《卫生经济学》课程参考文献（WHO年度报告）：World Health Report 2005_Make every mother and child count_PolicyBrief4 Working with civil society organizations

sThe World Health report 2005 b Make every mother and child count World Health organization Policy briet tour Working with civil society organizations Governments hold the ultimate responsibility for ensuring access to maternal, neonatal and child health services. But civil society organizations(CSOs)are their necessary partners to develop equitable health systems that respond to the needs of all families and sustain the political will to achieve universal coverage. It is critical that governments build partnerships with CSOs and create an environment in which the active participation of CSOs in social policy dialogue becomes possible and fruitful. THE ROLES OF CIVIL SOCIETY ORGANIZATIONS Social mobilization) A first important way in which CSOs can IN MNCH: BEYOND SERVICE DELIVERY contribute is to improve the effectiveness of the health system by While the nature and strength of not-for-profit CSOs varies greatly helping families access the care to which they are entitled, but have from country to country, they often play a vital role in providing difficulty in obtaining. Often, administrative, cultural and financial health services for women and children. Civil society organizations, barriers to care appear insurmountable, and families are associations and networks also provide effective and efficient means for insufficiently aware of their rights and choices. In many countries, CSOs hearing the voices of the people regarding health issues, in particular, have developed innovative and empowering approaches in working with the functioning of health systems. Their strength and credibility lies communities and establishing support networks to set this right. This is in the responsible and constructive roles they play in many countries, particularly important where poorer families are subject to discrimina which engenders support from the community as a whole. The Inter- tion, financial exploitation, or overmedicalisation. Individual users are national Conference on Population and Development in 1994, and the often powerless in the face of complex legal procedures and obstructive subsequent movement for the right to access to reproductive health professional organizations when things go wrong. In many places CSOs services gave a new impetus to the involvement of CSOs in formulating, have offered them channels to protect and claim their rights implementing, monitoring and evaluating policies and programmes-a specific role that is distinct from that of service delivery but is often as Mobilizing political will and contributing to policy design b Effective important. The participation of CSOs in policy dialogue can strengthen policy development takes time and unwavering commitment governmental commitment to the health of mothers and children and to Changes in the political personnel or in the international environment may universal coverage, as well as reinforce the effectiveness of the public challenge this necessary continuity of purpose. Sustained long term stewardship of the health sector change can rarely be brought about without popular support. CSOs have

Policy brief four Working with civil society organizations Social mobilization ► A first important way in which CSOs can contribute is to improve the effectiveness of the health system by helping families access the care to which they are entitled, but have difficulty in obtaining. Often, administrative, cultural and financial barriers to care appear insurmountable, and families are insufficiently aware of their rights and choices. In many countries, CSOs have developed innovative and empowering approaches in working with communities and establishing support networks to set this right. This is particularly important where poorer families are subject to discrimina￾tion, financial exploitation, or overmedicalisation. Individual users are often powerless in the face of complex legal procedures and obstructive professional organizations when things go wrong. In many places CSOs have offered them channels to protect and claim their rights. Mobilizing political will and contributing to policy design ► Effective policy development takes time and unwavering commitment. Changes in the political personnel or in the international environment may challenge this necessary continuity of purpose. Sustained long term change can rarely be brought about without popular support. CSOs have Governments hold the ultimate responsibility for ensuring access to maternal, neonatal and child health services. But civil society organizations (CSOs) are their necessary partners to develop equitable health systems that respond to the needs of all families and sustain the political will to achieve universal coverage. It is critical that governments build partnerships with CSOs and create an environment in which the active participation of CSOs in social policy dialogue becomes possible and fruitful. THE ROLES OF CIVIL SOCIETY ORGANIZATIONS IN MNCH: BEYOND SERVICE DELIVERY While the nature and strength of not-for-profit CSOs varies greatly from country to country, they often play a vital role in providing health services for women and children. Civil society organizations, associations and networks also provide effective and efficient means for hearing the voices of the people regarding health issues, in particular, the functioning of health systems. Their strength and credibility lies in the responsible and constructive roles they play in many countries, which engenders support from the community as a whole. The Inter￾national Conference on Population and Development in 1994, and the subsequent movement for the right to access to reproductive health services gave a new impetus to the involvement of CSOs in formulating, implementing, monitoring and evaluating policies and programmes – a specific role that is distinct from that of service delivery but is often as important. The participation of CSOs in policy dialogue can strengthen governmental commitment to the health of mothers and children and to universal coverage, as well as reinforce the effectiveness of the public stewardship of the health sector. The World Health Report 2005 Make every mother and child count 4 World Health Organization 4 civil society1page.indd 1 2005-03-24 18:55:50

