Local Civil Society Organizations Research Articles

Assessing the role of non-state actors in health service delivery and health system resilience in Myanmar

BackgroundDue to the weaknesses of the public health system and its low reach, especially in border areas, provision of health services by non-state actors (NSAs) has historically played an important role in Myanmar. NSAs include local and international NGOs and civil society organisations (CSOs), but also Ethnic Health Organisations (EHOs) in the border areas, as well as the private (for profit) sector. This study aims to understand the changing role of NSAs in the shifting political environment of Myanmar between 2010 and 2022, and to explore their contribution to health system resilience.MethodsOur study includes three main components: a documentary review (n = 22), key informant interviews (KIIs) at central level (n = 14) and two township-level case studies (13 KIIs, 4 FGDs). Mostly qualitative data were collected in 2022 and synthesized, using a health system resilience framework to structure the analysis.ResultsDuring the transition period (2010–2014) and the new political era (2015–2020), while the country gradually transitioned to a democratic system, the government increasingly recognized NSAs. Initially, engagement with NSAs remained focused on disease-specific activities and government oversight was limited, but later it expanded to health system strengthening, including the start of a “convergence” with ethnic health systems. Progress was relatively slow, but defined by a clear vision and plans. The military coup of February 2021 brought a halt to this progress. Collaboration between government and NSAs was interrupted, and NSAs restored previous practices and parallel systems. Initially, most health service provision stopped, but with time coping strategies emerged, which showed the capacity of NSAs to absorb the shocks (focusing on basic services; using informal communication channels; maintaining buffer stocks of supplies) and adapt (changing modes of delivery and supply chains, and adjusting HRH training).ConclusionsThe study highlights the role of NSAs during crises, and provides insights on how the resilience capacities built over time by NSAs to provide services in adverse circumstances have informed the response to the latest crisis. While strategies of absorption and adaptation are noted in the study, we did not identify any transformation strategy – which might indicate the difficulty of NSAs to introduce radical changes when subjected to multiple shocks and a hostile political environment.

FERTILITY CARE IN LOW AND MIDDLE INCOME COUNTRIES: Implementing fertility care: insights from a participatory workshop in The Gambia.

The Gambia, West Africa, has made recent progress on infertility, a component of sexual and reproductive health that is lagging behind others. Since 2016, there is favourable policy environment stemming from infertility research and partnership building with national stakeholders and local civil society organisations focussing on infertility. Here, we report outcomes from a participatory workshop on infertility policy implementation in The Gambia and provide insights on setting national priorities for fertility care in resource-limited settings. We conducted a participatory workshop involving 29 participants from Gambia's public and private health sectors. Using selected participatory group work tools, stakeholders identified and prioritised key activities within the framework of five pre-defined areas of action, including (i) creating guidelines/regulations; (ii) recording/reporting data; (iii) building public-private partnerships; (iv) training health providers; and (v) raising awareness and health-seeking. A total of 17 prioritised activities were proposed across the five action areas, according to short-, medium-, and long-term timeframes. Three were further prioritised from the overall pool, through group consensus. A group model building activity helped to envision the complexity by elucidating links, loops, and connections between each activity and their expected outcomes. The participatory workshop identified actionable interventions for fertility care in The Gambia, with stakeholders setting a clear path ahead. Despite challenges, the continued engagement of Gambian policymakers, practitioners, researchers, and activists in efforts to move beyond policy creation to its implementation is essential. Improving fertility care in The Gambia and other low- and middle-income countries is feasible with effective collaboration and financial support. In The Gambia, a partnership of stakeholders from various domains, including research, grassroots activism, clinicians, and policymakers, contributed to an increased awareness of infertility. This, in turn, led to the inclusion of infertility in the national reproductive health strategic plan. An in-country participatory workshop involving participants from both public and private health sectors was held in October 2023 with the objective of identifying priorities for moving beyond planning to implementation, within the context of resource constraints. The top three identified priorities were: (i) training about infertility for health providers; (ii) harmonisation of data collection; and (iii) the development of clinical guidelines for infertility management. It is important for the Gambian Ministry of Health to implement these proposed locally relevant fertility care activities. Despite current and future challenges, having a clear vision and pathway will help establish fertility care in the country, with Gambia potentially leading the way among many other countries.

