经济

    从HIV/AIDS被发现以及成为全球健康隐患至今已有整整三十年了。

    自第一例艾滋病案例于1981年6月5日被诊断至今,已有三千万人死于这种疾病。全球领导人于上周一集聚一堂,共同对艾滋问题进行回顾与展望。虽然最新的联合国报告指出全球抗击艾滋的努力有效地降低了新增感染率,尤其是在亚太地区效果显著,但本地区仍然非常脆弱。

主持人:Sen Lam
演讲者:联合国艾滋规划署,亚太区代理司长JaneWilson



Wilson:艾滋病毒携带者的数量保持稳定,相比较2001年,新增感染者的数量确实下降了20%。因此我认为这对我们来说是一个非常重要的讯息。通过为高危群体提供高质的治疗服务,艾滋病的流行程度锐减,这个巨大的改变是我们共同的努力的结果。

    柬埔寨是全世界八个能够实现全国80%人口获得ART(抗逆转录病毒治疗)普及治疗的国家之一,这是一个非常大的成就。

    泰国对母婴之间的病毒传播的预防覆盖率也达80%。印度所取得的成就更为巨大,特别是在南印度地区。总体来说,2001年至2009年间,全球新增感染率下降25%,而在印度这一数值超过50%。如果考虑到印度的人口比例,这就是一个非常重大的发现。我认为需要强调的是,所有的这些成就都是通过一点一滴积累起来的。你也许听说过在那些地区开展的很多大型项目,医疗服务的提供、与当地政府和社区之间所建立的强大的合作关系都对项目的成功起了关键的作用。

LAM: 那么你能不能简单地给我们介绍一下太平洋地区的情况?

WILSON: 太平洋地区的数据又有所不同。从2001年至2009年,艾滋病毒携带者的数量从2万8千人升至5万7千人。和亚洲相比较,这些数值并不高,但是对于本地区来说,这确实是一个不小的数字。对于某些社会来说,影响是巨大的。这个地区非常多样化。如果你从整体来看,巴布新几内亚是本地区艾滋流行度最高的国家,感染率达0.9%,但该数值目前日趋平稳,这是共同努力的成果。该区域艾滋感染主要通过性行为传播,特别是在巴布新几内亚。但同时我们也看到注射吸毒也是主要感染途径之一,尽管数值相对较小,但在某些社区和国家却造成很大的影响。

LAM:考虑到亚洲各国发展的不同程度,以及其它社会经济因素,我们是否可以做出这样的假设:即使我们取得很多成果,但该地区仍将非常脆弱?

WILSON: 这真是个非常好的问题,因为当我们谈论覆盖率这个问题时, 尽管整个区域治疗率达31%,东南亚地区更是达到43%,但是更为重要的是如何维持现有的治疗率,如何保持我们目前所取得的成果。总体来说,性工作者、注射吸毒者、男男性行为者以及跨性别者是最容易感染艾滋病毒的群体,我们必须保证艾滋预防和治疗项目的持续性。例如,目前很多国家正在商讨自由贸易协议,这将严重威胁到病患获得药品的途径,这些协议将对整个区域产生可怕的影响。

LAM:你并未提及社会和文化因素,亚洲很多国家都设有严格的反毒品和反同性恋法律,对于性工作的立场也非常严苛。这些因素是否对艾滋病毒感染者来说构成巨大的挑战呢?

WILSON:毫无疑问,这些因素产生的影响非常巨大。我认为各国政府正逐渐意识到这些问题。很多国家,例如中国、越南、印尼,已经开始对政策进行修改,美沙酮项目和针头交换项目正在各地大量展开。我觉得总体来说,公共卫生官员已认识到性工作是一项职业,从人类出现的那一天就一直伴随着我们。但还是有很多案例,在该地区一些国家仍然保留殖民时期遗留下来的法律。我们必须废除这些过时的法律和政策,以便让大家在区域能够自由地活动,使那些携带艾滋病毒的人能够不受歧视,自由地接受预防、治疗、关爱和支持服务。

LAM: 我知道在这些国家很多项目经费都来自外国援助,而非该国自己的财政。这将也是未来发展的趋势吗?