Policy brief Working with civil society often played a vital role in ensuring a core place on the health agenda for and universal coverage can provide the basis for sustaining the necessary maternal, newborn and child health. They have often focused on neglected political impetus and momentum. By building on the mobilization efforts issues such as unsafe abortion, adolescent pregnancy, child abuse, or the of cSOs, governments can gain credibility and staying power for their marginalisation of population groups. Most importantly, they have often initiatives to move towards universal coverage for MNCH helped those within the system wishing to introduce changes by placing the weight of public support behind them or by creating opportunities Create a supportive environment for partnerships with CSOs p Govern- to link health sector policies with agendas to reduce gender inequity, ments have to create the legal, financial and political environment that poverty and exclusion make partnerships with CSOs possible and effective. CSOs require ad- equate information to contribute effectively. They also require financial Holding governments and health providers accountable b There is a long resources and support to build their capacities for providing effective history, in both developed and developing countries, of CSOs providing the inputs. Some countries do this through social fund-like mechanisms, checks and balances that are so greatly needed to keep health systems, others have institutionalized collaboration and contracting with non-profit public and private, accountable This is perhaps one of the most useful organizations for service delivery, then expanding that collaboration into vays in which CSOs contribute to progress towards universal coverage. policy dialogue. Others still facilitate contributions by local and foreign CSOs have often shown great independence and ability to go against donors. Stronger CSOs, that have the freedom to act, the resources to interests in signalling mismanagement of health services, or in work and can be held accountable can contribute more effectively to g for equitable, efficient and sufficient budget allocations. In many research, design, implementation and monitoring of progress towards nces they have advocated on behalf of marginalized groups that universal coverage for MNCH governments found hard to reach; elsewhere they have worked to ensure that services respect the legal frameworks that entitle people to care, Invite CSo participation in policy and program design For partnerships achieve quality standards, and support equitable access between governments and CSOs to develop and to thrive, it is necessary to institute specific channels and mechanisms to facilitate constructive STRENGTHENING PARTNERSHIPS WITH dialogue on programmes and policies. This means creating concrete CSOS-POLICY RECOMMENDATIONS opportunities for CSOs, particularly those that speak for constituencies Build on CSOs to mobilize the broad constituencies that can sustain po- of women and young people to participate with governments and devel litical commitment b Experience shows that time and money invested opment partners in setting priorities, suggesting budget allocations and to mobilize constituencies in support of equitable access to MNCH yields service delivery models, and assessing progress. Dialogue needs to be good returns. CSOs often have a good track record of credibility and cre- sustained over time, including when governments change or development ativity in mobilizing broad constituencies. Women's organizations, con- partners shift their interests. Only in this way can significant contributions sumer groups and other CSOs that advocate and work in support of MNch on the path to universal coverage be made ur Rahman/ Reuters The health of mothers and children is an issue of rights entitlements and lay-to-day struggle to secure these entitlements For further information concerning The World Heal pleasevisitourwebsiteathttp://www.whoint or contac Joy Phumaphi, ADG FCH (phumaphij@ who. int) Tim Evans, ADG ElP (evant@who. int) Wim Van Lerberghe, Editor-in-Chief WHRO5 (vanlerberghew @who int Cover photo credits: left, L. Gubb/WHO-right, WHO Archives

Policy brief Working with civil society often played a vital role in ensuring a core place on the health agenda for maternal, newborn and child health. They have often focused on neglected issues such as unsafe abortion, adolescent pregnancy, child abuse, or the marginalisation of population groups. Most importantly, they have often helped those within the system wishing to introduce changes by placing the weight of public support behind them or by creating opportunities to link health sector policies with agendas to reduce gender inequity, poverty and exclusion. Holding governments and health providers accountable ► There is a long history, in both developed and developing countries, of CSOs providing the checks and balances that are so greatly needed to keep health systems, public and private, accountable. This is perhaps one of the most useful ways in which CSOs contribute to progress towards universal coverage. CSOs have often shown great independence and ability to go against vested interests in signalling mismanagement of health services, or in working for equitable, efficient and sufficient budget allocations. In many instances they have advocated on behalf of marginalized groups that governments found hard to reach; elsewhere they have worked to ensure that services respect the legal frameworks that entitle people to care, achieve quality standards, and support equitable access. STRENGTHENING PARTNERSHIPS WITH CSOS – POLICY RECOMMENDATIONS Build on CSOs to mobilize the broad constituencies that can sustain po￾litical commitment ► Experience shows that time and money invested to mobilize constituencies in support of equitable access to MNCH yields good returns. CSOs often have a good track record of credibility and cre￾ativity in mobilizing broad constituencies. Women’s organizations, con￾sumer groups and other CSOs that advocate and work in support of MNCH and universal coverage can provide the basis for sustaining the necessary political impetus and momentum. By building on the mobilization efforts of CSOs, governments can gain credibility and staying power for their initiatives to move towards universal coverage for MNCH. Create a supportive environment for partnerships with CSOs ► Govern￾ments have to create the legal, financial and political environment that make partnerships with CSOs possible and effective. CSOs require ad￾equate information to contribute effectively. They also require financial resources and support to build their capacities for providing effective inputs. Some countries do this through social fund-like mechanisms, others have institutionalized collaboration and contracting with non-profit organizations for service delivery, then expanding that collaboration into policy dialogue. Others still facilitate contributions by local and foreign donors. Stronger CSOs, that have the freedom to act, the resources to work and can be held accountable can contribute more effectively to research, design, implementation and monitoring of progress towards universal coverage for MNCH. Invite CSO participation in policy and program design ► For partnerships between governments and CSOs to develop and to thrive, it is necessary to institute specific channels and mechanisms to facilitate constructive dialogue on programmes and policies. This means creating concrete opportunities for CSOs, particularly those that speak for constituencies of women and young people, to participate with governments and devel￾opment partners in setting priorities, suggesting budget allocations and service delivery models, and assessing progress. Dialogue needs to be sustained over time, including when governments change or development partners shift their interests. Only in this way can significant contributions on the path to universal coverage be made. Rafiqur Rahman/Reuters The health of mothers and children is an issue of rights, entitlements and day-to-day struggle to secure these entitlements. For further information concerning The World Health Report please visit our website at: http://www.who.int/whr/en/ or contact: Joy Phumaphi, ADG FCH (phumaphij@who.int) Tim Evans, ADG EIP (evanst@who.int) Wim Van Lerberghe, Editor-in-Chief WHR05 (vanlerberghew@who.int) Cover photo credits: left, L. Gubb/WHO - right, WHO Archives 4 civil society1page.indd 2 2005-03-24 18:55:52