About Mother NGOs (MNGOs)
The Government of India and several state governments have been encouraging NGO involvement in various development sectors over the years. Well-established GO-NGO collaborative models are available in the sectors of Education, Women and Child Development, HIV/AIDS and Natural Resource Management amongst others. The collaborators are as partners in primary health care for over two decades and more recently in the area of Reproductive and Child Health (RCH).
MNGO Scheme 1997- 2000
The Mother NGO (MNGO) scheme was introduced in the Department of Family Welfare (DFW) on the 9th Five Year Plan, (1997-2000) under the Reproductive and Child Health (RCH) program. The underlying philosophy of the MNGO scheme is one of nurturing and capacity building through partnership between larger NGOs and smaller NGOs.
From the time of inception in 1998/99,till March 2003, 105 Mother NGOs (MNGOs) and over 800 field NGOs (FNGOs) have been participating in the scheme. More MNGOs and FNGOs are expected to join by end of December 2004 under the revised NGO scheme, which is likely to take up the numbers to nearly 300 MNGOs including Service NGOs. The presentation of the scheme as it evolved is divided into two sections, from 1998-2000 till 2004 in-order to highlight the learning and processes adopted for strengthening the partnership effort.
The design of the MNGO scheme during the 9th five year plan placed a major focus on capacity building of implementing NGOs. A number of positive outcomes are available in terms of FNGO gaining management and technical skills and leveraging resources with other donors and thus graduating to applying for MNGO status.
MNGO Scheme 2001- 2004
The MNGO scheme has witnessed a very active period from the early 2001 and 2003 in terms of introduction of policies and changes in program content towards strengthening GO-NGO partnership. The National Population Policy 2000, National Health Policy 2000, National Health Policy (NHP) 2002 and 10th plan document (2003-2008) which place emphasis on decentralization and RCH service delivery using a gender sensitive approach, guided the development of revised NGO guidelines. Apart from the policy framework, field insights from the MNGO/FNGO evaluations and lessons from other NGO initiatives guided the above process. For example, the GOI-UNFPA supported initiative titled “Support to Gender Issues” (SGI) (1999-2003) focused on gaining greater understanding of gender issues in RCH and mainstreaming gender through partnership and transfer of knowledge between large and small NGOs.
The key learning from the SGI project includes: Capacity building goes beyond making funds available. Selection of the technical support unit must be done carefully to avoid friction with the implementing NGOs. Creating frequent interaction opportunities between NGOs and the state/district government and among NGOs for sharing and learning, establishment of enabling mechanisms, and organized systems that bring clarity in roles and responsibilities for all the stakeholders, are critical for strengthening partnership and capacity building.
The period between 2001-2003 could also be termed as a period of transition for the MNGO scheme. The revised guidelines development required that the number of procedural administrative and program content issues were discussed adopting a participatory and consultative process by governments and NGOs, prior to finalizing the guidelines. Accordingly, in 2003, all of the existing 105 existing MNGO went through an orientation on the revised guidelines, providing them with an opportunity to comment and provide feedback on the various aspects of the implementation. \five regional level advocacy workshops were organized to orient the state government health officials and an opportunity to provide their views, perspectives and suggestions.
Strategies for Strengthening Partnerships
The revised guidelines have identified strategies that would promote and strengthen collaboration and partnership between and among the stakeholders. The overall approach shifted from a project mode to a program mode (from one-year cycle to 3-5 year cycle) thereby creating an opportunity for a longer period of collaboration and involvement of NGOs and Government. Rationalization of NGO jurisdiction (reducing coverage from 5-8 districts or more to 1-2 only) is expected to facilitate intensive NGO involvement and bring in more NGO participation in the process of population stabilization through RCH services. The pool of MNGOs will expand from the current 105 to nearly 300, including new category of Service NGOs, under which each NGO will provide exclusively clinical services covering 100,000 population. Under the revised mode, NGOs are expected to provide RCH service delivery in addition to addressing the awareness education requirement.
Administrative strategy such as establishment of a smooth fund flow mechanism for program implementation is expected to improve trust between the NGOs and the government in order to reduce uncertainties of receipt of funds.
Another strategy that could build trust and enhance mutual understanding between the NGO and the district level health functionaries is the identification of un-served and under-served areas with poor RCH indicators for NGO involvement, jointly by the MNGO and the district health functionaries.