WILSON:这确实令人担忧,特别是在某些国家,例如越南正逐渐成为中等收入国家,该国一直都非常依赖海外捐赠,但将来也许无法获得相同的捐赠。如果病人开始进行抗逆转录病毒治疗,那该治疗必须保持一生,一旦停止病人的健康将受到危害。如果病人产生抗药性,但又必须服药,那么他们只能选择那些昂贵的二线药物。因此维持目前的抗逆转录病毒治疗的管制非常重要,保证每个病患都能持续治疗,这也是预防艾滋非常重要的方法。


Asia Report 翻译

原文链接: http://www.radioaustralia.net.au/connectasia/stories/201106/s3236705.htm




It's thirty years since HIV AIDS was identified and recognised as a global health threat.


Thirty million people have died since the first AIDS case was reported on 5th June 1981. World leaders gather in New York on Monday, to look at the way forward, even though the latest United Nations report says the response to the global HIV-AIDS epidemic has resulted in a significant fall in new infections.

Asia and the Pacific registered some of the best results in stopping new HIV infections, but the region remains extremely vulnerable.


Presenter: Sen Lam
Speaker: Jane Wilson, acting director, UN AIDS, Asia and the Pacific

WILSON: The number of people living with HIV remains stable and new infections are actually twenty percent lower than they were in 2001. So I think that's a very important message to get across. They've turned their epidemics around, and they're providing quality services to their most at risk populations, so really making a very big difference. Cambodia's one of only eight countries worldwide, to have reached eighty percent universal access to anti-retroviral therapies, so that's a real success story.

Thailand also has a coverage of eighty percent for prevention of parent to child transmission services. India's really making quite significant strides, particularly South India. Compared to 2001 to 2009, overall, the average is that rates of infection have fallen by twenty-five percent globally, but India's rate of new infections has fallen by over fifty percent. And when you consider the population scale in India, that's a very, very significant finding. And I think what we say is, alot of this has been achieved by scaling up. You perhaps have heard of some of the very large programmes that are operating there. Many more points of service delivery, very strong partnership with the community and the government. This is the way these things have been achieved.


LAM: And Jane, can you give us a quick snapshot of what's happening in the Pacific?

WILSON: The Pacific, we're talking about very different numbers, as you'd know. I mean, we have between 2001 and 2009, from 28-thousand people living HIV, to 57-thousand. So if you compare with Asia, these are not large numbers, but for the Pacific, these are very significant numbers. And it can have a very major impact on their specific societies. It's a very diverse region. if you look over all, Papua New Guinea has the region's largest epidemic, with the prevalence rate of point-nine per cent but that is gradually starting to level off, so there is some progress being made in the Pacific. It is largely being driven by sexual transmission, particularly in Papua New Guinea and over all, but we are seeing injecting drug use, which is described as a small but significant factor, as becoming apparent in some communities, in some countries in the region.


LAM: And Jane, given the socio-economic factors and the uneven levels of development in Asia, may we assume then, that if gains have indeed been made, that the region is still extremely fragile?

WILSON: That's a really, really good question, because while we can talk about coverage rates, for example of treatment of thirty-one percent overall, and in Southeast Asia of forty-three percent, maintaining these treatment rates, maintaining the progress that we've reached is extremely important. Over all, the communities that are the most vulnerable to HIV, that is sex workers, people who inject drugs, men who have sex with men and transgender people, we really need to make sure that programmes aimed at prevention and treatment are maintained, and that challenges for treatment are dealt with. For example, some of the current free trade agreements being negotiated at present, really have tangible threats to accessible drugs, which would have an appalling effect on the region.


LAM: You touched a little on social and cultural factors, that many Asian countries have strict anti-drug and anti-gay laws, and also a tough stance against sex work. do these factors pose a huge challenge to HIV sufferers?

