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The Critical Need for Funding Civil Society Organizations by Global Health Initiatives
GFO issue 451

The Critical Need for Funding Civil Society Organizations by Global Health Initiatives


George Njenga Kiai

Article Type:

Article Number: 5

Global Health Initiatives (GHIs) can significantly enhance their effectiveness by involving Civil Society Organizations (CSOs), particularly those in the Global South. This article, drawing from the "Too Southern to Be Funded" report and Transparency International's IDA21 report, underscores the critical need for GHIs to fund CSOs. Despite their essential role in delivering health services, advocating for policy changes, and ensuring accountability, CSOs face substantial funding challenges due to stringent donor requirements, lack of direct funding channels, capacity constraints, and perceived risks. Funding CSOs is not only equitable but also efficient, as local organizations often provide better value for money and enhance program sustainability. The article offers recommendations for GHIs, including creating dedicated funding channels, enhancing capacity building, promoting inclusive funding practices, fostering partnerships, increasing transparency, and supporting long-term funding. Addressing these disparities is vital for sustainable health outcomes and global equity, providing a clear roadmap for GHIs to better support CSOs and achieve more effective health interventions worldwide.



Global Health Initiatives (GHIs) have been pivotal in combating health crises and improving health outcomes globally. However, to enhance their effectiveness and sustainability, there is a growing recognition of the need to more robustly involve Civil Society Organizations (CSOs). This article integrates insights from the “Too Southern to Be Funded” report on the Development Assistance Committee (DAC), which operates under the Organization for Economic Co-operation and Development (OECD) and the Transparency International report for IDA21 (The World Bank’s International Development Association), underscoring the necessity of funding CSOs and providing detailed recommendations for GHIs.


The Role of CSOs in Global Health


CSOs are fundamental in delivering health services, advocating for policy changes, and ensuring accountability in health programs. They are often on the front lines, reaching populations that government programs might overlook. Their intimate connection with local communities allows them to understand and address specific health needs more effectively than large, bureaucratic organizations. For instance, CSOs in the Global South have been crucial in not only addressing various health challenges but also in providing essential services such as vaccinations, maternal and child health, health education, and chronic disease management. Their work encompasses a broad spectrum of health services, ensuring that communities receive comprehensive and culturally relevant care. For instance, local CSOs in Kenya have been instrumental in delivering maternal health services in remote areas, significantly reducing maternal and infant mortality rates. In India, grassroots organizations have successfully implemented community-based monitoring of health services, leading to improved accountability and service delivery. In Poltava, Ukraine, civic activists successfully exposed and dismantled a significant corruption scheme in the medical sector. By leveraging local knowledge and mobilizing community support, these activists were able to uncover fraudulent activities that were siphoning off vital healthcare funds. Their efforts led to greater transparency and accountability within the medical sector, ultimately improving healthcare delivery for the local population.


Challenges Faced by CSOs


Despite their critical role, CSOs, particularly those in the Global South, face significant challenges in securing funding. The “Too Southern to Be Funded” report by the #ShiftThePower movement highlights several barriers:


  1. Stringent Donor Requirements: Many donor countries in the OECD have complex application and reporting processes that smaller, local CSOs struggle to meet. This includes detailed financial reporting, compliance with international standards, and extensive documentation that require resources and expertise that many local CSOs lack.
  2. Lack of Direct Funding Channels: A significant proportion of development aid is channeled through large international NGOs based in donor countries. According to the report, over 90% of civil society support from the OECD’s DAC, goes to domestic and other Global North CSOs, leaving less than 10% for CSOs in the Global South (Figure 1)​​.


 Figure 1: Percentage of bilateral ODA provided to CSOs that goes directly to global south CSOs (Average 2009-2021)



  1. Capacity Constraints: Many local CSOs operate with limited staff and financial resources, making it challenging to scale their operations or engage in long-term planning. This is exacerbated by short-term, project-based funding that does not cover core operational costs.
  2. Perception of Risk: Donors often perceive funding local CSOs as riskier than funding international NGOs due to concerns about governance, financial management, and accountability. This perception persists despite evidence that local organizations can deliver high-quality, cost-effective services.


The Importance of Funding CSOs


Funding CSOs is not just a matter of equity but also of efficiency and effectiveness. Local CSOs can provide better value for money due to lower operational costs and their ability to mobilize community resources. They also enhance the sustainability of health programs by building local capacity and fostering community ownership. Moreover, CSOs play a crucial role in holding governments and international agencies accountable, ensuring that health interventions meet the needs of the communities they serve.