Public sector readiness for value co-creation: the diffusion of a governance innovation

IMPACT Public services, particularly in sparsely populated areas, are increasingly required to demonstrate their value—especially in terms of the public benefits they provide to local communities. In Scandinavia, local civil society organizations have long been overlooked as key partners in creating public value together with municipalities. Since 2010, Sweden has been experimenting with collaborative co-creation models that involve both municipal and third sector service providers. This article explores the specifics and reception of such models in rural areas of Finland and identifies the key lessons learned. It delves into the impact of legal frameworks and entrenched public sector norms on the success of these initiatives. The aim is to enhance the understanding of the prerequisites for applying this model among public and civil society actors.

Toward better pandemic governance and preparedness: South Korea’s whole-of-nation approach to COVID-19

BackgroundThe profound impact of coronavirus disease (COVID-19) has led to an increased demand for sustainable pandemic governance practices. This study explored emerging hybrid governance practices that provide robust evidence on how to address the complex challenges of pandemics effectively. South Korea, which was severely affected by COVID-19, has implemented a novel governance approach using a whole-of-nation (WoN) model. This hybrid pandemic governance approach, which integrates both whole-of-government and whole-of-society approaches, has enabled synergistic and cohesive multi-sectoral coordination among all stakeholders (public authorities, private enterprises, and civil society) to address multifaceted challenges collectively and strengthen their resilience capacity. This study investigated South Korea’s WoN practices and their embedded context and identified key governance enablers facilitating this approach.MethodsThis study employed a case study design based on an extensive analysis of policy and program documents, drawing on South Korea’s publicly available data from January 1, 2020 to March 30, 2023. It assessed six system-level collaborative pandemic governance practices and key enablers, all of which were intended to fortify the country’s pandemic response.ResultsThe primary areas of the country’s WoN governance practices for COVID-19 control were (i) whole-of-government policy-making and response, (ii) COVID-19 testing system, (iii) digital surveillance of COVID-19, (iv) COVID-19 triage and treatment system, (v) domestic vaccine production, and (vi) community engagement. Key governance enablers for implementing the WoN model were establishing a legal foundation, ensuring decisive and strong governance and leadership, increasing public investment, applying a whole-of-health approach with augmented investment in public health, enhancing crisis communication, and mobilizing local leaders and civil society organizations in the national public health response.ConclusionsIn exploring innovative approaches to pandemic governance for increased efficacy, responsiveness, and impact, the WoN approach emerged as highly relevant. This example of emerging practice allows policy-makers to re-evaluate their governance strategies and initiatives to improve multi-agency partnerships across the country in their pandemic-preparedness planning.

Programme science in action: lessons from an observational study of HIV prevention programming for key populations in Lusaka, Zambia.

Optimizing uptake of pre-exposure prophylaxis (PrEP) for individuals at risk of HIV acquisition has been challenging despite clear scientific evidence and normative guidelines, particularly for key populations (KPs) such as men who have sex with men (MSM), female sex workers (FSWs), transgender (TG) people and persons who inject drugs (PWID). Applying an iterative Programme Science cycle, building on the effective programme coverage framework, we describe the approach used by the Centre for Infectious Disease Research in Zambia (CIDRZ) to scale up PrEP delivery and address inequities in PrEP access for KP in Lusaka, Zambia. In 2019, CIDRZ partnered with 10 local KP civil society organizations (CSOs) and the Ministry of Health (MOH) to offer HIV services within KP-designated community safe spaces. KP CSO partners led KP mobilization, managed safe spaces and delivered peer support; MOH organized clinicians and clinical commodities; and CIDRZ provided technical oversight. In December 2021, we introduced a community-based intervention focused on PrEP delivery in venues where KP socialize. We collected routine programme data from September 2019 to June 2023 using programme-specific tools and the national electronic health record. We estimated the before-after effects of our intervention on PrEP uptake, continuation and equity for KP using descriptive statistics and interrupted time series regression, and used mixed-effects regression to estimate marginal probabilities of PrEP continuity. Most (25,658) of the 38,307 (67.0%) Key Population Investment Fund beneficiaries were reached with HIV prevention services at community-based venues. In total, 23,527 (61.4%) received HIV testing services, with 15,508 (65.9%) testing HIV negative and found PrEP eligible, and 15,241 (98.3%) initiating PrEP. Across all programme quarters and KP types, PrEP uptake was >90%. After introducing venue-based PrEP delivery, PrEP uptake (98.7% after vs. 96.5% before, p<0.001) and the number of initiations (p=0.014) increased significantly. The proportion of KP with ≥1 PrEP continuation visit within 6 months of initiation was unchanged post-intervention (46.7%, 95% confidence interval [CI]: 45.7%, 47.6%) versus pre-intervention (47.2%, 95% CI: 45.4%, 49.1%). Applying Programme Science principles, we demonstrate how decentralizing HIV prevention services to KP venues and safe spaces in partnership with KP CSOs enabled successful community-based PrEP delivery beyond the reach of traditional facility-based services.

