan AS, Dejman M, Afzali HM,
Djalalinia S, et al. A qualitative study of community‑based health
programs in iran: An experience of participation in I.R. Iran. Int
J Prev Med 2014;5:679‑86.
40. Biermann O, Eckhardt M, Carlfjord S, Falk M, Forsberg BC.
Collaboration between non‑governmental organizations and
public services in health‑a qualitative case study from rural
ecuador. Glob Health Action 2016;9:32237.
41. Brooke‑Sumner C, Lund C, Petersen I. Bridging the gap:
Investigating challenges and way forward for intersectoral
provision of psychosocial rehabilitation in south africa. Int J Ment
Health Syst 2016;10:21.
42. Bwimana A. Heath sector network governance and state‑building
in south kivu, democratic republic of congo. Health Policy Plan
2017;32:1476‑83.
43. Dawad S, Jobson G. Community‑based rehabilitation programme
as a model for task‑shifting. Disabil Rehabil 2011;33:1997‑2005.
44. Ejaz I, Shaikh BT, Rizvi N. NGOs and government partnership
for health systems strengthening: A qualitative study presenting
viewpoints of government, NGOs and donors in pakistan. BMC
Health Serv Res 2011;11:122.
45. Gómez‑Jauregui J. The feasibility of government partnerships
with NGOs in the reproductive health field in mexico. Reprod
Health Matters 2004;12:42‑55.
46. Heo HH, Jeong W, Che XH, Chung H. A stakeholder analysis of
community‑led collaboration to reduce health inequity in a deprived
neighbourhood in south korea. Glob Health Promot 2020;27:35‑44.
47. Mazzeo J, Makonese L. Experiences of collaboration, coordination
and efficiency in the delivery of HIV/AIDS home‑based care in
zimbabwe. Afr J AIDS Res 2009;8:443‑53.
48. Scott K, George AS, Harvey SA, Mondal Sh, Patel G, Vr R,
et al. Government helper and citizen advocate? A case study
of the multiple roles and pressures facing a nongovernmental
organization contracted by government to strengthen
community health in Northern India. Int J Health Plann Manage
2018;33:391‑404.
49. Spicer N, Harmer A, Aleshkina J, Bogdan D, Chkhatarashvili K,
Murzalieva G, et al. Circus monkeys or change agents? Civil
society advocacy for HIV/AIDS in adverse policy environments.
Soc Sci Med 2011;73:1748‑55.
50. Srivastava A, Bhattacharyya S, Gautham M, Schellenberg J,
Avan BI. Linkages between public and non‑government sectors
in healthcare: A case study from uttar pradesh, india. Glob Public
Health 2016;11:1216‑30.
51. Wandwalo E, Kapalata N, Tarimo E, Corrigan CB, Morkve O.
Collaboration between the national tuberculosis programme
and a non governmental organisation in TB/HIV care at
a district level: Experience from tanzania. Afr Health Sci
2004;4:109‑14.
52. Yagub A. Collaboration between government and
non‑governmental organizations (NGOs) in delivering curative
health services in north darfur state, sudan‑ a national report.
Iran J Public Health 2014;43:561‑71.
53. Pick S, Givaudan M, Reich MR. NGO‑government partnerships
for scaling up: Sexuality education in Mexico. Dev Pract
2008;18:164‑75.
54. Kelly JA, Somlai AM, Benotsch EG, Amirkhanian YA,
Fernandez MI, Stevenson LY, et al. Programmes, resources, and
needs of HIV‑prevention nongovernmental organizations (NGOs)
in africa, central/Eastern europe and central asia, latin america
and the caribbean. AIDS Care 2006;18:12‑21.
55. Unnithan M, Heitmeyer C. Global rights and state activism:
Reflections on civil society‑State partnerships in health in NW
India. Contrib Indian Sociol 2012;46:283‑310.
56. Nurul Alam SM. Health service delivery: The state of
government‑non‑government relations in Bangladesh. Public
Adm Dev 2011;31:273‑81.
57. Hou J, Xiao R. Identifying critical success factors of linkage
mechanism between government and non‑profit in the geo‑disaster
emergency decision. Int J Emerg Manage 2015;11:146‑68.
58. Razavi SD, Kapiriri L, Abelson J, Wilson M. Who is in and who is
out? A qualitative analysis of stakeholder participation in priority
setting for health in three districts in uganda. Health Policy Plan
2019;34:358‑69.
59. Rached DH, Ventura DF. World health organization and the
search for accountability: A critical analysis of the new framework
of engagement with non‑state actors. Cad Saude Publica
2017;33:e00100716.
60. Roche S, Hall‑Clifford R. Making surgical missions a joint
operation: NGO experiences of visiting surgical teams and the
formal health care system in guatemala. Glob Public Health
2015;10:1201‑14.
61. McLoughlin C. Factors affecting state‑non‑governmental
organization relations in service provision: Key themes from the
literature. Public Adm Dev 2011;31:240‑51.