International health organizations & NGOs | CHAPTER 21 | Community Health Nursing

International health organizations & NGOs  – This book covers the entire syllabus of ” Community Health Nursing” prescribed by the Universities of Bangladesh- for Basic and diploma nursing students. We tried to accommodate the latest information and topics.

This book is an examination-friendly setup according to the teachers’ lectures and examination questions. At the end of the book previous university questions are given. We hope in touch with the book students’ knowledge will be upgraded and flourish. The unique way of presentation may make your reading of the book a pleasurable experience.

International health organizations & NGOs

The International Health Regulations are an international legal instrument which is legally binding on all WHO Member States who have not rejected them and on all Non-Member States of WHO that have agreed to be bound by them.

Purpose:

International health regulation ensure maximum security against spread of disease with minimum interference with world traffic which cover only four diseases considering a threat to international health and as such are qurantinable diseases;

These are:

A. Small pox (eradicated)

B. Yellow fever.

C. Plaque

D. Cholera.

[Ref- BT Basavanthappa/3d and K Park 26/1012]

Geneva Convention

There are four Geneva Conventions adopted on 12 August 1949.

They are:

A. Geneva conventions 1:

✔ To protect wounded and sick in armed forces on land as well as medical personnel.

B. Geneva conventions II:

✔ To protect the same categories of people at sea as well as the shipwrecked.

C. Geneva conventions III:

✔ Concerning treatment to prisoners of war.

D. Geneva conventions IV:

✔ Regarding protection of civilians in time of war.

[Ref- BT Basavanthappa/3 and K Park 26/1012]

International health agencies

International health agencies can be classified into as follows:

1. United Nation agencies.

2. Bilateral agencies.

3. Non- Governmental organization(NGO’S)

1. United nations agencies:

✔ WHO (World health organization)

✔ UNICEF (United Nations International Children’s Emergency)

✔ UNDP (United Nation’s Development programme)

✔ UNFPA (United Nation’s Fund for Population Activities)

✔ FAO (Food and Agriculture Organization.)

✔ ILO (International Labour Organization)

✔ WB (World Bank)

✔ ADB (Asian Development Bank)

✔ UNEP (United Nation’s Environmental Programmed)

✔ UNFPA (United Nation’s Family Planning Association)

2. Bilateral agencies:

✔ USAID (United States Agencies for International development)

✔ Colombo Plan.

✔ SIDA (Swedish International Development Agency)

✔ DANIADA.

3. Non-governmental organizations (NGO’S):

✔ Rockefeller foundation.

✔ Ford foundation.

✔ ICDDRB (International Center for Diarrhea Disease Research, Bangladesh)

✔CARE (Co-operative for American Relief everywhere)

✔ IFRCS (International federation of Red cross/crescent societies)

✔ HHI (Hellen killer international)

✔ Save the Children Fund.

✔ Asia Foundation

✔ Concern.

✔ International Islamic Relief Organization.

International health agencies working in Bangladesh

International health organization/Agencles working in Bangladesh:

1. WHO (World health Organization.)

2. UNICEF (United Nations Children Emergency Fund.)

3. UNDP (United Nations Development Programme.)

4. UNFPA (United Nations Fund for Population Activities.)

5. UNEP (United Nations Environmental Programme.)

6. FAO (Food and Agriculture Organization.)

7. WFP (World Food Programme.)

8. ILO (International Labour Organization)

9. WB (World Bank)

10. ADB (Asian Development Bank)

11. Colombo Plan.

12. CARE (Co-operative for American Relief everywhere)

13. USAID (United States Agencies for International development) 14. IFRCS (International federation of Red cross/crescent societies)

15. Rockefeller foundation.

16. UNCHR (United Nations High Commission for Refuse)

[Ref- BT Basavanthappa/3 and K Park 26/1012]

International organizations working with health in BD:

i. WHO (World health Organization.)

ii. UNICEF (United Nations Children Emergency Fund.)

iii. UNDP (United Nations Development Programme.)

iv. CARE (Co-operative for American Relief everywhere)

v. USAID (United States Agencies for International development)

vi. IFRCS (International federation of Red cross/crescent societies)

[Ref- BT Basavanthappa/3d and K Park 26/1012]

United Nations

It is an association of many countries, which aims to improve economic and social condition and to solve political problems in the world in a peaceful way.