Why do some cities support irregular migrants? Qualitative comparative analysis of municipal activism for irregular migrants in 13 European global cities

ABSTRACT The present study seeks to understand under which conditions cities enact inclusionary policies and practices for irregular migrants. Previous research points out the influence of political ideology, local autonomy, economic capacity, diversity, or civil society alliances. We argue that a city’s proactive and supportive stance towards irregular migrants may not be explained fully by one or another single factor, but rather by their combination. Through a fuzzy-set Qualitative Comparative Analysis of 13 European cities, it was found that the combination of a political discrepancy between the local government and national state, as well as local alliances between the municipality and local civil society organizations, is a necessary condition for municipalities to take a proactive and supportive stance towards irregular migrants.

The experience of intercultural mediators in the Italian COVID-19 vaccination campaign

ABSTRACT This research investigates the experience of intercultural mediators who worked with local health authorities and civil society organizations to disseminate information about COVID-19 vaccines to migrants in two Italian territories. Interviews with intercultural mediators underlined the challenges that they faced when translating on the frontline of the vaccination campaign, including the translation of highly specialized terminology and the handling of vaccine-hesitant narratives circulating among the migrant population. In the context of COVID-19, translation involved not only transmission between languages, but also a negotiation between medical discourse and the hopes, concerns, fears, and desires of a culturally and linguistically diverse population.

Locally Led Opportunities for Water, Sanitation and Hygiene, Climate Change and Gender Equality Partnerships in the Blue Pacific

Partnerships between water, sanitation and hygiene (WASH) and rights-holder organisations (RHOs) have become more common, important and impactful in the international development sector, and they have been driven by aligned agendas, mutual benefits and the pursuit of locally owned and inclusive development agendas. There are opportunities to broaden partnerships and coalitions to include climate change advocacy, adaptation and mitigation organisations given the increased focus on the links between WASH, resilience and climate change action. This article takes a first step in addressing the question: How can the experience of WASH, gender equality and climate organisation partnerships and coalitions in the Blue Pacific inform the WASH sector in its growing support of and investment in diverse partnerships in support of localism? We conducted a systematic scoping review to identify the literature on gender equality, WASH and climate change-related partnerships and coalitions in the Blue Pacific. Three key themes emerged from the systematic scoping review based on 23 studies published from 1996 to 2024. Firstly, partnerships and coalitions are part of a critical localism agenda, though care needs to be taken by potential partners and donors to understand and manage power dynamics between actors and organisations working within and across sectors. Secondly, a range of benefits and success factors have been documented on partnerships and coalitions in the Blue Pacific, including support for emerging leadership, leveraging policy outcomes, facilitating learning and the sharing of frameworks and tools between partners. Thirdly, like all parts of the community and governance ecosystem, gender dynamics and social norms inform and influence partnerships and coalitions. At the same time, partnerships are important for informing and driving gender equality and inclusion at the local and regional levels including within the WASH sector. This article is useful for local actors, donors and civil society organisations wishing to pursue the mutually beneficial goals of WASH, gender equality, climate change action and localisation in the Blue Pacific.

