161840 Good governance and health: Creating a healthy platform for democracy

Monday, November 5, 2007: 2:50 PM

Gamal El-Khatib , Pathfinder International Egypt, Maadi, Cairo, Egypt
Andy Cole , Pathfinder International Egypt, Maadi, Cairo, Egypt
Taroub Faramand, MD, MPH , Palestinian Health Sector Reform and Development (Flagship) Project, Chemonics International Inc., Ramallah, Palestine
Mohamed Abou Nar, MS, MBA , TAHSEEN/CATALYST, Cairo, Egypt
International research indicates that poor governance negatively impacts economic and social development. The Pathfinder International-managed Takamol Project, which will operate in 12 governorates and 200 clinics promotes democracy and good governance through its integrated health model, which improves physical infrastructure, builds community trust, empowers individuals, and encourages dialogue between society and government.

Takamol's integrated activities start with community meetings involving project staff, local government health officials, community and religious leaders, and local residents in an open forum of discussion where project goals and objectives are discussed. The provision of a tangible asset follows a renovated health facility. The delivery of tangible enhancements to benefit the entire community develops a sense of trust in the project, donors, local leaders, and government. Often previously lacking, this trust serves to stabilize the community and encourages democratic processes.

Takamol emphasizes transparent and accountable local governance by signing governorate-level Memoranda of Understanding, forming or re-forming clinic management boards through a democratic election process, reactivating clinic service improvement funds, which the boards are trained to manage, and making clinic ledgers and workplans open to public scrutiny. The involvement of local NGOs, women's groups, business associations, religious leaders, schools, youth, outreach workers, governorate leaders, and literacy facilitators across a broad range of project activities creates opportunities for democratic discourse between locals and the authorities. These opportunities not only increase healthy behavior but encourage greater openness in society, create opportunities for people to participate in local governance, and increase transparency and accountability in how local services operate.

Learning Objectives:
1. Recognize the importance of community trust in promoting democracy and good governance 2. Assess to what degree health projects in the developing world contribute to improved governance 3. Articulate how transparency and accountability encourage good governance at the local level.

Keywords: International Reproductive Health, Government

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.