1. It was established as the consequence of the UNA Conference on International Organization held at San Francisco, USA on 26th June, 1945. Then United States President Franklin D. Roosevelt devised the name United Nations.

2. The charter of the United Nations is a multilateral treaty which establishes the rights and obligations of member countries. At present the membership of United Nation has reached 192 countries.

3. The charter represents the wishes and aspiration of the peoples of the world as to what their country jointly would be obliged to do through the UN.

4. 24th October is observed as UN day in all the member countries.

Organization of UN:

1. General assembly

2. Security council

3. Economic and Social council

4. The trusteeship council

5. International court of justice

6. A Secretariat.

Special agencies within UN system:

1. World Health Organization (WHO)

2. Food and Agricultural Organization (FAO)

3. International Labour Organization (ILO)

4. United Nation Scientific and Cultural Organization (UNESCO)

5. World Meteorological Organization(WMO)

6. International Monetary Fund (IMF)

7. International Atomic Energy Agency(IAEA)

8. Industrial Developmental Organization (UNIDO)

9. International bank for Reconstruction and Development (IBRD)

10. International telecommunication Union (ITU)

11. World trade organization (WTO)

• Other UN agencies:

1. UN Developmental program (UNDP)

2. United Nations Children Fund(UNICEF)

3. Fund For Population Activity (UNFPA)

4. UN Environmental Program (UNEP)

[Ref- BT Basavanthappa/3 and K Park 26/1013]

WHO (World health Organization):

The world health organization is a specialized, non-political international health organization. It is a part of united nation but it is not the sub-oriented of the united nation, Because It has its:

a. Own constitution.

b. Own governing bodies.

c. Own membership

d. Own budget.

Establishment year:

✓ April 1945 in UNA Conference on International Organization held at San Francisco

✓ “WHO was fully established on 7th April 1948. It was declared as world health day. Headquarter: Geneva, Switzerland.

Membership: Objectives:

✓ Objectives of WHO establishment; Attainment by all peoples of the word of the highest level of health so that every citizen can lead a socially and economically productive life.

✓ Current objectives of WHO: Health for all by the year 2005.

[Ref- BT Basavanthappa/3 and K Park 26/1013]

Work of WHO/Functions/Activities:

A. Prevention and control of specific disease:

✓ Epidemiological surveillance of communicable disease.

✓ Global battle against AIDS

✓ Control of communicable and non-communicable disease such as cancers, CVS disease, drug addiction etc.

✓ Expanded program on immunization.

B. Development of comprehensive health services: –

✓ Health system should be based on primary health care.

✓ Development of health manpower and utilization.

✓ Development of health infrastructure.

C. Family health improvement: – The activity is broadly subdivided into –

✓ MCH care.

✓ Human reproduction.

✓ Nutrition and health education.

D. Improvement of environment health:

WHO advises governments for the provision of basic sanitation services.

✓ Sanitary disposal of excreta.

✓ Safe water supplies.

✓ Protection of quality of air, food, waters.

✓ Health condition of worker (radiation protection)

E. Health statistics: WHO supplies various mortality and morbidity statistics..

The data is published in the –

✓ Weekly epidemiological record.

✓ World health statistics quanerly.

✓ World health statistics annually.

F. Biomedical research: The WHO does not itself do research but stimulated and coordinated research work. E.g. Leprosy, Filariasis, Kala-azar, etc.

✓ Health literature and information.

✓ Co-operation with other health agencies.

Source of finance:

a. Member countries.

b. Non-government and Government organization.

c. World Bank.

(Ref- BT Basavanthappa/3 and K Park 26/1013)

Regional headquarter of WHO with region

Regionalization:

In order to meet the special health needs of different areas, WHO has established six regional organizations on the basis of geography, tempered or distempered by politics and not on stages of development and health problems.

[Ref-K Park 26/1013]

Collaborative programmes of WHO in Bangladesh:

1. Control of communicable diseases, such as bacterial, viral, parasitic and mycobacterial diseases, STD and HIV/AIDS, ARI, CDD, vector-borne diseases etc.

