Global Health Practitioner ConferenceSilver Spring, 9 May 2014

Dr. Roma Solomon

Individuals and organizations independent of the government

Civil society includes…Activist groups

Civic groups

Clubs (sports, social, etc.)

CBOs & FBOs

Environmental groupsNGOs

PVOs

Policy institutions

Professional associations

Political parties

Social enterprises

Trade unions

Non-Profit Organisations (NPOs)

Academia

Charities

Cooperatives

Men’s /Women’s groups

Consumers

How are we perceived??Watch Dogs/Pet dogs?

Activists/Champions of rights? Fault finders?

How do we perceive ourselves?

• Backbenchers ?• Loud campaigners / Belligerent activists?• Champions of the underdog ?• Hesitant Do-gooders ?• Spies & fault finders?• Anti government ?

CredibleEqual partners with a supporting attitudeTechnically sound and armed with data

Action orientedInnovators

What should be our perception?

Why should Civil Society be engaged?

Civil Society is usually understood as the social arena that exists between the state and the individual or household *

Though it lacks the coercive or regulatory power of the state and the economic power of the market, it provides the

social power or influence of ordinarypeople.

This social power/capital is our USP

* WHO Discussion Paper Dec. 2001

Key features of civil society organizations

• Articulating citizens' interests and demands • Defending rights

• Providing goods and services directly.

Civil society & Government Expectations from each other?

• Is only the government expected to be accountable?• Mutual respect for each others’

experience and potential to make efforts, complementary• Ability to see eye to eye and recognizing

each others’ limitations

CSOs provides excellent laboratories for pioneering new methods and strategies in a

relatively efficacious and cost-effective manner.

They combine the spread and reach of government with depth and flexibility - the

ideal method for achieving development objectives.

Potential of civil society

Harnessing this Potential

An Example

The India Polio Programme

• Government – Prime implementers• WHO - Technical support & surveillance • Rotary International – Advocacy & Funding• Unicef & CORE– Communication & Social mobilization

The Polio Partnership

What was the need to engage civil society?

• Children were being missed

• Rumours were spreading

• Resistance was building up

Understanding of community needs• Communities were being

taken for granted • Communication was

prescriptive • Baggage of “We know what is

good for you” unloaded • Timing as per vaccinators’

convenience • It was NOT positioned as a

peoples program

• Community/leaders/institutions did not believe in the program

• It was not a priority for families• Suspicions about the vaccine• Trust deficit between government &

community

Identification of Barriers

Overcoming these Barriers

Lessons we Learnt!

• The key - Equal partnership!

• NO blame game

• Timely response – put out smaller fires before they spread

• Give facts

http://youtu.be/6wzatF6TiHI

Workers need to be equipped with

knowledge and the ability to transfer this knowledge to others

Knowledge leads to change in attitude

and behaviour

Capacities of front line staff were built

to analyse resistance and develop ‘Negotiation' approaches

Shift from instructive to negotiation approach

Identification and engagement of influencers –

children, priests, local healers,

barbers, ration shop owners,

film stars, cricketers, etc

• Strategies were tailor made for various audiences

• Special initiatives kept the program exciting & alive for implementers & caregivers

Involvement of religious & other community leaders

• Religious institutions engaged to handle communication with specific groups

• Each query was heard & responded to with facts

• Burning issues were tackled immediately

Religious scholars were able to counter negative propaganda against immunization based on their

interpretation of the Quran and Hadees

Importance of Data

• Data collection and compilation• Recording & documentation of successes and

failures.

All led to a strong MIS that supported planning and implementation of effective activities

27th March 2014Declaration of A Polio-Free India

Sharing lessons with other CORE Group Polio Project countries

Nigeria, S. Sudan, Angola, Ethiopia &

Horn of Africa

Support in communication strategies, disease surveillance, IEC material, M&E

systems, mHealth, etc

Using the Polio Legacy to improve Routine Immunisation

• Shoring up Routine Immunisation alongside

polio• Microplanning• Identifying High-risk groups and tracking

unimmunised children • Capacity building of frontline workers

Recognition at last!!Traditionally CSOs have provided services to the

underserved but are usually left out of policy making and planning.

GAVI formed a CSO Constituency Providing a seat on the Board not only gave

recognition but also paved the way to the engagement of CSOs in other health

programmes

GAVI’s Strategic Goal 2Strengthening health systems to deliver

immunisation

Under this goal, GAVI provided an umbrella grant to the Steering Committee of the GAVI

CSO constituency. CRS was nominated as the fund manager and

national level CSO platforms were formed in 23 countries for effective engagement in health

systems strengthening and immunisation.

WORKINGTOGETHER

WORKS!