Changing Health in South Africa

Topic: Towards New Perspectives in Research

Author(s): Dr Derek Yach

Place: California

Organization: The Henry J. Kaiser Family Foundation

Description: COHRED’s Working Group on Community Involvement conducted five country case studies, including the following one in Bangladesh.

With a population of about 123 million people, with a majority living in rural areas, Bangladesh faced real problems of community representation. Nearly half of its citizens live in poverty and only 45% of people over 7 years-old are literate. Local government structures are weak in terms of resources and development functions. In this context, NGOs have played an important role in social welfare activities, and later in promoting community participation in development. Bangladesh has an important presence of NGOs, with over 2,000 registered in the area of health and population alone.

The Bangladesh Rural Advancement Committee (BRAC) played a key role in the process of implementing ENHR and housed the ENHR Secretariat. In national workshops on ENHR, NGOs were well represented and even constituted the largest category of participants. Likewise, the National Forum and the Working Group for ENHR have a high proportion of NGO representatives. This is based on the assumption that NGO involvement ensures community participation. The question is: in what sense do NGOs represent communities?

The obvious answer is that NGOs are a community of interests and represent themselves in the ENHR process. But group discussions held in connection with the Bangladesh study suggested more concern with how the NGOs might represent their grass-roots target groups. One view was that there was indirect community participation in ENHR because the NGO representatives belong to organizations that work directly with people at grass-roots level and therefore reflect their health needs and perspectives. A more critical view was that NGO executives attend workshops and sit on committees and have little direct interaction with poor villagers. Lower level (frontline) NGO personnel might be better representatives.

Date: 1991

Page Number: 120



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