MAXIMIZING POSITIVE SYNERGIES - World Health Organization

Some informants felt that local NGOs benefited greatly from GHI funding and partnerships with
international NGOs that had more resources and experience to share:
Discussion
Local NGOs, they benefited from the experience of international NGOs. They
learnt from them. It is like small soccer teams. When a small soccer team from the
village plays with a big experienced team, it does have the fear to lose the game,
however the small team learns from the big one. For sure local NGOs have learnt
a lot; we have noticed that in the area of how they now work, plan, and how they
organize themselves. This strengthens both the Rwandan society and the health
system. And we strengthen more the lower level institutions, it is very important
for us.
Rwanda is an example of how, with strong coordination at the national level, the money from GHIs
can strengthen health systems. Specific examples of the linkage between the stewardship of the
Rwandan government and the utilization of GHIs that were demonstrated by the qualitative
analysis are: the unified procurement system CAMERWA with medications beyond targeted
diseases funded by Global Fund with technical capacity building by PEPFAR. Both GHIs were
called upon to contribute to the national insurance system of “mutuelle de santé” which increased
access for targeted and non-targeted diseases. The national plan to spread and decentralize
services across the country was supported by both of the main GHIs in Rwanda. Lastly, the
Rwandan government successfully coordinates even international NGOs to work within the
national framework through the PEPFAR steering committee that was created by the government.
This strong national framework with donor collaboration with the clear intent of designing a
health system as a national priority and, in that context to deliver equitable, well distributed HIV
care, is a critical lesson to both national governments, international NGOs and donors. This
approach highlights the importance of government oversight and planning and stewardship in
the long-term success of such projects.
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