+Global Health Initiatives, Civil Society and the Evolution of Accountability 

Carlos Bruen, Annie Parsons & Rachel Hammonds Coordinated on behalf of the INCO-GHIs Consortium

www.globalhealthobserver.org/

+Workshop Format

3 Presentations NGO Accountability - Introduction NGO Accountability in the Global Context NGO Accountability in the Country Context

Facilitated Group Discussions Open Floor Discussion

+‘GHIs in Africa’ Study

GHIs – global health initiatives that fund ‘global’ diseases independent of country context

Focus: Impact of GHIs on country health systems Research at national, provincial and district levels in Angola,

Burundi, Lesotho, Mozambique & South Africa Incl. the impact of GHIs on the health workforce

Research at global level on how the GHIs were formed, evolved and responded to health systems challenges and an increasingly complex global health governance environment

Methods: Interviews, focus groups, surveys

Funding from EC 6th Framework INCO-Dev Program (2007-2011)

+Global Health Initiatives, Civil Society and the Evolution of Accountability

PART INGO Accountability: An Introduction

Carlos BruenRoyal College of Surgeons in Irelandcarlosbruen@rcsi.ie

+What is Accountability?… “the responsible use of power.” (Humanitarian Accountability

Partnership - HAP)

… “about keeping beneficiaries informed in such a manner that they have the necessary tools to hold us accountable.” (Niels Bentzen, global accountability focal point, Danish Refugee Council)

… “really about systems and processes. Do you have the right staff? How do you communicate? What are your participation methods? Boiling accountability down to feedback mechanisms is a bit of a cop-out.” (Gregory Gleed, member of roving team, HAP)

… “about bridging the gap between listening to what affected people say and taking action based on that feedback.” (Ground Truth program)

… “leadership/governance; transparency; feedback and complaints; participation; design, monitoring and evaluation.” (Inter-Agency Standing Committee Sub-Group on Accountability to Affected Populations)

Source: Irin News ‘Whats in a Word?’

+Civil Society – Defining Features

The realm where citizens associate voluntarily to advance their interests, ideas or ideologies Separate from political and economic society, i.e. the realm

where the strategic purpose and function of actors is in seek to control and manage state power and economic production

Non-profit making Can include NGOs, CBOs, social movements, faith-

based organisations, professional or academic associations etc

Jordan and van Tuijl (2006)

+NGO – Defining Features NGOs

Embedded in civil society May provide services or advocacy to promote particular issues, e.g.

human rights and other social objectives Usually non-membership based and linked by networks or alliances An intermediary organisation with a defined legal body and

organisational shape qualifying them to receive finances from donors

Distinguished from community-based organisations – comparable to NGOs, but small,

local and less absorbed into broader networks and alliances Social movements – effective capacity to engage mass-based

constituency of support and are not characteristic of organisations Both can articulate the interest of supporters, operate within less

formal structures and receive less external financial assistance

Jordan and van Tuijl (2006)

+History of NGO Accountability Capacity Building Phase (1980 – 1995)

1980-1989 – A by-product of performance management activities Focus: financial accountability, organisational capacity, efficiency and

performance delivery 1989-1995 – Rise of civil society accompanied by increased calls for

accountability Focus: quality of internal governance, and formalisation of organisational

intent and behaviour (eg codes of conduct, mission statements)

Governance Phase (1995 - ) 1995-2002 – Mainstreaming of ‘good governance’

Focus: legitimacy, self-regulation and independent accreditation mechanisms Trend: NGO consultancy and observational status in global institutions

2002 onwards – i) State resurgence; ii) a rights-based discourse Focus: i) screening credibility and promotion of external (state) controls and

regulatory frameworks; ii) balancing multiple responsibilities to different constituencies and stakeholders, with preference for accreditation over regulation

Trend: consultancy and observation coupled with increased governance roleJordan and van Tuijl (2006)

+NGO Accountability in Question

Questions of accountability arise as NGO & civil society involvement in advocacy, service delivery and governance increases. Do unelected civil society organisations have a right to

participate in global public policy?

Despite being largely undemocratic, are NGOs legitimate advocates for demanding greater democratic practice in global and country governance?

What is the impact on public services and populations of an increased role for NGOs in the delivery of social services?

+Accountable to Whom?

