Background: Non-governmental organizations (NGOs) operate within the process of health sector reform in many countries throughout the world. A model of the process and content of health sector reform was developed using a concept analysis and integrated review of the literature. The model depicts the flow of influence and ideas of reform and reveals external, intermediary, and internal players within a context of precipitating factors. Tools and strategies of reform are developed and provided for internal providers. The model depicts NGOs as increasingly important in the provision of health care around the world. However, little is known about the relationships between NGOs and other planners and providers. Purpose: The purpose of this study was to explore the nature of Nicaraguan NGOs' multiple relationships within the context of health sector reform. Methods, Sample and Analysis: A multiple-case, embedded units strategy was used with two case NGOs and their relationships with the ministry of health, donors, communities served, and other NGOs. Data sources included documents, participant observation, and semi-structured interviews. Data analysis was done by case and across cases using naturalistic methods. Results: Study findings clarify the specific influence of precipitating factors. National NGOs do not experience the same pressure to utilize the tools and strategies as do other provider groups. In addition, NGOs have a much more in depth relationship with the community they serve than the model of reform would advocate. A typology of NGO relationships also emerged.
Learning Objectives: 1) To explore the nature of Nicaraguan NGOs' multiple relationships within the context of health sector reform, and 2) To decribe the relationships between NGOs and other planners and providers
Keywords: Health Care Reform, International
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.