Social Science Research Council

Global Processes, Local Impacts: Non-Governmental Organizations and the Distribution of Health Care Services in Developing Countries

Processes of economic liberalization that have swept through developing countries over the past two decades have altered the balance between State and market in the provision of a variety of public goods, and have engendered an array of novel institutional mechanisms for the delivery of such services. Nowhere is this more evident than in the sphere of health care in developing countries, where the role of the state in delivery of services is declining and where NGOs are assuming increasingly prominent roles. Not only does this entail the reconfiguration of longstanding institutional arrangements, it also propels substantial change in the roles, forms, practices, and organization of NGOs themselves, as the latter adjust to their central place in what amounts to a new model for social services delivery, if not for economic and social development more broadly.Just as NGOs are being transformed by globalization, they are becoming increasingly important institutional mechanisms for transmitting the impact of global processes onto particular sectors of the population. Where the issues at stake involve services that are basic to individual and community welfare, as is the case of health care, the ways in which these "agents of change" are affected by global processes generates tangible outcomes in terms of distribution. While these institutional changes have been unfolding across Latin America for a number of years, there has been little systematic analysis of their consequences for the distribution of health services or for their quality in different settings.In an effort to generate the knowledge needed to improve health sector performance and to maximize the productive contribution of NGOs, the SSRC is seeking funds to support a multi-year program of research and workshops that would analyze the role of NGOs in health service delivery in Latin America. The proposed project would begin with studies of Argentina, Chile and Mexico, carried out in collaboration with researchers at the University of Texas-Austin and at several Latin American universities. The objective would be to generate structured comparisons of the trajectory and context of health sector reform and map the landscape of health-related NGOs in all three countries, situating these in comparative global perspective. In turn, this effort would inform comparative analyses of the transformation of NGOs, undertaken in collaboration with the Center for Democracy and the Third Sector at Georgetown University. Participating units at the Council include the SSRC Program on Philanthropy and the Nonprofit Sector and the Program on Latin America.