Zaidi Shehla, Gul Xaher, Nishtar Noureen Aleem
The Aga Khan University, Karachi, Pakistan.
Glob J Health Sci. 2012 Dec 27;5(2):171-5. doi: 10.5539/gjhs.v5n2p171.
Policy measures for preventive and promotive services are increasingly reliant on contracting of NGOs. Contracting is a neo-liberal response relying on open market competition for service delivery tenders. In contracting of health services a common assumption is a monolithic NGO market. A case study of HIV control in Pakistan shows that in reality the NGO market comprises of parallel NGO networks having widely different service packages, approaches and agendas. These parallel networks had evolved over time due to vertical policy agendas. Contracting of NGOs for provision of HIV services was faced with uneven capacities and turf rivalries across both NGO networks. At the same time contracting helped NGO providers belonging to different clusters to move towards standardized service delivery for HIV prevention. Market based measures such as contracting need to be accompanied with wider policy measures that facilitate in bringing NGOs groups to a shared understanding of health issues and responses.
预防和促进性服务的政策措施越来越依赖于与非政府组织签约。签约是一种新自由主义的应对方式，依赖公开市场竞争来获取服务提供标书。在卫生服务签约中，一个常见的假设是存在一个单一的非政府组织市场。巴基斯坦的一个艾滋病毒防治案例研究表明，实际上非政府组织市场由并行的非政府组织网络组成，这些网络的服务包、方法和议程差异很大。由于垂直政策议程，这些并行网络随着时间的推移而演变。为提供艾滋病毒服务而与非政府组织签约面临着两个非政府组织网络能力不均衡和地盘竞争的问题。与此同时，签约帮助不同群体的非政府组织提供者朝着标准化的艾滋病毒预防服务提供方向发展。像签约这样的基于市场的措施需要伴随更广泛的政策措施，以促进非政府组织群体对健康问题和应对措施达成共同理解。
