Monday, December 10, 2012




Third Annual Public Health Conference, Health Services Academy, Islamabd, Pakistan

Role of NGOs in Addressing Social Determinants of Health

Najibullah Safi, MD, MSc.HPM

Social Determinants of Health (SDH) refer to broad social factors that lead to or influence health and development. They are the conditions in which people are born, grow, live, work and age, including the health system. These conditions are formed by the distribution of money, power and resources at global, national and local levels. The SDH are mostly responsible for health inequities seen within and between countries. In order to respond to the increasing concern about these persisting inequities in health, it is necessary to involve collaborative partners as catalysts for change at global, national and local levels. Partners can be NGOs, community based organization, government agencies, corporations, academic institutions, and faith communities etc.
Action on health must involve the whole of government, civil society and local communities, business, global fora, and international agencies. The Social Determinants of a Community Health or development may be unique to a particular community or group, or may be part of the larger society. Therefore, it is necessary to use participatory approach to analyze and address SDH.
Collecting community based data and holding consultation with grassroots are critical in understanding the bottlenecks for services delivery. NGOs are well positioned to partner with for data collection, bottleneck analysis and in addressing those barriers to social services delivery. 
The Rio Political Declaration on SDH (October 2011) re-emphased that civil society including NGOs can play an important role in ensuring transparent governance; participation in policy and planning; foster collaboration; advocacy; social mobilization; implementation of intervention addressing the SDH and the establishment of an appropriate monitoring system for measuring the progress.
NGOs are uniquely placed to reach out to communities, to express their needs, and to engage in a grass roots dialogue about SDH and the ways to address them. Experience from around the globe indicates that NGOs are playing an important role in addressing SDH through identifying the various social factors affecting health and development, mediation, community organization, health education and promotion, capacity building at the local levels, establishment of coalition and partnership and advocacy at local, national and global levels.  The role of NGOs in addressing SDH is gradually increasing as they are growing in size, quality and impact. They are shifting their focus from charity to development and advocacy; linked to marginalized groups and local communities on the grass root level; are focusing on alternative strategies in development and contributing to the development of innovative demonstrative models for addressing social and developmental issues.
In developing countries including Pakistan and Afghanistan due to limited capacity and growing perception of lack of transparency the public sector has failed to deliver the results according to the needs and expectations of the people. Therefore, the international partners are increasingly engaging the civil society and NGOs to address rampant poverty, illiteracy, poor access to health care and other social services.