Approach Paper to Health
Background
ARAVALI was initiated as an organisation in the mid nineties to
facilitate the process of collaboration among government and Voluntary
agencies and while doing so ARAVALI has taken two pronged approach. It
has worked with the government to improve the environment within which
partnerships develop and has worked with the NGOs to help themselves
enhance their capacities to be able to take more evolved role that
partnerships require.
Working with small and medium voluntary organizations over the past 10
years and living with them through their growth process has provided us
with a better understanding of what these organizations require. During
the process of providing the generic and sector specific inputs in the
field of microfinance, agriculture, natural resource management etc we
realized that our partners need concurrent support in the health
programmes as well within their organization and that there is a need to
build their perspective on health from boarder livelihood framework
(where the health expenditure seems to be maximum from a family). We
also feel a necessity to enter into the field of health very concretely
as the NRHM framework provides a platform for partnerships to broaden.
The increased expectations have highlighted the lack of institutional
and individual capacity to address health system constraints. These
constraints include lack of capacities of voluntary agencies to fulfill
their roles and responsibilities in addressing health system issues.
ARAVALI being a catalyst in the partnership development process strongly
feels that the ground of any partnership lies in the capacity to keep
promises made in the partnership agreement. Given the due commitment to
partnership arrangements in NRHM it is required to build the sector for
the expected roles.
Over the last 3 years, we have taken few initiatives on health,
(although not in a strategic manner). Some of our initiatives include
assessment of NGOs for Rajasthan State AIDS Control society under the
target intervention project on HIV/AIDS, facilitating discussions on
health in the GO-NGO-PRI forums in Dholpur, Baran and Jhalawar districts
of Rajasthan, providing institutional and to some extent technical
trainings to NGOs who are working on health issues on various components
of maternal and child health.
ARAVALI has also initiated its dialogue with the NGO community which is
engaged in addressing the health issues. The process of understanding
the capacity building requirements of the voluntary sector is on.
ARAVALI organised a workshop at Udaipur in collaboration with ARTH to
understand the voluntary sector needs in terms of capacities. The
workshop was instrumental in highlighting some of the critical areas of
capacity building.
Idea
ARAVALI intends to take a role in health as a support organisation.
However ARAVALI needs to develop certain capacities within the
organisation to undertake such a support process. ARAVALI would not like
to thrust an approach or strategy but attempt to develop on the NGOs own
ideas relating to their work in health/ livelihood with the community
further. The support plan has two components-one related to the
organisation and one to the programme. Where ARAVALI can provide sector
specific support ARAVALI will do so. In the event that the capacities
are not available with ARAVALI, we will help the organisation link up
with some other support agency, which can provide support.
Statement of Intent
ARAVALI intends to increase the number and capacity of effective
organisations working on health in every district of Rajasthan which
will enhance the quality of life of the community. ARAVALI’s mission has
its focus on most deprived people of the society and the most effective
way to reach to them is through credible NGOs having a genuine and
sustainable relationship with the community. In the next three years
ARAVALI wishes to support 20 small and medium sized NGOs to achieve
enough level of capacities and skills to play significant role in health
sector. This will be done through the following mechanisms:
Develop the capacity of the target NGOs to be able to understand the
health sector and enable them to either strengthen their existing
programmes or initiate programmes in the health sector.
Strengthen community outreach and advocacy skills within target NGOs to
promote better quality of primary health.
Promote constructive engagement and policy dialogue among various
stakeholders on the issue of primary health care in the state of
Rajasthan.
Strategies
ARAVALI will not aim to get into the technical space of working on
health issues but focus on developing institutional capacities to be
able to work on health. This is also proposed to be done by developing a
better understanding among these organisations on the social
determinants of health, and understanding of the health service delivery
structures in Rajasthan and also importantly, through the understanding
of the various issues (including demographics) on health.
To start with the process ARAVALI would work on:
• Research,
• Capacity Building and
• Collaborations.
Research
For ARAVALI to gain an in-depth understanding of the present health
scenario in Rajasthan we would look forward to:
Identify community health issues (with specific focus on social
determinants of health and primary health care) across regions through
our partner organizations and reviewing the secondary data available in
the state.
ARAVALI will then asses the approaches and capacities of organisations
which are working on health issues or are willing to work on health in
future (this will be done through primary data collection and intensive
hand holding of NGOs.).
Map the donors/other agencies strategy on addressing health issues in
the state. (It is essential to understand how donors/other agencies look
at health, what is their perspective and approach to it and what are the
different health support mechanisms available in different regions of
the state with the support of these agencies.)
Capacity Building
The NGOs have a very critical role to play in health sector as health
care providers, disseminators of health education and catalysts for
mobilizing communities to address health needs and to advocate for
better delivery of health services. To develop and enhance the
capacities of the NGOs to carry out the above mentioned roles require
strategic planning and concrete efforts.
Our capacity building assistance for around 25-30 small and medium sized
NGOs to achieve health for all will incorporate both sector specific and
generic inputs. The capacity building initiative will include the
following reinforcing elements:
Participatory organization assessment: an approach and a set of tools
for helping NGOs to identify own problems, work out options for handling
with, develop an action plan for capacity building and organize to carry
the plan out. This will be done for both the institutional capacity
building needs and the capacities required for the sector.
Need-based and customized organization development assistance: an
approach to providing organization development training and follow on
consultations to the target health NGOs. It will be adapted to fit
customized needs of the target organization in terms of both the
institutional and sector specific.
Participatory Community Reflection and Action Planning: Shall have a
focus on training on community empowerment approaches and skills that
lead to an increased outreach and the establishment of confidence skills
and strategy within the organization for solving community health needs.
Collaborations
ARAVALI will make an attempt to facilitate the process through creation
of a forum for constructive dialogue, ensuring that the capacities
required for collaboration in NGOs are more generic widespread and
standardised and Government programmes are modified and designed for
constructive collaboration.
In the present context given the opportunities like the National Rural
Health Mission, the NGOs are seen as critical partners in performing
national and regional goals towards attainment of the vision called
“Health for All”. ARAVALI will make an attempt to understand the role of
different stakeholders under the mission, the partnership process,
mechanisms, gaps etc.
Based on our experiences of the GO-NGO-PRI forum in the bordering
districts of Rajasthan (Dholpur, Baran and Jhalawar districts of
Rajasthan) ARAVALI will try to initiate these forums in the other
districts to address various health issues.
Linkages with other Organisations
ARAVALI has a very limited in-house capacity in health sector and thus
there is need to build internal capacities on health to address the
capacity building needs of our partner organisations on health. To move
further on this we need to collaborate with agencies like ARTH, IIHMR,
Prayas etc to be able to access core competencies on health.