Membership organisations Principally accountable to their membership and use

franchise/voting, reform and dues as accountability mechanisms

Service organisations Principally accountable to their donors and use performance

assessment, evaluation, reporting, laws and regulations as accountability mechanisms

NGO networks and alliances Accountable to the organisational members? Who are the primary actors? Who sets the agendas? Are there

transparent flows of information, decision making and resource flows?

A problematic area, given that networks and alliances are the most common form of organising to deliver services and advocate, yet beneficiaries do not have many options to hold these actors to account, as they would in a democratic process

+NGO Accountability Requirements Effectiveness: quality and quantity of services delivered

‘Upward’ accountability to donors, driven by donor models of financial accountability

Organisational reliability: management structures, HR policies etc ‘Horizontal’ accountability to the sector, driven by both donor

and NGO sector-wide associations

Legitimacy: transparency, ties to the public, representative status, relationship to the community served and value to society as a whole ‘Downward’ accountability to those effected by the (in)actions

and decisions of NGOs, driven by advocacy partners, political opponents and affected communities.

Bendell (2006);Jordan (2005)

+NGO Accountability Mechanisms Tools and processes

To powerful external stakeholders Include annual reports, financial accounts, performance

assessment, audits, logical frameworks Practiced by NGOs

Include incentivized accountability accreditation and certification, complaints procedures for external and internal stakeholders, conflict of interest policies, social and community audits

Multilevel governance systems that combine accountability mechanisms E.g. financial, ‘reputational’ etc

+Challenges

Accountability in a ‘web’ of interconnected actors/stakeholders Multiple accountability requirements Differences between international and country NGOs, CBOs,

FBOs… Ambiguity of ‘Global Civil Society’

Tensions between accountability requirements E.g. Between donors and NGOs

Log frame goals vs service user demands from feedback mechanisms

Lack of joint or coordinated accountability mechanisms beyond voluntary codes and good intentions

+References & Further Readings

Amoore, Louise, and Paul Langley. "Ambiguities of Global Civil Society." Review of International Studies 30, no. 01 (2004): 89-110

Bendell, Jem. "Debating Ngo Accountability." New York: United Nations, 2006.

Brunt, Carol and Willy McCourt. “Do International Non-Governmental Organisations Walk the Talk? Reconciling the ‘Two Participations’ in International Development”. Journal of International Development 24 (2012): 585-601

Doyle, Cathal, and Preeti Patel. "Civil Society Organisations and Global Health Initiatives: Problems of Legitimacy." Social Science & Medicine 66, no. 9 (2008): 1928-38.

Ebrahim, Alnoor. "Accountability in Practice: Mechanisms for Ngos." World Development 31, no. 5 (2003): 813-29.

Edwards, Michael, and David Hulme, eds. Non-Governmental Organisations: Performance and Accountability. London: Earthscan, 1995

IRIN Global. “Accountabilty: What’s in a Word?”. IRIN: Humanitarian News & Analysis. URL: http://www.irinnews.org/Report/95741/AID-POLICY-Accountability-what-s-in-a-word (last accessed 4 July 2012)

+References & Further Readings

Jordan, Lisa. "Mechanisms for Ngo Accountability." In GPPi Research Paper Series. Berlin: Global Public Policy Institute, 2005.

Jordan, Lisa, and Peter van Tuijl, eds. Ngo Accountabilty: Politics, Principles & Innovations. London: Earthscan, 2006.

Kapilashrami, Anuj, and Oonagh O'Brien. "The Global Fund and the Re-Configuration and Re-Emergence of 'Civil Society': Widening or Closing the Democratic Deficit?" Global Public Health  (2012): 1-15.

Moon, Suerie (2007) Accountability in Poverty Reduction Policies: The State, Civil Society and the World Bank (http://tinyurl.com/moon-acc)

O'Dwyer, Brendan, and Jeffrey Unerman. "The Paradox of Greater Ngo Accountability: A Case Study of Amnesty Ireland." Accounting, Organizations and Society 33, no. 7-8 (2008): 801-24.

Romzek, Barbara S., Kelly LeRoux, and Jeannette M. Blackmar. "A Preliminary Theory of Informal Accountability among Network Organizational Actors." Public Administration Review 72, no. 3 (2012): 442-53