ANALYSIS OF AN NGO: THE CASE OF AMREF
Analysis of An NGO: The Case of AMREF
The 1950s in Africa was the beginning of decolonization. Kenya at this time was experiencing social and political unrest. Six years before Kenya’s declaration of independence from the British, an NGO, the African Medical Research Foundation (AMREF) was established by three doctors to address the health needs of populations whose access to medical services was very minimal. This paper looks into formation and operations of AMREF from a Regime Theory Perspective. It attempts to explain the beginnings of the NGO, the international system that gave rise to the NGO, and the function of the NGO as an element of the larger international system.
History, Founders, and Mission Statement
The African Medical Research Foundation (AMREF) was established in response to healthcare needs of communities in East Africa. Over the years, since its formation, this non-government organization (NGO) launched interventions to address specific needs of its beneficiaries. The strategies AMREF used were designed in consideration of the physical, social, economic, and political context of its project sites.
The NGO was formed in 1957 by individuals who had first-hand knowledge about the needs of the communities. According to its website, the AMREF founders, namely Doctors Archibald McIndoe, Michael Wood and Tom Rees, were reconstructive surgeons. They were familiar about the situation in East Africa because they have worked there for years. They knew about the physical and socio-economic conditions of their target communities. The ratio of doctor to patients in East Africa in the 1950s was 1:30,000 and access to medical facilities was almost non-existent because of the rough terrain and impassable roads (amrefusa.org). The need for medical services was matched by the doctors’ expertise in healthcare.
AMREF’s intervention over the years reflected the changes taking place in the project location as well. The NGO started with flight-based medical services due to lack of roads. In the next decade, ground-based medical services were introduced in addition to the flight-based. Then from the 1970s onwards, the training of local health workers became an important component of the organization’s activities. In the next decades, the organization collaborated with government agencies and international organizations and the programs being implemented also broadened to accommodate other pressing concerns such as disaster management and strengthening of health systems.
The mission statement of AMREF is “to empower the people of Africa, through better health, to escape poverty and improve the quality of their lives” (amrefusa.com). Accounts about its success in implementing this vision are manifested in news reports and journal articles. For more than 50 years, AMREF has continued to carry out its mission through programs like HIV/AIDS and malaria prevention and treatment,” water and sanitation, surgical outreach, training of health professionals and community health” (Global Journal, 2012). In 2007, AMREF became and implementing partner of the Global Health Workforce Alliance and it contributes to the global efforts of addressing the health workforce crisis through the AMREF International Training Center in Nairobi, Kenya (WHO 2013).
International System that Gave Rise to AMREF
The coming of the doctors to Africa was in part a result of the colonization of Europeans of many African countries. At that time, Kenya, was still a British colony and AMREF was established by a British doctor in 1957. In later decades, though, the process of globalization contributed to the development of AMREF. Information about the needs of the populations are shared with other stakeholders and development organizations. Contributions from various sources from other parts of the globe come in and are utilized for key projects. Training is accessed by health workers from the neighboring countries as well. Advances in technology and medicine also contributed to the implementation of AMREF projects.
International organizations such as the United Nations and World Health Organization contribute to the programs of AMREF. The MDGs was a result of a UN summit and the WHO has partnered with various organizations for programs that would improve the health for all especially the vulnerable populations in Africa. International philanthropy was at work through the fundings provided by private organizations to specific projects. It is also important to note that projects that NGOs implement are influenced by available funding which in turn are dictated by the current thrusts of international foundations. The interactions of these different systema has generated and impetus for the the creation of an NGO that would address the health issues in Africa.
. Function of the NGO in the Larger International System
Conduit of Funds
AMREF’s operations in Africa is supported by its partner organizations in other parts of the globe. In the US, the NGO accepts funding from a variety of sources from government agencies such as the Center for Disease and Prevention and USAID, from private foundations, and even from individuals through its website. As a conduit of funds, AMREF provides opportunities for organizations and individuals to extend assistance to populations in need.
Millennium Development Goals (MDGs)
The programs and activities of AMREF contribute to the attainment of the MDGs particularly in maternal and child health. The NGO works with international partners to implement programs that increased communities’ access to safe water, vaccines, and medicines. They also implement projects for HIV/AIDS victims. AMREF implemented projects in collaboration with the local health organizations. According to Kibua et al. (2009), AMREF’s implementation of projects which were in accordance to the government’s health policy indicate “AMREF’s sensitivity and responsiveness to health concerns in a changing development environment over the years” (p. 25).
Countries who belong to the United Nations have attested their agreement to the MDGs. The States are the ones held accountable for the targets of the millennium development goals, thus by being a partner of the state’s health departments, AMREF acts as an enabler of change in the countries where it is implementing its programs. AMREF is likewise involved in the training of personnel and by doing so, it has multiplied the effects of its interventions.
In 2008, the World Health Organization identified the workforce crisis in the health sector as a major issue that needs to be addressed. As one of the implementing partners of the Global Health Workforce Alliance, AMREF has a major contribution to the training of local health workers. Its training center in Nairobi hosts courses that are attended by health workers not only in Kenya but from other neighboring countries in Africa. Through these trainings, AMREF is instrumental in increasing the capacities of local health workers so that they are able to give the needed services. With better trained health workers, it is expected also that patients, particularly those from the most marginalized situations would recover from their illness resulting in better health for African countries.
This paper has analyzed the NGO, AMREF, by using the perspective of the Regime Change Theory. The regime referred to is AMREF’s health interventions in East Africa. The preceding sections explained the beginnings and development of the organization, described the international system that gave rise to the NGO, and discussed the function of the NGO in relation to the international system. AMREF was established in the 1950s to address a specific health need – that is the access of populations to critical medical health care. AMREF began with a flight-based mobile health system which later on evolved into a ground-based system, then into partnerships with local health organizations. The international systems that generated the creation of the NGO are the cooperation of different states through the United Nations as well as the increasing presence of international philantrophy. AMREF has several functions within this international system. It acts as a conduit of resources with funds from government, private organizations, and individuals being converted into services and provided to the target beneficiaries. Second, AMREF implements projects aimed at attaining the millennium development goals. Finally, AMREF contributes to the solution for the global workforce crisis in the health sector and this is done through the courses it offers in the Training Center in Nairobi as well as through its existing partnerships with local organizations. AMREF has already half a century of experience in the field and its programs have evolved over the years to address both the needs of its beneficiaries and the capacities of its implementers. This process of analyzing using the Regime Change theory has indeed deepened this author’s understanding NGOs, particularly of AMREF.
“#81-AMREF.” The Global Journal. Januray 23, 2012. accessed October 5, 2013. http://theglobaljournal.net/article/view/544/.
AMREF USA. “Our History.” accessed October 5, 2013. http://www.amrefusa.org/who-we-are/about-us-/our-history-/.
Kibua, Thomas N., Daniel M. Muia and Margaret Keraka. Efficacy of Community-Based Health Care in Kenya: An Evaluation of AMREF’s 30 Years in Kibwezi, AMREF Discussion Paper Series. Kenya: The African Medical and Research Foundation, 2009.
WHO.“African Medical and Research Foundation.” Global Health Worforce Alliance. accessed October 5, 2013 http://www.who.int/workforcealliance/members_partners/member_list/amref/en/index.html.