2. Control of non-communicable diseases, such as cardiovascular diseases, cancer, diabetes, mentaldisorders, drug dependence etc.

3. Family and community health (child and adolescent health, reproductive health).

4. Sustainable development of health services (strengthening of health infrastructure for PHC, manpower development and training).

5. Promotion of environmental health which includes water supply and sanitation.

6. Health technology and pharmaceuticals (essential drugs, vaccines immunization, drug safety, clinical technology).

7. Evidence and information for policy (research policy and promotion, institutional strengthening for research).

[Ref- K Park 26/1013]

Brief description of activities of WHO in BD:

1. Health policy and management:

• Women’s health and development.
• Health development strategies and plan.
• Emergency preparedness programme.
• Strengthening country health information to support national health planning, monitoring and evaluation,
• Library and health literature services.

2. Health service development:

• Promotion coordination and information exchange in the practice of health system research.
• Strengthening of Bangladesh medical research council.
• Support of PHC development through district health system.
• Strengthening of medical and paramedical education.
• Strengthening of Bangladesh cottage of physicians and surgeons and postgraduate medical education.
• National drug policy.
• Integration of traditional medicine into national health care system.
• Strengthening of nursing and midwifery.

3. Promotion and protection of health:

• Alliance for women’s health and safe motherhood.
• Community based care for aging and health.
• Promotion of occupational health.
• Prevention treatment and management of Neuro-psychiatric disorders.
• Community based rehabilitation.
• Awareness raising of food safety.
• Strengthening water supply and sanitation programme.

4. Integrated control of diseases:

• Elimination of leprosy by the yr. 2000.D.
• Immunization
• Control of TB, rabies.
• Control of diarrhea and respiratory’ infection
• Prevention of deafness
• Prevention and control of AIDS
• Vector borne disease control
• Prevention of blindness
• Control of diabetes
• Oral health

[Ref- K Park 26/1013]

UNICEF

It is one of the specialized agencies of the United Nations. It was established in 1946. Formerly known as UNICEF (United Nations International Children Emergency Fund) It is now called United Nations Children’s Fund (1953) but title UNICEF is retained.

Headquarter:- New York, U.S.A.

• Regional headquarter: – New Delhi (India)

Objective of UNICEE:

a. To reduce infant mortality through an attack on principal causes of preventable disease.

Organization structure:

a. Executive board: -composed of 36 members of all regions.

b. Secretariat: is the staff of UN ICEF

Activities of UNICEF:

1. Child health:

✓ Environmental sanitation programme.

✓ Oral rehydration.

✓ Primary health cares.

✓ Family planning.

2. Child nutrition: Improve child nutrition by-

✓ Improved infant feeding practices.

✓ Promotion of breast feeding and proper weaning.

✓ Child growth monitoring.

✓ Intervention programme against nutritional deficiency diseases.

3. Family and child welfare:

✓ Parent education

✓ Day care center

✓ Child welfare and youth agencies

✓ Women’s club

4. Education:-

✓ Formal and non-formal.

[Ref- K Park 26/1013]

Role of UNICEF in promoting health services in BD:

1. Growth monitoring.

2. Oral rehydration.

3. Breastfeeding.

4. Family planning and MCH.

5. TBAs (Traditional Birth Attendants) training programme.

6. Food supplementation programme.

7. Helps BRAC in the ORT Extension activities by giving fund.

8. Also helps ICDDR B in the ORS development and training activities.

9. Supports the Public Health Engineering Department in supplying tube-well and water seal sanitary latrines to the villagers.

10. Supports Universal Childhood Immunization programme by supplying vaccines.

11. Supply transports (car, bus, truck etc.) to use in specific health and health related programmes.

[Ref- K Park 26/1013]

Functions of UNICEF in Bangladesh:

1. In health:

a. Support EPI Provision of safe drinking water and sanitation latrines.

b. Supporting the national ARI control programme for early recognition and prompt case of management of pneumonia.

c. Helps in three areas in women and maternal health

✓ Emergency obstetrical care.

