Collaboration between Government and NGOs in Delivering Curative Health Services in North Darfur State
7.3 Forms of collaboration between the State Ministry of Health and NGOs in providing curative health services in North Darfur State
7.3.1 Providing human resources
As shown in Table 7.2 below, 43 out of 49 (94%) interviewees stated that international NGOs provide qualified health staff for curative health services delivery in North Darfur State.
Table 7.2. Interviewees‟ responses on international NGOs providing human resources for curative health service delivery in North Darfur State.
Government levels Number of responses
Type of response Percentage (%)
Yes No Yes No Total
State level 16 13 3 81% 19% 100%
District level 20 18 2 90% 10% 100%
NGOs sector 13 12 1 92% 8% 100%
Total 49 43 6 88% 12% 100%
Source: Fieldwork Data, December 2010.
The health personnel include those working in the health facilities and community staff working in the same catchment area as the health facilities (rural areas and camps). According to a WHO report (2010:12), in North Darfur State the number of health workers managed by NGOs and who provide services to the vulnerable population (1390) is more than those of the State Ministry of Health (1164). NGOs also provide training courses for health staff in the public sector, especially for doctors, nurses and midwifes. According to the State Ministry of Health Survey Report (2010), since 2003 NGOs have provided technical assistance to hospitals, rural hospitals and health clinics in the State. As a result, more than 50 nurses have been trained to provide care and treatment; more than 23 doctors have been trained in laboratory equipment operation; and approximately six senior doctors and hospital directors have received management training.
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According to an interviewee (1-1, 18 January 2011, El Fasher) work ing in Kepkabiya rural hospital:
Without the NGO health staff who are well qualified and trained, the government cannot deliver curative health services to the poor and conflict affected- population in the State, because the government health institutions, whether rural hospitals, health centres or basic health units in Kepkabiya district, are facing a lack of human resources. NGO health staff help us to deliver curative health services, where population numbers increase in the ra iny season when malaria spreads. Without NGO health staff, the government sector does not have the capacity and capability to deliver curative health services alone to all people in the district.
7.3.2 Providing financial resources
International NGOs have been supporting the State Ministry of Health with financial resources for delivering curative health service to the poor and conflict-affected people in North Darfur State. As shown in Table 7.3 below, 47 out of 49 (96%) interviewees stated that this is the case.
Table 7.3 Interviewees‟ responses on international NGOs providing financial resources for curative health service delivery in North Darfur State.
Government levels Number of responses
Type of response Percentage (%)
Yes No Yes No Total
State level 16 15 1 94% 6% 100%
District level 20 19 1 95% 5% 100%
NGOs sector 13 13 0 100% 0% 100%
Total 49 47 2 96% 4% 100%
Source: Fieldwork Data, December 2010.
The extent of this contribution was discussed previously (see Chapter 5, especially Table 5.14 in section 5.5.1).
148 7.3.3 Providing materials and equipment
As shown in Table 7.4 below, 63% of all the interviewees and 92% of those in NGOs indicated that NGOs provide materials and equipment to government health institutions to assist with curative health services.
Table 7.4 Interviewees‟ responses on international NGOs providing materials and equipment for curative health service delivery in North Darfur State.
Government levels Number of responses
Type of response Percentage (%)
Yes No Yes No Total
State level 16 8 8 50% 50% 100%
District level 20 11 9 55% 45% 100%
NGOs sector 13 12 1 92% 8% 100%
Total 49 31 18 63% 37% 100%
Source: Fieldwork Data, December 2010.
The interviewees pointed out that the materials and equipment provided include generators, some kinds of laboratory equipment, some medical machines, beds for patients, and contributions towards maintenance of health institutions. In addition, all health centres established and managed by NGOs are provided with substantial materials and equipment, whether in rural areas or in IDP camps. This is confirmed by the State Ministry of Health Survey Report (2010), which noted that the capacity of the State Ministry of Health to provide health materials and equipment is limited.
According to an interviewee (1-2, 28 January 2011, El Fasher) working in a teaching hospital in El Fasher:
The hospital, which serves all people in the State, faces an extreme lack of modern health service appliances and equipment; 90% of health appliances and equipment in the hospital are old and some are not available. The 10% modern equipment is provided by NGOs. Therefore patients have their tests done outside the hospital in private labs. NGOs make a good effort in providing materials and equipment to
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health facilities in the public sector but what they provide is still little and does not cover all health facilities in the public sector.
According to an interviewee (1-3, 13 January 2011, El Fasher) based at the district hospital in Dar El Salam:
The NGOs provide some materials and equipment, such as generators and other small medical equipment, but still there is a lack of appliances and equipment in the hospital and there are no private clinics. Due to the lack of modern materials and equipment in public health facilities and the expensive treatment in the private sector, the majority of patients seek health care from traditional healers.
International NGOs and donors make a good effort to provide health materials and equipment to the public health facilities but still there is a need for modern materials and equipment in the public sector.
A doctor with WHO said (1-4, 13 January 2011, El Fasher) that:
NGOs, especially WHO, provide medicines for the hospital to supply the IDP patients free of charge. In this regard, there is an agreement between the State Ministry of Health and the hospital‟s administration and NGOs that the NGOs supply El Fasher teaching hospital with medicines and the rural hospitals with materials and equipment, because health institutions in the public sector face a lack of these materials and equipment.