WILSON: They're absolutely massive. And I think governments are gradually becoming much more aware of these factors, and you've got significant changes of policy in countries like China, like Vietnam, like Indonesia, where methadone programmes, and needle exchange programmes are being rolled out. I think public health officials are overall, aware that sex work is a profession that's been around as long as man has been on the earth. But there're still in many cases, outdated laws. In many cases, handed down from colonial pasts, in some cases not, but these kinds of laws and policies really need to be overtaken so that people can move around the region freely, those people living with HIV and also access treatment, care and support and prevention, without experiencing discrimination.

LAM: And Jane, I understand that many of these countries don't spend their own money; that much of the funds for treatment and other programmes come in the form of foreign aid. Is that likely to be an issue in the future?

WILSON: It's extremely worrying, particularly in some countries - we take Vietnam, which is becoming a middle income country and they're very reliant on international donors and then, can't access donor funding in the same way. People when they go on anti retroviral therapy need to maintain it for the whole of life, and if they stopped taking drugs, of course their health suffers, they become resistant, and if they have to start taking drugs, they have to go to more expensive second-line drugs, so it's extremely important that drug regimes, anti retroviral regimes are maintained and that people can continue treatment, because that's also a very good way of preventing HIV infection.


Weblink: http://www.radioaustralia.net.au/connectasia/stories/201106/s3236705.htm

  In 2010, the Population Services International (PSI) program, Sun Quality Health (SQH), and its sister network of village health workers, Sun Primary Health, performed more than 2.1 million client consultations in Myanmar. John Hetherington, who has managed the network since 2007, talked to CHMI (Center for Health Market Innovations) about how--in the second-poorest country in the Asia-Pacific region--SQH has assembled one of the broadest service packages of any social franchise network operating today in an attempt to provide high quality, well regulated priority health services to local people.


CHMI: You offer a wide range of services under the Sun Quality Health brand. How do you select the services the brand will include?
John Hetherington: With a backbone of 1200 doctors in more than 200 townships, we can be entrepreneurial. We first ask, is there a need not being met? And is there an opportunity for a network of providers to offer that service? In Myanmar, the largest health concerns - malaria, family planning, pneumonia, diarrheal disease, TB - are either too expensive to treat, or doctors don't provide the right quality service. As in many places, we started with reproductive health and family planning, where there is a natural fit for social franchising.

Why is it that so many social franchising programs start by offering family planning?

JH: I think family planning is unlike other services because everyone from 15-49 is potentially a client - meaning, they are theoretically all fertile -- and this makes it different than addressing diseases which require many more inputs to be efficient, targeting, testing, etc., particularly in Asia, where many of the big diseases tend to be concentrated epidemics. With FP, you have the potential to offer (almost) anyone you interact with something that can be of service to them. You have the potential for large scale impact without the precise geographical targeting that you would need to treat an epidemic.


Without using the media to market to clients, how does your franchise attract clients?

JH: Advertising for medical services is illegal. Here, as in many countries, there are lots of people who go to their local doctors when they are ill or think they are ill. Many of these doctors have practiced for 20-30 years without continuing medical education. These are the doctors we retrain, so [with their clients] we have a captive audience, in a way.
How do you set prices?

JH: We set prices in a way that they are not a barrier to the poorest person we want to reach in the given target. We make services available at a price people are expecting--50 cents to a dollar for a malaria treatment, versus the five to six dollars it would cost otherwise. If we were not subsidizing these services, doctors would not provide them, or they might give patients the wrong drugs--give an injection, for example.

Speaking of which, how do you ensure quality?
JH: Social franchising is more complex to manage than other channels of social marketing--you need higher levels of training, monitoring and supervision.

On our staff, we have close to 80 doctors that, on average, visit each of the 1200 clinics every six weeks. They observe service delivery and answer the franchisee doctors' questions. We also send mystery clients to assure that the level of service quality remains intact. We use vignettes in training.