Equipping local self governments and development practitioners in managing common pool resources – A case of Pampa River in Kerala State, India

Governments face challenges and constraints in managing Common Pool Resources (CPRs) worldwide. Almost all developing countries have begun to implement decentralised policies and decision-making systems for delivering public services and the management of environmental goods. In any government structure, distributing public goods is difficult as it will be challenging to exclude potential beneficiaries from obtaining the goods. Similarly, it’s challenging to exclude potential beneficiaries from obtaining benefits from common pool resources. The phenomenal work ‘Governing of Commons’ argues that the CPRs can be managed locally, provided there need to be well-defined institutions at the local level. The actors can govern CPRs themselves to obtain mutual benefits from the CPRs by avoiding problems of exclusion of beneficiaries, conflicts and exploitation of resources. For establishing well-defined rules and norms, it is essential to have constant deliberations and participation of various actors for collective action in managing CPRs. However, at the decentralised level, most local governments have given less attention to prompt decision-making in CPRs, especially concerning environmental resources. This article investigates the capacity and role of local-level institutions in managing CPRs by discussing a Training of Trainers (ToT) programme associated with the health of the Pampa River in Kerala State, India. The ToT programme has helped 41 development practitioners to change their approach toward River Health Management. The deliberations have resulted in an alliance of practitioners and a people’s framework for action projects. It was also studied that the role of local governments and civil society organisations in influencing the decisions made regarding River Health Management has to be improved.

Development of Students' Leadership at University Level: Perceptions and Perspective

The study examines student leadership, its importance, and the various factors involved in cultivating and growing student leaders. Effective student leadership fosters a sense of belonging, raises engagement levels, and enables people to take an active role in their education. Student leaders need to encourage, support, and work towards addressing societal issues like poverty, healthcare, and environmental sustainability. Student leaders collaborate with local and national civil society organizations working on anti-corruption initiatives. There is a growing curiosity about student leadership`s effects on learners, educational institutions, and society as a whole. The design of the quantitative investigation was created. The study's population consisted of all public and private universities in Lahore that have been accredited by HEC. The method of stratified sampling was applied. A public institution and a private university were chosen. A total of 100 students from public and 100 from private universities were taken into consideration. 200 students made up the sample in total. The results suggest certain aspects of leadership emphasizing the significance of the university environment including educational and co-curricular activities.

Environmental and economic sustainability and conservation of natural resources in the context of rural territories

The impact of human activity on the environment is becoming increasingly evident in the modern world. Growing industrialization, the use of natural resources, and environmental pollution lead to serious environmental problems at the global level. In this context, preserving natural resources in rural areas is particularly important. Villages and rural areas, an essential component of society, also play a crucial role in ensuring environmental and economic sustainability. Balanced environmental and economic sustainability in rural areas is a task that requires a comprehensive approach and interaction between different actors, including local authorities, communities, businesses, and civil society organizations. Environmental sustainability involves preserving the diversity of nature, maintaining ecosystems, and using resources rationally without harming the environment. Economic sustainability is the development of agriculture and enterprises that provide vital goods and services while preserving the region's ecological integrity. The study aims to analyze the ecological and economic sustainability of rural areas and provide recommendations on preserving natural resources and ensuring their sustainable development. This article analyzes various aspects of the environmental and economic sustainability of rural areas in Ukraine. The importance of preserving natural resources, the possibility of using new technologies for sustainable agriculture, and the role of communities and the state in achieving these goals are considered. The trends and critical issues are assessed across dimensions like natural resource management, pollution in rural areas, etc., drawing upon data from national statistics, government reports, academic studies, and field surveys. It is determined that it is necessary to implement measures aimed at conserving natural resources to ensure the sustainable development of rural areas. This is achieved by introducing resource-saving and environmentally friendly technologies, developing alternative energy sources, promoting environmental culture, and improving the socio-economic situation in rural areas. This is achieved by creating new jobs, developing infrastructure, and providing social services. An essential condition for ensuring the sustainable development of rural areas is an integrated approach that considers all these factors. Rural areas play an essential role in ensuring food security and sustainable development of the country. However, in the process of economic activity in rural areas, significant environmental and economic problems arise that threaten the sustainability of these areas. Particular attention should be focused on integrated approaches that enhance synergies between the economic, environmental, and social spheres rather than individual initiatives. The importance of involving rural residents is emphasized to implement sustainability principles in rural lifestyles and institutions. Keywords: sustainable development, rural areas of Ukraine, theoretical aspects, practical aspects, environmental sustainability, economic sustainability, natural resource conservation, agriculture, communities.