✓ Establishment of women friendly initiative in facilities and ✓ A campaign for communication and advocating for issues related to high MMR as well as violence against women (YAW)

2. In nutrition:

a. Help to combat the three major micronutrient deficiencies (vitamin A deficiency, iodine deficiency disorders and nutritional anemias especially iron deficiency).

b. UNICEF initiated and supported the Campaign for promotion and protection of breast feeding.

c. Worked close with the health consortium in the development of the sector-wide programme and Bangladesh integrated Nutrition Programme for ten years.

d. Engaged in conduction joint nutrition survey with the Bangladesh Bureau of Statistics since 1994.

[Ref- K Park 26/1013]

Red Crescent/Red Cross

It is a non-political non-official international humanitarian organization devoted to the service of mankind in peace & war.

It was founded by Henry Dunant a Young Swiss businessman, who when traveling through north Italy in 1859 happened to be on the scene of one of the most savage battles of history, the battle of Solferino.
International Red Cross and Red Crescent Movement: International Red Cross and Red Crescent Movement is as worldwide humanitarian organization.

Working bodies: It comprises two bodies working at an international level –

1. The International Committee of Red Cross (ICRC), founded in 1863 works in time of armed conflict.

2. The International Federation of Red Cross and Red Crescent Societies (IFRCS), founded in 1919 works in peacetime.

Principles:

✓ Humanity

✓ Impartiality

✓ Neutrality

✓ Independence

✓ Voluntary

✓ Service

✓ Universality

The following are some of the major projects supported by the Red Crescent Society of Bangladesh;

➤ Five general hospitals in the Dhaka City.

➤ Six MCH Hospital (Total 110 beds) in the urban areas.

➤ Fifty-three maternal & child welfare centres in rural areas.

➤ Urban & rural based charitable dispensaries.

➤ Blood transfusion service, ambulance service. FP, Eye camps, first aid etc.

Activities:

➤ Giving legal protection and material assistance to military victims of wars.

➤ Providing medical aid. Relief assistance and emergency food supplies.

➤ Evacuation of the wounded and refugees

➤ Repatriation of prisoners of war.

➤ Protection of refugees.

➤ Visit to detainees.

[Ref- K Park 26/1013]

Non-Governmental Organizations (NGOs)

Concept:

The term, “non-governmental organization” or NGO, came into currency in 1945 because of the need for the UN to differentiate in its charter between participation rights for intergovernmental specialized agencies and those for international private organizations. At the UN, virtually all types of private bodies can be recognized as NGOs.

At present there are about 15,000 NGOs in Bangladesh of which about 750 organizations receive international assistance. Their role in primary focus on: eradication of illiteracy, provision of health care, poverty alleviation and human resources development. The government considers the NGOs and private sectors as partners in national development.

Definition of NGOs:

A non-governmental organization (NGO) is any non-profit, voluntary citizens’ group which is organized on a local, national or international level. Task-oriented and driven by people with a common interest, NGOs perform a variety of service and humanitarian functions, bring citizen concerns to Governments, advocate and monitor policies and encourage political participation through provision of information.

Or,

A non-governmental organization (NGO) is a citizen-based association that operates independently of government, usually to deliver resources or serve some social or political purpose.

[Ref- K Park 26/1018]

Types of NGOs:

[Ref- K Park 26/1018]

Roles of NGOs:

1. Development and Operation of Infrastructure:

• Community-based organizations and cooperatives can acquire, subdivide and develop land, construct housing, provide infrastructure and operate and maintain infrastructure such as wells or public toilets and solid waste collection services.
• They can also develop building material supply centres and other community-based economic enterprises. In many cases, they will need technical assistance or advice from governmental agencies or higher-level NGOs.

2. Supporting Innovation, Demonstration and Pilot Projects:

• NGO have the advantage of selecting particular places for innovative projects and specify in advance the length of time which they will be supporting the project – overcoming some of the shortcomings that governments face in this respect.
• NGOs can also be pilots for larger government projects by virtue of their ability to act more quickly than the government bureaucracy.

3. Facilitating Communication:

• NGOs use interpersonal methods of communication, and study the right entry points whereby they gain the trust of the community they seek to benefit.
• They would also have a good idea of the feasibility of the projects they take up.
• The significance of this role to the government is that NGOs can communicate to the policy-making levels of government, information about the lives, capabilities, attitudes and cultural characteristics of people at the local level.

4. Technical Assistance and Training:

• Training institutions and NGOs can develop a technical assistance and training capacity and use this to assist both CBOs and governments.