These techniques ensure that [franchisees] are not gauging people with prices or giving the wrong treatment. However, we don't own these clinics. We hope the training around good hygiene, infection prevention, client relationships, and counseling improves overall practices, since we don't monitor health areas outside the SQH basket of services.

Is it difficult to get providers to participate?

JH: No - their business increases. Their reputation is better, they have more services to offer, and their customers can get an IUD for 50 cents instead of 50 dollars.
In Myanmar, the public sector is not able to serve the needs of most people; 80-90% of people go to the private sector for health care. This is not unique. The private sector, while used by everyone, is atrocious in most places. With proper management, however, it can be made to do less harm--and even do very good work.
I have had surrealistic conversations with some country officials or [global health policy makers] where someone asks [a policy maker], what is your national protocol for first-line treatment for malaria? Yet, if you look at the data, 99% of people go to a pharmacy and buy drugs off the shelf. Some have to have a philosophical shift to understand this.

Describe your relationship with the Myanmar government.

JH: There is always a give and take between an NGO and the government. We have a longstanding relationship with the government in Myanmar and some of our staff are former civil servants. [Officials] appreciate that we are improving the quality of services by providing continuing medical education where there is none, and reporting on treatments not captured by the national health management information system.
The health minister has also seen the impact of Sun Quality Health. It's not minor--it's providing something like 25% of all family planning services, and we are detecting and treating more than 12% of all TB cases nationally.
We heard you are now offering screening for cervical cancer, which is very unusual even though 80% of cases occur in the developing world.

JH: Our franchising director at the time, Dr. Nyo Nyo Mihn learned a couple of years ago at a medical quality conference funded by one of our donors that you can screen [for abnormal cells] with acetic acid and treat abnormal cells with cryotherapy using Co2 in low resource environment, all without electricity. PSI's innovations fund allows us to be entrepreneurial without massive amounts of money, so we are now beginning training.

Some people in the health ministry are concerned that private sector doctors should be doing something they consider to be a hospital service. But almost no one is doing cervical screenings anywhere, so again, there is a choice of doing nothing, or doing something in partnership with the health facilities that are actually being accessed by people.

We are also piloting a basic package of anti-retroviral therapy with 100 clients, which hasn't yet been done in social marketing.

You also provide TB screening and treatment.

JH: Starting this intervention in 2004 was our biggest gamble. A recent study showed that the TB prevalence in Myanmar is five to six times higher than what was previously estimated. Now, our franchise does more than 12% of all case detection and treatment in the country.

Recently, in a village meeting, a woman spontaneously came up to us in tears. She told us she had been dying from TB and the treatment she got from a government clinic wasn't working for her. A PSI health worker told her to go to a [Sun Quality Health] doctor. She said, 'I'm healthy now and you saved my life'. I was thinking, that's one person, and there are 17,000 people every year getting that service that would otherwise die, and give TB to eight other people.

Yet, you still have people outside the country saying you can't work ethically inside the country, and the regime here can also be xenophobic. We can negotiate between those two things--the government doesn't see [the program] as impinging on their sovereignty and the opposition doesn't see it as giving succor to the regime. This model would be interesting to use in other difficult political situations, perhaps in Zimbabwe.


Organization: the Population Services International (PSI)

Learn more about Social Franchising

Weblink: http://healthmarketinnovations.org/blog/2011/may/26/how-engage-private-sector-doctors-deliver-high-quality-and-affordable-priority-care


CHMI

    国际人口服务组织(the Population Services International),Sun Quality Health (SQH)组织与其姐妹组织--Sun Primary Health乡村健康工作者网络于2010年在缅甸全国提供超过210万次健康咨询服务。于2007年接管该项目的John Hetherington接受健康市场创新组织(Center for Health Market Innovations-CHIMI)的采访,介绍SQH如何在缅甸--这个亚太地区最贫穷的国度之一,基于目前可利用的社会特许经营网络,集合最广泛的服务为当地人群提供高质、管理完善的医疗服务。

CHMI:贵机构以Sun Quality Health为商标提供各种各样的服务,你们是如何选择将要提供的服务类别的?

