The role of non-governmental organisations in strengthening the South African health system: a commentary

Abstract

The need to strengthen the South African health system (public and private) has long been acknowledged. South Africa's failure to meet the health-related Millennium Development Goals (Byass et al., 2015) and the challenges to meet the Sustainable Development Goals, especially given the impact of COVID-19 on health outcomes, point to the need to strengthen the health system.Various policies have been developed to address the challenges experienced by the system -the latest of which is National Health Insurance (NHI). Many Ministers of Health have recognised that government working alone will not be able to solve the many challenges that the health sector faces. In this commentary, we focus on non-governmental organisations and their roles in supporting government to strengthen the health system.International non-governmental organisations (NGOs) have a long history of working in lowand middle-income countries. These range from missionaries and religious organisations, humanitarian groups, social rights-oriented NGOs, health and human rights groups, university-based organisations, and contactors (Birn et al., 2017). The roles played by these organisations and groups are diverse, ranging from research, humanitarian interventions, advocacy for human, social and health rights, health systems strengthening as well as the provision of direct health services, usually to the most vulnerable and marginalised.Many authors have commented on the role of international organisations. These range from those that argue that such assistance is another form of colonialism or post-colonialism (Hanchey, 2018;Kim, 2021). The continuing impact of colonialism and racism has received recent attention in the context of global health and the role of universities from the global north. For example, Daffé et al. ( 2021) noted that, . . . one way the 'coloniality of knowledge' shows up is in our norms and perceptions surrounding expertise (p. 558). By knowingly or unwittingly devaluing the expertise of local collaborators and indigenous populations -their lived experience or other ways of knowing -we reproduce colonial practices and miss critical opportunities for impact.

Intersectionality in South African health care – what is to be done?

“…• • Access and innovation in the health sector must include all relevant stakeholders, including NGOs. Pillay (2022) details the role of NGOs in the provision and improvement of health care services. • • Mental health services should form an integral part of primary health care.…”

Creating International Student Experiences Through Academic–INGO Partnerships

“…One strategy that academic institutions can use to design effective, mutually beneficial STEGHs is through development of a cross-cultural partnership with an international nongovernmental organization (INGO). It has been well established that INGOs play a key role in humanitarian work and provision of health outreach in underserved communities throughout the world (Pillay, 2022; Storeng et al, 2019). However, there is a paucity of descriptive information about academic–INGO partnerships for creating mutually beneficial STEGHs and educational partnerships.…”