Recommendations for GHIs


To address these challenges and leverage the strengths of CSOs, both the “Too Southern to Be Funded” report and the Transparency International report for IDA21 offer comprehensive recommendations:


  1. Create Dedicated Funding Channels: GHIs should establish dedicated funding channels for local CSOs to ensure they receive the financial support necessary to carry out their work. This includes simplifying application processes and reducing administrative burdens that disproportionately affect smaller organizations. For example, the OECD DAC has recommended increasing the transparency of aid flows to ensure more direct funding reaches Global South CSOs​​.
  2. Enhance Capacity Building: Investment in capacity building is essential to enable CSOs to meet donor requirements and scale their operations. This includes providing training in financial management, monitoring and evaluation, and advocacy skills. Capacity-building initiatives should be tailored to the specific needs of local organizations, focusing on areas such as governance, strategic planning, and resource mobilization.
  3. Promote Inclusive Funding Practices: Donors should adopt more inclusive funding practices that recognize the unique contributions of local CSOs. This includes moving away from a one-size-fits-all approach to funding and developing tailored support mechanisms that address the specific needs and contexts of different CSOs. For instance, the Transparency International report highlights the need for funding mechanisms that are flexible and adaptable to local contexts .
  4. Foster Partnerships: GHIs should foster partnerships between international NGOs and local CSOs to leverage the strengths of both. This includes promoting models of co-implementation and co-funding that build the capacity of local organizations while ensuring accountability and transparency. Successful partnerships often involve joint planning and decision-making processes that respect the autonomy and expertise of local CSOs.
  5. Increase Transparency and Accountability: Transparency and accountability mechanisms should be strengthened to ensure that funds are used effectively and that CSOs are held accountable for their performance. This includes regular audits, performance evaluations, and feedback mechanisms that involve beneficiaries in the oversight process. The Transparency International report recommends the use of digital platforms to track and report on funding flows and project outcomes .
  6. Revise Funding Criteria: Donors should revise their funding criteria to prioritize equity and inclusivity. This includes redefining what constitutes a ‘local’ organization to ensure that funding commitments do not inadvertently favor Global North CSOs with local offices in the Global South. Clear guidelines and metrics should be established to track disaggregated aid flows to individual Global South CSOs consistently.
  7. Support Long-Term Funding: Short-term, project-based funding limits the ability of CSOs to engage in strategic planning and sustainable development. Donors should provide long-term, flexible funding that covers core operational costs and allows CSOs to innovate and respond to emerging needs. This approach not only strengthens the organizational capacity of CSOs but also enhances the impact and sustainability of their interventions.


The Broader Implications of Funding CSOs


Addressing funding disparities is not just about improving health outcomes; it is also about correcting historical injustices and fostering global equity. The funding bias against CSOs in the Global South reflects broader systemic issues of neo-colonialism and economic disparity. By redirecting funds to these organizations, GHIs can contribute to a more balanced global development landscape, where power and resources are more equitably distributed.


Moreover, the push for funding local CSOs aligns with broader trends in international development that emphasize localization and sustainability. The “Too Southern to Be Funded” report advocates for a shift in power dynamics within the development sector, encouraging donors to trust and invest in local capacities. This is crucial for creating resilient health systems that can withstand future crises.




The integration of CSOs into the funding frameworks of GHIs is essential for achieving sustainable health outcomes. By addressing the barriers to funding and implementing the recommendations outlined above, GHIs can ensure that CSOs continue to play their vital role in improving health outcomes worldwide. The need for action is urgent, as the challenges faced by CSOs will only intensify if left unaddressed. Both the “Too Southern to Be Funded” report and the Transparency International report for IDA21 provide a clear roadmap for how GHIs can better support CSOs, ultimately leading to more effective and equitable health interventions worldwide. Moreover, their involvement in the institutional frameworks of GHIs for policy setting is crucial, recognizing their indispensable role in achieving global health goals.


In light of the upcoming Civil Society Policy Forum, 2024, to be hosted by the World Bank and International Monetary Fund in Washington D.C. aimed at engaging with CSOs on development topics of importance, CSOs can leverage their collective voice to ensure that they get heard as the call for proposals to organize sessions is underway. Given that GHIs are at pains to showcase their inclusivity and diversity but invariably organize such platforms in the Global North (never mind the carbon footprint) at great expense, it beggars belief that they are so unwilling to loosen their purse strings to sustain the operational costs of CSOs on a sustained basis just as a starting point.


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