JH:我们遍布在全国超过200个乡镇的1200名医生能够支持我们开始工作。我们首先会询问是否有需求?如果某个资源网络有能力填补该需求空缺,是否能够为其提供机会?在缅甸,痢疾、计划生育、肺炎、腹泻以及肺结核是最大的健康问题,这些疾病要不就是治疗费用过于高昂,要不就是医生无法提供高质量的服务。在很多地区,我们首先开始提供生殖健康以及计划生育服务,这类服务对于社会特许经营来说比较容易实现。

CHMI:为什么很多社会特许经营项目都以计划生育项目开始?

JH:我认为计划生育和其它服务不一样,因为每一个年龄在15-49岁之间的人都是我们的潜在客户,理论上说她们都有怀孕的可能性。因此,计划生育项目与那些对高效的、目标性和实验性的投入要求更多的疾病防治项目有所不同,特别是在亚洲地区,很多这类疾病都是传染性的。计划生育项目几乎能够为你接触到的每个人提供一些适合她们的服务。和流行疾病项目不同,计划生育项目不需要严格地以地理面积来锁定服务目标群体,也能产生很大的影响力。

CHMI:既然你们不利用媒体来宣传,那是如何吸引顾客呢?

JH:对医疗服务做广告是违法的。和很多国家一样,在这里大家通常都找本地的医生看病。很多医生已经行医20-30年了,但在这段时间中却没有持续接受相关医疗教育。我们对这些人进行培训,这样做也同时能留住他们的老顾客。

CHMI:你们如何定价?

JH:对于项目锁定的目标群体中最贫困的人来说,我们所设定的价格不会对他们造成任何障碍。我们所提供的服务的价格都保持在人们的预期范围内:疟疾治疗我们每次收费50美分至一美元,其它地方对该项服务的收费大约是五、六美元。如果我们不补贴这些医疗服务,医生将拒绝诊断病患,或者有可能不对症下药。

CHMI: 说到这里,你们如何保证医疗质量?

JH:社会特许经营比起其它种类的社会营销管理起来都更为复杂,需要更高级别的培训、管理和监督。我们整个医生团队人数将近80人,平均每六个星期对1200个诊所逐个访问。他们观察诊所医生的工作情况,并解答他们所提出的问题。我们也派遣一些"便衣"病患去就诊,以检查医疗质量是否能保持一致。

用这些方法能够确保特许经营方不乱向病患收费,也能保证医疗服务的质量。但是这些合作的诊所并非我们所有。我们希望通过对卫生学、传染预防、客户关系以及咨询服务开展培训来提高医疗特许经营的实践的整体效果。

CHMI: 让医护人员加入这个项目是否困难?

JH:不,事实上他们的工作量增加了,声望也越来越大,所提供的服务也越来越多。现在他们的顾客花50美分就能够买到一个节育器(IUD),而过去需要美元。在缅甸,公共医疗无法满足大部分人的需求,80-90%的人在私营医院接受医疗服务。这种情况并不罕见。然而大多地方的私营医疗机构却非常糟糕,但如果能够对其进行适当的管理,这些机构将能够为公众提供很好的服务。

CHMI:请向我们描述你与缅甸政府的关系?