Breaking The Silence: Civil society organizations promoting women’s personal security against sexual violence in Jombang Islamic boarding schools

The prevalence of sexual violence against women (SVAW) in Indonesian Islamic boarding schools highlights that these institutions have not yet become safe spaces. The physical and psychological harm of sexual violence experienced by women poses a significant threat to their human security, a fundamental right that the state should ideally ensure. However, promoting personal security requires the collective support of society as a whole. This study focuses on Jombang Regency's pesantren (Islamic boarding schools), which is renowned as a city of Islamic education or “Kota Santri”. It explores the role of local civil society organizations (CSOs) in promoting personal security against sexual violence in these settings. Through qualitative methods such as in-depth interviews with CSOs’ representatives and a comprehensive literature review from 2017 to 2022, the research reveals that CSOs in Jombang Regency engage in prevention, protection, and empowerment. However, the roles are not fully optimized, particularly in terms of protection, due to limited implementation and a focus on case management. The findings highlight the importance of implementing binding policies to govern pesantren management and encourage active participation in preventing and addressing sexual violence within religious educational institutions.&#x0D; CSOs, islamic boarding school, personal security, pesantren, sexual violence against women

At the Intersections of Gender Inequality and State Fragility in Africa

ABSTRACT Intersectionality has become a widely used theoretical lens through which scholars examine women’s political and economic participation. Intersectional frameworks analyze the ways in which formal state structures produce gender inequalities. It is precisely this conceptual and empirical strength that make a theory originally rooted in the experiences of Black women in the United States, applicable to other groups of women in a range of national contexts. Extensive debates surround the generalizability of intersectional theory. Using my work on gender inequality as a predictor of state fragility in the African region, this piece addresses these questions both conceptually and methodologically. My larger project is a cross-national study; however, I will use original country case study datasets from women’s local civil society organizations in Nigeria and Ghana to illustrate the relationships between institutionalized inequalities and the mobilization efforts of different groups of women. First, I begin by defining intersectionality. Next, I combine African feminists and African Muslim feminists’ theoretical contributions which extend and expand intersectionality. This piece contributes to conversations about the ways in which intersectionality can be applied to other groups of Black women outside of the United States. Third, I demonstrate how intersectionality is used to capture the range of priorities and strategies activists used to define and promote gender equality within formal state structures.

Counter-Hegemonic Resistance and Framing of the Anti–KORUS FTA Protests in South Korea

Abstract: This study analyzes the framing of protests against the Korea–United States Free Trade Agreement (KORUS FTA), arguably one of the most significant and contentious contemporary movement events that occurred in South Korea. The anti-KORUS FTA protests have drawn the largest public, committed to challenging the hegemonic rhetoric of the Korean government's neoliberal policy initiatives, by asserting the trade deal as posing various social and economic ills to human life. Drawing on the combined framework of Gramscian analysis and the framing perspective, this study highlights the ways in which the anti-KORUS FTA protest activism exercises power by disseminating alternative discourse against the existing political condition. By examining a broad range of data, the study identifies three specific counter-hegemonic framings of collective action used by local civil society organizations to delegitimize the official discourse—'neoliberalism as the problem,' 'public accountability,' and 'national independence.'

How to Leverage Action Research to Develop Context-specific Capacity Building for Civil Society Organizations

Abstract In recent decades, increased attention has been given to the hierarchical nature and intrinsic power dynamics of CSO capacity building programs. In a global context, international donors tend to design and implement capacity building programs, which then prioritize donors’ objectives and employ Western concepts in the Global South. This research note aims to reframe capacity building around inclusive and equal partnerships centered on civil society leaders who participate in designing and delivering capacity building programs. We propose action research as a process for co-creating contextually appropriate models that enable local ownership for capacity building and thus equip civil society to improve the lives of people in communities. We apply this approach to the Liberian case to develop a process to engage local civil society organizations in developing participatory capacity building programs that address place-based needs in non-Western contexts.

