Where are the NGOs and why? The distribution of health and development NGOs in Bolivia

Galway, Corbett, Zeng, Zeng Leilei

Description

The presence and influence of nongovernmental organizations (NGOs) in the landscape of global health and development have dramatically increased over the past several decades. The distribution of NGO activity and the ways in which contextual factors influence the distribution of NGO activity across geographies merit study. This paper explores the distribution of NGO activity, using Bolivia as a case study, and identifies local factors that are related to the distribution of NGO activity across municipalities in Bolivia. Methods The research question is addressed using a geographic information system (GIS) and multiple regression analyses of count data. We used count data of the total number of NGO projects across Bolivian municipalities to measure NGO activity both in general and in the health sector specifically and national census data for explanatory variables of interest. Results This study provides one of the first empirical analyses exploring factors related to the distribution of NGO activity at the national scale. Our analyses show that NGO activity in Bolivia, both in general and health-sector specific, is distributed unevenly across the country. Results indicate that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. Results for NGO activity in general and health-sector specific NGO activity were similar. Conclusions The uneven distribution of NGO activity may suggest a lack of co-ordination among NGOs working in Bolivia as well as a lack of co-ordination among NGO funders. Co-ordination of NGO activity is most needed in regions characterized by high NGO activity in order to avoid duplication of services and programmes and inefficient use of limited resources. Our findings also indicate that neither general nor health specific NGO activity is related to population need, when defined as population health status or education level or poverty levels. Considering these results we discuss broader implications for global health and development and make several recommendations relevant for development and health practice and research.

Sujets

• Non-governmental organization
• Bolivia
• Linear regression
• Count data

Informations

• Publié par: biomed
• Publié le: 01 janvier 2012
• Nombre de lectures: 5
• Langue: English
• Poids de l'ouvrage: 1 Mo

Extrait

Galwayet al. Globalization and Health2012,8:38 http://www.globalizationandhealth.com/content/8/1/38

R E S E A R C HOpen Access Where are the NGOs and why? The distribution of health and development NGOs in Bolivia 1* 12 Lindsay P Galway, Kitty K Corbettand Leilei Zeng

Abstract Background:The presence and influence of nongovernmental organizations (NGOs) in the landscape of global health and development have dramatically increased over the past several decades. The distribution of NGO activity and the ways in which contextual factors influence the distribution of NGO activity across geographies merit study. This paper explores the distribution of NGO activity, using Bolivia as a case study, and identifies local factors that are related to the distribution of NGO activity across municipalities in Bolivia. Methods:The research question is addressed using a geographic information system (GIS) and multiple regression analyses of count data. We used count data of the total number of NGO projects across Bolivian municipalities to measure NGO activity both in general and in the health sector specifically and national census data for explanatory variables of interest. Results:This study provides one of the first empirical analyses exploring factors related to the distribution of NGO activity at the national scale. Our analyses show that NGO activity in Bolivia, both in general and healthsector specific, is distributed unevenly across the country. Results indicate that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. Results for NGO activity in general and healthsector specific NGO activity were similar. Conclusions:The uneven distribution of NGO activity may suggest a lack of coordination among NGOs working in Bolivia as well as a lack of coordination among NGO funders. Coordination of NGO activity is most needed in regions characterized by high NGO activity in order to avoid duplication of services and programmes and inefficient use of limited resources. Our findings also indicate that neither general nor health specific NGO activity is related to population need, when defined as population health status or education level or poverty levels. Considering these results we discuss broader implications for global health and development and make several recommendations relevant for development and health practice and research. Keywords:Nongovernmental organizations, NGOs, Global health and development, Bolivia, Multiple regression, Count data

Introduction Nongovernmental organizations (NGOs) have become increasingly important players in the realm of global health and development. They operate projects in low and middleincome countries (LMICs) throughout the world. Their number has grown twentyfold since 1951 and increasingly donors prefer to channel aid to and through NGOS rather than directly to foreign governments [1]. In 2006, transfers of official development aid to NGOs

* Correspondence: [e-mail] 1 Faculty of Health Sciences, Simon Fraser University, Blusson Hall 8888 University Drive, Burnaby, BC V5A 1S6, Canada Full list of author information is available at the end of the article

totaled more than $2 billion (US) according to OECD statistic and services such as education and health care, historically managed and implemented by the public sector, are increasingly provided by NGOs [2,3]. Despite the growing prominence of NGOs in LMICs, the ways in which these organizations influence and are influenced by the context in which they work is not well understood. NGO research has emphasized exploration of the impacts of individual organizations or projects, often overlooking the broader implications of NGOs and their work [4,5]. Relative to their importance, systematic and empirical analyses of NGOs in global settings are

© 2012 Galway et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.