Research about "The contribution of the international fund to developing the Palestinian health care system: focus NGOs, Palestine, 2013". PPT

2.  To assess the contributions of the IF
through the NGOs in developing the
PHCS in the Gaza Strip, thus providing
suggestions about the appropriate
utilization of donated funds.
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3.  To illustrate the nature, features and trends of the internationally
donated funds.
 To appraise the relevance, appropriateness, effectiveness and
sustainability of the IF.
 To assess the contribution of the IF in supporting HCS different
components.
 To identify strengths, weaknesses and factors affecting the IF.
 To provide recommendations for better utilization of IF in
supporting PHCS.
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4. Relevancy & Appropriateness
Political, economical & financial factors
Characteristics: Types, features, nature,
mechanisms, S & W
Input (IF)
Coordination & Process Output
cooperation
Efficiency, M&E
Transparency & Responsiveness to Palestinian society needs
governance NGO development
Meeting NHGs & MDGs (Indicators)
Effectiveness & Sustainability
Self developed
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5. Methodology
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6. Descriptive analytic design, with
triangulation between qualitative
and quantitative approaches.
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7. All Palestinian health NGOs (59) that work in the GS which are
concerned in the health field and receive external fund in the
implementation of its activities. 6 of them actually inactive.
The study participants was 53 health NGOs were included but
the organizations that responded were 48 health NGOs.
Response rate: The study population formed 53 health
PNGOs and only 48 health PNGOs responded with a
response rate 90%.
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8. The study focus on health PNGOs, it
was conducted at the 48 selected health
PNGOs in all GS governorates in
Palestine to reflect representative
results.
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9.  The study was conducted in November
2011 till April 2012. Actual data was
collected in November 2011 to January
2012. Data analysis and discussion was
completed in March and April 2012.
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10.  Quantitatively: Census sampling approach was used.
MOH, MOI, UNESCO directory, PNGOs cluster and HI
Guide lists was obtained, they were merged into one
single list, then the NGOs that were frequently, inactive,
closed, or the organizations that that do not work in
providing health services were excluded. They
were 59 NGOs, 53 NGOs meet the criteria and 6 did not.
 Qualitatively: Purposive sampling approach was used.
conducting In-depth interviews with 8 keys informants'
policy makers, experts, academics who were selected
with the supervisor.
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11.  To have official institutionalized status.
 To be independent from the government, and self-
administered.
 A non-profit.
 Not inherited, membership is voluntary and is not based
on blood or tribe.
 Representative which means that membership is limited to a
specific sector and aims to defend the interests of that sector.
 It must be licensed.
 Actually operates.
 Works in the health scope, and provides health services.
Health NGOs that do not meet the above criteria were excluded.
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12. Mohammed Al Khaldi 12

13.  The researcher conducted initial
study before starting data collection.
 3 health PNGOs were chosen from the
target population.
 There is no major changes were introduced
therefore we included them.
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14.  1. Interviewed questionnaire: the questionnaire
was prepared and designed by the researcher to get
information about general ch.ch. of NGOs and IF,
and directors perceptions about IF contributions in
the health sector.
 2. In-depth interviews with 8 experts, whom were
purposively chosen. The researcher agreed with
the experts on the time and place of the interview
which lasted in a week. Every interview took
from 40 - 60 minutes; all interviews were tape
recorded, then data were ordered and coded.
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15. Data processing were conducted using the (SPSS 19)
including;
 Data were gathered and then the filled questionnaires were
reviewed,
 Appropriate data entry model were designed
 Coding of variables
 Data entry
 Data cleaning
 Frequencies and descriptive analysis for NGOs, respondent's
characteristics and the other variables in the questionnaire.
 In-depth interviews were analyzed using Open Coding
Thematic Analysis (OCTA).
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16. Reliability
 Study instrument standardization and filling
out it the same way with all PNGOs. In
order to test the internal consistency of the
questionnaire, The Cronbach’s Coeffecient
alpha value for the entire questionnaire was
(0.899).
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17. Validity
 Face validity: the researcher organized the
questionnaire in domains with logical sequence
to facilitate the filling simplicity. Layout and
format look professional.
 Content validity: the questionnaire was sent to
16 different qualified and experienced referees.
In qualitative part, the researcher reviewed the
supervisor and colleagues via peers review and
member check.
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18.  Lack of consistent figures and statistics
about IF and NGOs.
 Some PNGOs were reluctant to disclose
financial information.