Local civil society organisations’ appreciation of different local policy decision-making instruments

ABSTRACT In societies with a neo-corporatist tradition, organised interests like civil society organisations (CSOs) are largely embedded in the policy-making process. However, as (local) governments increasingly experiment with new forms of democratic innovation, this challenges the traditionally privileged position of CSOs in the policy-making process. We investigate the attitudes of local CSOs towards different types of policy decision-making instruments with an increasing level of decision-making power by individual citizens. Cluster analysis and a subsequent multinomial logistic regression analysis on survey data show that the extent to which CSOs appreciate increased participation of individual citizens is related to an organisation’s role in democracy (policy influence) and relationship with local government (financial dependence).

Community Participation in the Implementation of Development in the Panamas Village, Selat District, Kapuas Regency

This research focuses on community participation in implementing development in the Panamas Village, Selat District, Kapuas Regency. This study is designed to measure the level of participation, understand the factors that encourage and inhibit participation, and provide recommendations for increasing community involvement in development. The research methodology was carried out through in-depth interviews and focus group discussions with various stakeholders. The research results show that the level of community participation in the development process still varies, with some segments of society being more active than others. Factors influencing this include knowledge of the development project, access to information, trust in local government, and capacity to participate. The study notes that increased communication and transparency, as well as community empowerment through education and training, can be effective strategies to deepen community participation. The results of this study are expected to contribute to the local government and civil society organizations in efforts to increase community participation in development in the Panamas Village.

지방도시 정책 과정의 협력적 거버넌스

Drawing on Ansell and Gash(2007)’s Collaborative Governance model, this study attempts to explain how and why a city succeeds in making a policy solution in the seemingly non-partisan, re-distributive tasks such as inviting a General University Hospital to a locality. A basically identical policy initiatives taken by two mostly similar port cities (Yeosu and Gunsan) in Cholla region, Korea are compared. Collaborations among local power elites, university hospital leaders and local civil society organizations are analyzed through both elite interviews and observations on the flow of events. Efforts by Gunsan was successful while that by Yeosu was not. Itemized analyses find that the policy process in both cities commonly show low-level collaborative governance, especially in the domains of accountability and responsiveness. That in Gunsan, nevertheless, shows a comparatively higher-level collaboration among the actors in the domains of participation, autonomy, network, openness, trust and institutionalization. The researchers interpret it as the key to the success. In conclusion they emphasize both voluntary collaboration, trust-building and network-making among actors in the process.

Operationalizing Food System Governance: The Case of Fort Portal Food Change Lab

Transforming the current food system into one which delivers healthy, sustainable diets will require some form of governance. Due to the complex nature of the food system, multi-stakeholder platforms (MSPs), which bring together actors from multiple sectors into a shared space for joint decision making, have been proposed as one potential governance structure. Using the Food Change Lab, a multi-stakeholder platform led by a local civil society organization in Fort Portal, Uganda, as a case study, this paper uses an explicit conceptual framework for food system governance to understand how such an MSP can support improved food system outcomes. Local-level, civil-society-led MSPs have a limited ability to support a system-based problem framing, due to a tension between a holistic view of the system and identifying concrete entry points for action. They can support boundary spanning by creating horizontal linkages but are less effective in creating vertical linkages due to their locally embedded nature. Because such MSPs are not dependent on formal policy processes, they can be very adaptable and flexible in prioritizing issues and focus areas. The greatest influence of such MSPs in food governance is in supporting inclusiveness, especially of marginalized voices. While such MSPs are unlikely to be able to achieve food system transformation alone, they do play a key role in engaging with marginalized groups, supporting inclusion of local issues and promoting alternative food system visions.

Civil society organisations in and against the state: Advice, advocacy and activism on the margins of the labour market

AbstractThis article contributes to our understanding of the complex role of civil society organisations (CSOs) in tackling precariousness through advice, advocacy and activism. It draws on qualitative data gathered primarily from two local CSOs in the north of England that help clients navigate a highly flexible labour market and an increasingly punitive welfare system. The findings reveal that in marginalised communities, CSOs compensate for retreating state services by providing clients with individual advice and advocacy, but there is little evidence of the grassroots activism observed in labour CSOs in North America. We argue that the uneven tradition of community organising across cities in the UK combined with the complex dependencies of service‐oriented CSOs on state resources has restricted their role to that of labour market intermediaries that serve primarily to integrate clients into low‐wage jobs.