5. Research, Monitoring and Evaluation:

• Innovative activities need to be carefully documented and shared effective participatory monitoring would permit the sharing of results with the people themselves as well as with the project staff.

6. Advocacy for and with the Poor:

• In some cases, NGOs become spokespersons or ombudsmen for the poor and attempt to influence government policies and programmes on their behalf.
• This may be done through a variety of means ranging from demonstration and pilot projects to participation in public forums and the formulation of government policy and plans, to publicizing research results and case studies of the poor.
• Thus NGOs play roles from advocates for the poor to implementers of government programs; from agitators and critics to partners and advisors; from sponsors of pilot projects to mediators.

[Ref- K Park 26/1018-19]

International NGOs Working in Health and Family Planning Sectors in Bangladesh

A. Community Health/Nutrition:

• Helen Keller International.
• Concern Bangladesh
• CARE
• Food for Hungry International
• Rangpur Dinajpur Rural Services (RDRS)

B. Health and Family planning:

• The Asia Foundation.
• Family planning International Assistance(FPIA)

C. MCH and Family planning:

• Save the Children Fund (USA)
• Save the Children Fund(UK)
• Save the Children Fund(Australia)
• Raddabarnen
• Infants DU Monde (EDM)

D. Family planning:

• The Path Finder Fund
• Association for Voluntary Surgical Contraception (AVSC)

1. Domestic/ National / Local NGOs working in health and family planning sectors in Bangladesh

A. Specific disease:

• National Antitubercular Association of Bangladesh(NATAB)

B. Health and family planning:

• Community Health Care Project (CHCP)
• Family Development Services

C. Maternal & MCH & Family Planning:

• Kumudini Welfare Trust of Bangladesh Limited.
• Bangladesh Association for maternal & Neonatal Health
• Bangladesh Association for Prevention of Septic Abortion (BAPSA)

D. Family Planning:

• Family Planning Association of Voluntary Sterilization (FPAB)
• Concerned Women for Family Planning(CWFP)

E. Community Health & Nutrition:

• Bangladesh Rural Advancement Committee (BRAC)
• ASA (Association for Social Advancement).
• Grameen Bank
• Gonosastho Kendro (GSK)
• Bangladesh National Society for the Blind(BNSB)
• Voluntary Health Services Society (VHSS)
• Red Crescent Society.

[Ref- K Park 26/1018-19]

Health Related Activities of the NGOs in Bangladesh:

1. Prevention and control of specific disease:

• Global battle against AIDS
• Epidemiological surveillance of communicable diseases
• Control of communicable and non-communicable diseases
• Immunization against common diseases of childhood

2. Development of comprehensive health care:

• To promote and support national health policy development and development of comprehensive national health program.

3. Family health:

• Maternal &child health care.
• Human reproduction
• Nutrition and health education

4. Environment Health:

• National programs for provision of basic sanitary services.
• Production of the quality of air, water, and soil; health conditions of work, radiation protection.
• Early identification of new hazards originating from new technological development.

5. Health statistics:

WHO has been concerned with the dissemination of a wide verity of morbidity and mortality statistics published in the –

• Weekly epidemiological record
• World Health Statistics Quality
• World health Statistical Annual

6. Bio medical research:

• Research, stimulates and co-ordinates research work, eg. malaria, filariasis, leishmaniosis, leprosy.

7. Health literature and information:

• Various NGO acts as a cleaning house for information on health problems.
• It has a public information service both at headquarters and each of the six regional offices.

8. Co-operation with other organization:

• NGO collaborates with the various NGOs and with other specialized agencies and maintains various degrees of working relationship.

(Ref-K Park 26/1018-19)

Ongoing health programme in Bangladesh:

• Expanded Programme on Immunization (EPI).
• ARI control programme.
• Control of Diarrhoeal Diseases (CDD).
• Tuberculosis & Leprosy Control Programme in Bangladesh.
• Malaria control programme.
• Blindness Prevention Programme of Bangladesh (BPPB).
• Iodine Deficiency Diseases (IDD) programme.
• Community Food & Nutrition Programme.
• Bangladesh breast feeding foundation.
• Health education programme.

[Ref-K Park 26/1018-19]

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