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20. Health NGOs characteristics
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21. Rafah 8.3%
Khanyounis
Governorates
14.6%
Middle area 8.3%
Gaza 58.3%
North Gaza 10.4%
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22. Distribution of NGOs activities coverage
National Level 6.3%
Local Area 16.7%
Governorate level 18.8%
GS level 58.3%
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23. 95.8%
54.2%
45.8%
35.4%
25% 20.8%
10.4% 4.2%
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24. Total number and gender of health
NGOs employees
No. of female employees
54% 46%
No. of male employees
No. of female employees 1442
No. of male employees 1683
Total No. of NGOs employees
3125
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25. N. Gaza M. Khan. Rafah Total
Type of facility Gaza City Area
Health care 9 23 8 13 8 61 42.6
center/PHC
Hospital 3 6 2 1 0 12 8.3
Community-
rehabilitation 7 14 7 7 7 42 29.3
center
Culture &
education 5 11 7 3 2 28 19.5
centers
Total 24 54 24 24 17 143 100
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26. Health NGO suffer from financial deficit
39.6%
33.3%
25%
2.1%
Yes Sometime No Don’t know
NGO suffer from a financial deficit
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27. Description of financial deficit
52.1%
20.8%
Intermittent Constant
Description of deficit
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28. Distribution of the NGOs needs and priorities
Providing drugs for the poor freely 4.2%
Set corporation policies 16.7%
All of above 29.2%
Networking 62.5%
Community collaboration 62.5%
Develope planning & development 70.8%
Running expenses 79.2%
Specialized HR 81.3%
Equipments 81.3%
Fund raising 81.3%
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29. Directors of health NGOs
characteristics
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30. Distribution of directors gender
15%
85% Male
Female
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31. Distribution of director age
47.9%
27.1%
25%
to From to From More than
years years years
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32. 47.9%
37.5%
6.3% 8.3%
Secondary Bachelor Master Ph.D
& diploma degree degree
degree
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33. The International Fund
characteristics
34
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34. D. K 2.1%
Internal conflicts in the Org 2.1%
Managerial obstacles 12.5%
Hidden agendas 20.8%
Lack of experts in the NGO 27.1%
Lack of donors interaction with 64.6%
NGOs
Prevailing political conditions 83.8%
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35. Direct (from donor to Organization
Indirect (through channels
37%
63%
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36. 83.3%
60.4%
45.8%
31.3%
NGOs Civilian societies
Governmental institutions
Individuals donations
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37. Types of aid provided to the
NGOs (mean percentages)
Development Relife (emergency
Budget support
9%
38% 53%
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38. The conditions of donors 14.6%
Donor respect of the organization
56.3%
rules
NGO long experience and
58.3%
reputation
Necessity of the service 64.6%
Organization need 68.8%
The existence of a common vision 72.9%
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39. 2%
8% thousand Less than
10%
thousand to From
thousand to From
23% million
38%
million to From
million to From
19% million to From
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40. Distribution of NGOs according fund sources
Other Sources Self Fund PNA Inside Green
5% 3% 1% Land
Palestinian 2%
Diaspora
8%
Local Donations IF (Foreign &
23% Arab)
59%
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41. Distribution of challenges and factors
affecting the IF
Health and epidemiological challenges 29.2%
Weakness of donor MGM & transparency 37.5%
Socio-demographic challenges
37.5%
Lack of community cooperation and
participation 45.8%
Incompatibility of NGOs goals with
donors 52.1%
Economical and financial factors 54.2%
Organizational factors (weak of NGO
strategic MGM, capacities 56.3%
The absence of common visions & local
, international coordination 64.6%
Political factors 95.8%
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42. Distribution of the largest 20 donors agencies
HI 19%
UNFPA 22%
CA 23%
MH 24%
EU 27%
NDC 28%
OXFAM 28%
MC 29%
AMU 29%
IHH and Yardim 37%
UNRWA 39%
WAMY 42%
Care 44%
ANERA 46%
SC 57%
USAID 57%
OPEC 67%
WA 79%
Arab Fund 85%
IR 86%
0 10 20 30 40 50 60 70 80 90 100
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43. Study domains mean percentages
Overall domains 68.46%
Coordination & cooperation 60.67%
Meeting MDGs 63.39%
Meeting NHGs 64.86%
Responsiveness to Palestinian needs 65.07%
Nature of the IF 68.63%
Meeting needs of NGOs 68.79%
Transparency & governance 71.41%
M&E 73.61%
…Efficiency, effectiveness & 75.79%
Sustainability 78.3%
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45.  The importance of fund continuity and donor commitment with increasing its
role in crisis conditions such as medical materials shortage and electricity cut.
 Emphasis on working closely with national bodies based on national health and
developmental indicators through clear common agendas to ensure appropriateness
and effective results.
 Adopt transparency and credibility in disseminating information, as well as
involving the NGOs decision makers and local society planning.
 Donors should utilize a holistic and systematic approach (health determinants) in
funding programs by concerning less on ad-hoc project complimentary long-term
developmental programs.
 Emancipate the fund from any restrictive conditions and ought to support NGOs
self-reliance and respect the local and NGOs rules.
 Donors are supposed to follow and apply the OECD, Paris decl., AAA, and
Busan conference principles to strengthen the IF effectiveness.
 Encourage the need for coordination and interaction with the all varied
Palestinian actors on the basis of effective partnership to achieve the desired goals.
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46.  More fund utilization as much as possible to serve its vision
that is fully harmonized with the priorities of the national
health goals.
 Promote coordination, and create networks between all health
actors strengthen their role in attaining the desired goals.
 Increase their financial and managerial capabilities
empowerment especially in M&E, governance and planning.
 Invest diversified financial resources generation like
prosperous projects and pricing its services to increase the
revenues, reduce aid dependency and keep its sustainability.
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47. Recommendations (NGOs level)
(cont’)
 Pay more attention to programs that serve
children, women, and support the principles of life quality
through public health awareness.
 Reinforce the NCDs programs and elderly care and develop
mental health services.
 Set plans that include mechanisms to improve the health
environment infrastructure in order to control diseases and
threats.
 Develop services with high quality, equity, focus on the
beneficiaries sound, as well as encourage to use fund in other
ways like health research and establishing effective HIS.
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48.  Establish independent national health committee representatives from
the MOH, NGOs, private sector, academics and civil society to set the
national health priorities and to manage the negotiations with the
donors and fund allocation.
 Reactivate relevant acts and set clear policies by legislative authorities
to regulate the donor agencies work, and reactivating the monitory
bodies' duty to track the donors' performance.
 Establish a unified information system that is related to the projects
and the IF money to use it in the decisions making and planning.
 Find alternative funding sources like the PNA, companies, banks,
businessmen and Arab and Islamic fund.
 Act deeply for the issues of unemployment and poverty in a
comprehensive perspective through all parties’ participation.
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49. Mohammed Al Khaldi