Role of non-governmental organisations in provision of health services in KwaZulu-Natal.
This dissertation focuses on the role of non-governmental organisations in provision of health care services in KwaZulu-Natal. The study had three objectives which were: - identify the role of non-governmental organisations in the provision of health in KwaZulu-Natal. - describe mechanisms for enhancing collaboration between the government and non-government organisations. - investigate mechanisms for redistribution of resources from the public and private sectors to the non-government organisations. The Nationalist Party government, supported by its apartheid policies created imbalances in the provision of services in South Africa. Generally speaking, inequity in all spheres of life was visible between the white population which was the minority and their counterparts, the blacks which were the majority. Health care services were fragmented and divided in racial lines. The whites who were predominantly located in urban areas had access to curative health care which was affordable to them. The blacks were located in rural areas which were referred to as homelands. The health services were minimal and in most places they were unavailable. Curative facilities provided by hospitals and clinics were situated long distances from where the majority of the population could find them. Transport facilities like roads were not well developed, ambulances and health care workers were not available. Health care facilities was inadequate in these areas. The health care provided by the apartheid government was inadequate and structures which were outside the government known as non-government organisations were formed. These NGOs acted as the first line of health defence to the marginalised sectors of the South African communities. Non-governmental organisations were also functioning in the province of KwaZulu-Natal and some were comprehensive in approach and did not provide only health services but also training and education, housing, social services and other development activities. The role of these non-governmental organisations involved the following:- improving health in the most remote and disadvantaged communities, for example, informal settlements, rural and the ultra poor areas. - providing integrated and comprehensive services, for example, employment generating projects, education and training and housing. - unifying the different racial groups and breaking down prejudices and assumptions with regard to race and gender. Although non-governmental organisations operated in South Africa, there was always confrontation between the government structures and NGOs, particularly those which were actively involved in the upliftment of the lives of the previously disadvantaged communities, namely the blacks. These non-governmental organisations provided these services under a variety of unpleasant conditions, characterised by assassinations, tortures and imprisonment. These NGOs were banned by the government and others operated under restrictive and authoritarian government policies. The recent political changes which took place in South Africa - the unbanning of political organisations like the African National Congress and the Pan Africanist Congress highlighted the need for transformation in all aspects of life. In 1994 a democratic government which was ANC-Ied was legitimately elected. The government of national unity was committed to the upliftment of the lives of all South Africans, particularly the provision of health care for all. People were extremely optimistic when the new government (GNU) came into power. The role of non-government organisations was theoretically non-existence and minimal as the government was aiming at providing health care services to the previously disadvantaged communities. Foreign donors and funders redirected their financial assistance to the government and the funding was between government to government. The personnel from non-governmental organisations was recruited to business and government sectors which also challenged NGOs to replace these dedicated and committed people. The funding problem has become a major challenge to non-governmental organisations and most of them have been forced to shut down. The political transformation has challenged non-government organisations to reposition themselves and work with government in the upliftment of the lives of all South Africans. The government of national unity is committed to the provision of equitable, preventive, promotive, curative and rehabilitative services at all community levels, particularly the previously disadvantaged. The researcher has identified two non-governmental organisations as a case study and these NGOs are providing health care services in KwaZulu-Natal. The NGOs are the Health Systems Trust and the Valley Trust. In addition to these two NGOs literature which was relevant to this study was also reviewed. The researcher reached the following conclusions after the findings of the study were analysed: - Non-governmental organisations have played an important role in the past in the upliftment of the lives of South Africans. - Resources have been inequitable been distributed and there is a need to redistribute these resources equally. - South Africa is faced with health problems which needs all stakeholders to be involve in order to eradicate ill-health. The study offers a number of recommendations based from the conclusions which can be generalised to non-governmental organisations providing health services.