MNGOs/FNGOs will complement the government system in service provision related to FP, Immunization, MCH and access to institutional delivery. RTI/STI, adolescent reproductive health care, male involvement would be addressed wherever required and as per community need. The FNGOs will implement service delivery interventions in collaboration with PRI, sub center, PHC and district health system as the case may be.
Sharing of responsibilities between GOI and the state government through decentralization of program management and implementation at the state and district levels, is attempted as another step in partnership building. This measure is also expected to enhance ownership at state and district levels since the State RCH Society has been identified as the structure that would manage the entire process and provide policy support. The district NGO committee (formed by district RCH Society) is responsible for management and monitoring of the project implementation at the field level. Role of Government of India is related to provision of policy guidelines, technical support for capacity building and fund release to state government.
Partnership would thrive only when systems are available for establishing accountability of both NGO and the government. While NGO accountability is established through performance and outcome indicators, accountability of the government system is established through the involvement of state and district health functionaries in the program management and different stages of implementation and supportive supervision.
A mechanism for supporting the department of Family Welfare at the state level has been instituted with the appointment of State NGO Coordinators (SNGOC). The SNGOCs are responsible for monitoring the implementation, facilitating timely submission of NGO reports the state government and facilitating NGO dialogue with the district health system. Initially 11 coordinators were identified and placed. The rest of the states are in the process of identifying the coordinators. Though initially there has been resistance in accepting the state coordinators as part of the state team, slowly the acceptance level seems to improve.
Technical Advisory Group (TAG)
One of the weakness repeatedly identified in the MNGO scheme was the absence of a mechanism for enhancing government understanding of the NGOs and their work, as well as brining NGO perspectives into government policy making process. Formation of the technical advisory group (TAG) to some extent addressed the issue.
TAG came into existence in may 2001, bringing in a mix of policy, advocacy and technical expertise drawn from DFW, state governments, CAPART, planning commission, national level NGOs, academic institutions, individual experts, UNFPA and advocacy groups. Primarily, TAG is expected to provide guidance on how capacity building of NGOs could be undertaken to improve reproductive child health (RCH) and how partnerships with NGOs may be strengthened.
During the same period, 2 national level MNGO consultations in kolkatta and kodaikanal organized by the NGO division, GOI, clearly brought the demand for support organizations to meet a wide range of technical and managerial needs of the NGOs. Based on the MNGO demand, the TAG in June 2001 developed the profile of the regional resource centers (RRC), which became a reality in January 2002, with the support of UNFPA. On a pilot basis four RRCs were identified to provide support to all the existing 105 MNGOs.
Apart from the RRCs, the TAG recommended identification of best practices centers (BPC) to complement the efforts of the RRCs. Setting up of an Apex Resource Cell (ARC) was also recommended at the national level that could effectively coordinate the interventions of RRCs, strengthen RRC liaison with the state governments and assist NGO division with technical input related to NGO scheme.
The TAG also made recommendations that the GOI needs to develop a national level NGO strategy and NGO guidelines. Towards this, it was recommended that scattered and stand alone NGO projects that have no capacity for scaling up or for replication could be closed and specific projects addressing cross cutting issues such as gender may be mainstreamed as per the requirements of RCH II. The implementation of the innovative schemes, supported by GOI, have been stand alone and have not been able to demonstrate their ability to be replicated or up-scaled to regional or state levels.
Similarly, closing up of all the other small NGO projects that began during the 7th and 8th five year plan such as rolling fund scheme, special methods and sterilization schemes, model scheme for promotion of small family norms and population control, private voluntary Organizations on Health 1 and 2, was recommended. While welcoming a national perspective on NGO programs, the NGOs voiced their concern that since understanding gender issues and specifically gender in RCH context us complex, pilot experiences have to be supported for some time more.
Till September 2003 TAG met every quarter and gave critical input to the government for streamlining the NGO scheme, inline with the proposed goals of RCH II under the 10th plan period. The TAG guided the sub group working on the NGO guidelines revision, by critiquing the various draft in-order to build coherence in the NGO scheme and avoid duplication. By December 2003, the NGO guidelines were finalized and wide dissemination at MNGO and state levels began through state level GO-NGO partnership workshops, MNGO consultations cum training, and GOI website. Feedback from MNGOs and government officials is being considered for further simplification and modification in the guidelines.
The major advantage of the TAG is bringing collective input to policy-making processes with due respect to diverse views, that facilitated speedy decision-making process within the government. |