JH:非政府组织(NGO)与政府之间永远是合作与让步并行。我们与缅甸政府已结成一个长期的关系,这个项目里也有很多工作人员曾经是公务员。我们通过持续地提供医疗教育来改善服务质量,并对治疗的情况进行及时的汇报,这些工作目前在缅甸仍是一片空白,因此政府对我们的工作表示欣赏。

缅甸卫生部部长也看到了Sun Quality Health项目的影响力。我们的计划生育服务占该服务全国总量的25%,我们也对全国12%的肺结核病例开展追踪治疗,这并不是个小数目。


Asia Report 翻译

组织: the Population Services International (PSI)-- 国际人口服务组织

了解社会特许经营(Social Franchising


原文链接: http://healthmarketinnovations.org/blog/2011/may/26/how-engage-private-sector-doctors-deliver-high-quality-and-affordable-priority-care
组织:

The Open Society Foundations

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  投资家和慈善家George Soros1984年成立开放社会基金会(The Open Society Foundations)。项目活动遍及美洲、欧洲、亚洲、非洲和南美洲。基金会通过推动建立完善的政治、法律和经济系统来塑造健全的公共政策。

 

网址:http://www.soros.org/

 

联络方式:

Open Society Foundations
400 West 59th Street
New York, NY 10019, U.S.A.
Tel. 1-212-548-0600
Fax. 1-212-548-4600

组织:

IRIN

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IRIN是全球知名的人道主义网络新闻媒体,其新闻以及分析报道涵盖世界多数未经报道以及被忽略的地区。IRIN为世界各地超过100万的读者提供第一线的人道主义报道。

根据2008年全球市场营销公司ACNielsen调查,IRIN被读者选为人道主义新闻来源的首选网站,其报道广泛用于计划、倡导、政策发展的制定。

根据IRIN统计,网站主要读者52%为人道主义工作者,就职于各个国际/本国非政府组织,联合国、政府、资助方、人道主义与发展咨询公司。25%的读者来自学界,包括学者、老师、研究人员、分析员、智库、学生。9%的读者为媒体从业人员。14%为其他从业者,包括公司员工、私营者、军人等。

 

网址:http://www.irinnews.org/

组织:

RTI International

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    RTI International是世界顶级的研究机构,致力于通过把知识转化为行动来改善人类生存状况。机构2800余名研究人员为40多国政府提供研究和技术服务,涵盖主题包括:健康和药物、教育和培训、调查和统计、先进技术、国际发展、经济和社会政策、能源和环境、以及实验和化学分析。

 

网址:http://www.rti.org/

 

联络方式:

 

新闻媒体处
E-mail: news@rti.org
Lisa Bistreich: 919-316-3596
Patrick Gibbons: 919-541-6136

 

卫理公会联合救灾委员会(UMCOR)是联合卫公理会下一个非营利性的全球人道救援机构。包括美国在内,UMCOR在世界80多个国家实施项目。以宣传耶稣教义为基础,该机构以减少人类痛苦为工作重点,无论这种痛苦来自于战争、冲突或是自然灾害。

 

UMCOR和本土机构合作,共同致力于帮助生还者重建家园,帮助其恢复生计以及身体健康。UMCOR的项目范围主要包括:消除贫困和饥饿、可持续农业、国际和国内紧急救援、难民和移民问题、全球健康问题、过渡性发展等。

 

网站:http://new.gbgm-umc.org/umcor/

 

联系方式:
United Methodist Committee on Relief
地址:475 Riverside Drive, Room 1522, New York, NY 10115
电话: 212-870-3951
Email umcor@gbgm-umc.org

UMCOR International Field Offices (NGO)
地址:475 Riverside Drive, Room 1530
电话: 212-870-3552
传真: 212-870-3508
Email umcor_office@umcor.org

 

组织:

OXFAM 乐施会

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    乐施会是一个由14个机构共同组成的国际联盟,乐施会与地方合作伙伴在世界98个国家实施项目,致力于消除贫穷,以及与贫穷有关的不公平现象。

    乐施会深入社区开展项目,希望通过赋权改善贫困人口的生活,并有机会参与到政策制定的过程中来。

 

我们做什么

通过发起解决紧急事件的倡导运动,研究如何与他人合作共同对抗贫苦和社会不公。

 

为什么我们这么做

我们相信尊重人权能帮助人们走出贫困。

 

乐施会国际办事处

主席: Keith Johnston

副主席:Michael Henry

主管:Jeremy Hobbs

财务主管:Monique Letourneau

 

网址:http://www.oxfam.org/

 

地址:Oxfam International Secretariat,Suite 20 ,266 Banbury Road, Oxford OX2 7DL, United Kingdom

传真: +44 1865 339 101

电话: +44 1865 339 100

 

IRIN


YANGON, 1 March 2011  - The international community should make better use of local NGOs and community-based organizations in Myanmar, while at the same time building capacity among them, aid officials say.

