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Title: Performance analysis of Egyptian non-governmental organisations in primary health care.
Author: El-Sanady, Magdy Latif.
ISNI:       0000 0001 3443 485X
Awarding Body: University of Keele
Current Institution: Keele University
Date of Award: 2001
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Despite recent phenomenal growth of non-governmental organisations (NGOs) in the developing world, especially in the field of primary health care (PHC), their performance currently witnesses many paradoxes. For example, a paradox between their growth in size and diversity, yet increasing concerns about their impact; another paradox is that of the intense questioning of their performance in development and health, and yet the increasing flow of support from most international agencies; and, a third paradox, is that of the increasing pressures for, and acceptance of the need for, performance evaluation, and yet a lack of institutionalisation within NGOs themselves, and the scarcity of models that can guide/help NGOs in that direction. Many explanations have been suggested for these paradoxes, and are likely to include the following: first, an NGO may lack the performance system which enables it to look at its own performance and analyse in a systematic way; second, an NGO, when undertaking a selfevaluation exercise, may confine itself solely to the project level (for accountability reasons) and overlook the other levels of analysis (namely, the organisation, service delivery, and individual levels); and, third, an NGO may not hold an holistic view as to what areas should be analysed, nor may it have the analytical tools readily available which help it to undertake such an analysis. Evidence from different literature supports each of these possible explanations. Accordingly, within this thesis, to help an NGO self-analyse its performance, a performance analysis framework (PAF) has been developed. This framework is structured to analyse the performance of an NGO service provider at three main levels: organisational; project; and, service delivery. Each level addresses an area for analysis, drawing upon a set of criteria for each area, raising a group of relevant questions for each criterion, and casting light on a cluster of possible investigative tools largely, but not exclusively, qualitative in nature. Theunderlying hypothesis of this framework is that the performance of an NGO in health and social development is the outcome of an interaction of many factors within both its external and internal environments. Hence, in the PHC setting, an NGO is confronted with an external environment composed of contextual elements (political, economic, legal, and socio-cultural), as well as a cluster of relationships with different stakeholders (donors, beneficiaries, government bodies, and other NGOs). On the other hand, the internal environment of an NGO is formed of a four-fold set of inter-related elements: its identity, its strategy, its operations, and its resources. Thus, the kinds of interactions taking place in both these environments are key determinants of the overall performance of the NGO. The PAF was then field tested in Egypt through a series of investigations, including focus group interviews as well as instrumental case studies. Four cases were selected from a pool of Egyptian NGOs (ENGOs) with different histories and geographic locations, but all being Community Development Associations (CDAs); participants in umbrella capacity building (CB) programmes sponsored by intermediary NGOs and funded by one bilateral donor; and, having service provision in the area of Maternal and Child Health (MCH). While the PAF was applied at the project level, the four PHC/MCH projects have also served as entry points to the analysis of the four organisations through a participatory self-assessment approach. The PAF, therefore, served as both research tool and conceptual frame of reference against all four cases, relying upon various triangulation techniques, in pursuit of research validation and quality control. The outcome is that of robustly testing the framework: by so doing, important lessons and insights have emerged both about the external and internal environment of ENGOs; and about the levels and kinds of performance CDAs operating in health currently attain, and can attain in the future. The research concludes with recommendations for a proposed capacity-building programme for CDAs guided by the PAF
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: NGOs; Developing world; Egypt; Community; Service Medical care Management