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Strengthening health systems in poor countries: A code of conduct for nongovernmental organizations

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  • Pfeiffer, J.
  • Johnson, W.
  • Fort, M.
  • Shakow, A.
  • Hagopian, A.
  • Gloyd, S.
  • Gimbel-Sherr, K.

Abstract

The challenges facing efforts in Africa to increase access to antiretroviral HIV treatment underscore the urgent need to strengthen national health systems across the continent. However, donor aid to developing countries continues to be disproportionately channeled to international nongovernmental organizations (NGOs) rather than to ministries of health. The rapid proliferation of NGOs has provoked "brain drain" from the public sector by luring workers away with higher salaries, fragmentation of services, and increased management burdens for local authorities in many countries. Projects by NGOs sometimes can undermine the strengthening of public primary health care systems. We argue for a return to a public focus for donor aid, and for NGOs to adopt a code of conduct that establishes standards and best practices for NGO relationships with public sector health systems.

Suggested Citation

  • Pfeiffer, J. & Johnson, W. & Fort, M. & Shakow, A. & Hagopian, A. & Gloyd, S. & Gimbel-Sherr, K., 2008. "Strengthening health systems in poor countries: A code of conduct for nongovernmental organizations," American Journal of Public Health, American Public Health Association, vol. 98(12), pages 2134-2140.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2007.125989_5
    DOI: 10.2105/AJPH.2007.125989
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    Citations

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    Cited by:

    1. Qian, Nancy & Deserranno, Erika, 2020. "Aid Crowd-Out: The Effect of NGOs on Government-Provided Public Services," CEPR Discussion Papers 14755, C.E.P.R. Discussion Papers.
    2. Erika Deserranno & Aisha Nansamba & Nancy Qian, 2020. "The Unintended Consequences of NGO-Provided Aid on Government Services in Uganda," NBER Working Papers 26928, National Bureau of Economic Research, Inc.
    3. Marten, Meredith G. & Sullivan, Noelle, 2020. "Hospital side hustles: Funding conundrums and perverse incentives in Tanzania's publicly-funded health sector," Social Science & Medicine, Elsevier, vol. 244(C).
    4. Maes, Kenneth C. & Hadley, Craig & Tesfaye, Fikru & Shifferaw, Selamawit, 2010. "Food insecurity and mental health: Surprising trends among community health volunteers in Addis Ababa, Ethiopia during the 2008 food crisis," Social Science & Medicine, Elsevier, vol. 70(9), pages 1450-1457, May.
    5. Simukai Shamu & Jean Slabbert & Geoffrey Guloba & Dalene Blom & Sikhulile Khupakonke & Nomea Masihleho & Julius Kamera & Suzanne Johnson & Thato Farirai & Nkhensani Nkhwashu, 2019. "Linkage to care of HIV positive clients in a community based HIV counselling and testing programme: A success story of non-governmental organisations in a South African district," PLOS ONE, Public Library of Science, vol. 14(1), pages 1-14, January.
    6. Mackey, Timothy Ken & Liang, Bryan Albert, 2012. "Rebalancing brain drain: Exploring resource reallocation to address health worker migration and promote global health," Health Policy, Elsevier, vol. 107(1), pages 66-73.
    7. Kenneth Sherr & Antonio Mussa & Baltazar Chilundo & Sarah Gimbel & James Pfeiffer & Amy Hagopian & Stephen Gloyd, 2012. "Brain Drain and Health Workforce Distortions in Mozambique," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.
    8. Francis Amagoh, 2015. "Improving the credibility and effectiveness of non-governmental organizations," Progress in Development Studies, , vol. 15(3), pages 221-239, July.
    9. Smith, Ron J., 2015. "Healthcare under siege: Geopolitics of medical service provision in the Gaza Strip," Social Science & Medicine, Elsevier, vol. 146(C), pages 332-340.
    10. Kruk, Margaret E. & Freedman, Lynn P. & Anglin, Grace A. & Waldman, Ronald J., 2010. "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 89-97, January.

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