"Local NGOs... have local knowledge, contacts and they don't have to worry about getting permission on planning and resources from a central head office. They also have little problem accessing different parts of the country," said Walter Davis, programme manager for Paung Ku, a consortium of 11 international and local organizations established in 2007 to strengthen civil society in Myanmar.

But as things stand, most donors continue to funnel money through international NGOs (INGOs), which at times compete with local groups.

"INGOs need to change to do more capacity building. The rules of engagement still see local NGOs as subcontractors because their capacity is weaker," said Aung Tun Thet, a senior adviser to the UN Resident Coordinator in Myanmar.

"INGOs need to decide whether they are in direct competition with [local organizations] or whether they are here to mentor local NGOs," he added.

Post-Nargis growth

Cyclone Nargis in 2008 spawned hundreds of civil society organizations to cope with the humanitarian crisis that killed a reported 140,000 and affected another 2.4 million, by UN estimates.

"Nargis was a catalytic push for the mushrooming of local NGOs. There were 50 times as many NGOs as before," said Aung Tun Thet.

"Faced with the magnitude of Cyclone Nargis, donors needed to find a way to give money and not go through the government - the elephant in the room," he added.

Local groups were a natural funding vehicle as they reacted most quickly when the tidal surge hit.

But when the government declared an end to the tsunami's emergency phase in 2010, many of these same NGOs collapsed or turned to development activities - often lacking basic capacity to carry out the work.

"With such rapid evolution [of NGOs activated by Cyclone Nargis], the rigor required of NGOs did not accompany this expansion. These groups have good intentions but lack basic rudimentary management skills," said Aung Tun Thet.

Too often, local groups have been recruited and supported to serve the project needs of INGOs, but not beyond, said Ingeborg Moa, Myanmar director of Norwegian People's Aid, which has supported dozens of local groups since 2004.

"If more funding could be [made] available for organizational development, capacity building and support for initiatives that aim to strengthen local organizations' overall capacities, not just their capacity to 'deliver services' as implementing partners of international organizations, this would be a big step in the right direction," said Moa.

Removing barriers

Focusing on so-called shortcomings in local accounting and management systems may be misguided, according to a December report by Paung Ku, which includes Save the Children, Oxfam and CARE, as well as local groups.

Receipts, for example, are often difficult to obtain in Myanmar, leaving many organizations unable by international standards to account for resources and unable to qualify for international funds, Davis said.

"Myanmar has a long history of using accountability mechanisms related to religious donations, with Buddhist monks playing a key check and balance role. Strengthening these existing frameworks may ultimately be more effective in building accountability than continuing to use imported concepts," said Davis.

A cumbersome government NGO registration process is an additional obstacle for local groups to tap international funds.

"The government would not allow any group without a [memorandum of understanding] to accept donor funds. What is needed is a more transparent registration process," said Aung Tun Thet.

An official at the local relief NGO, Aung Yadanar, based in the town of Pyapon in southern Myanmar, said he applied for registration soon after he co-founded the NGO in 2008 - but has yet to receive any news.

"In the meanwhile, we have to keep [a] good relationship with township authorities so that we can do our job."

Even without being formally registered, the group still receives funding from the UK Department for International Development, which also provides technical assistance along with the Ministry of Agriculture.

There are an estimated 300 NGOs working in Myanmar, of which a maximum 10 percent are registered, according to the UN Myanmar Information Management Unit (MIMU).


Weblink:http://www.irinnews.org/report.aspx?ReportID=91949

Organization:Paung Ku



 

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