The 2008 Sichuan earthquake marked a tipping point for nongovernmental organizations in China. The Chinese government has since established funding mechanisms for civil society and made it easier for local aid groups to register with the authorities.
However, the situation for international development organizations working in the country remains challenging, and suspicion still lingers on both sided.
So how can we move forward on this? Through partnerships, according to Lily Liu, China country director for Marie Stopes International. Liu oversees the provision of reproductive health education and HIV prevention and care in nine Chinese provinces — an area in which she could never have imagined working as a child.
“When I was young, we all grew up with the idea that the government could do everything, but we gradually learned that civil society can also play a very important role,” she said during an exclusive interview in London, where Liu shared four key lessons learned for international NGOs on working together to address sexual and reproductive health and rights in China.
1. The power of advocacy by example.
While advocacy has proven a useful strategy in creating change on HIV and AIDS in many developing countries, MSI’s experience is that when it comes to working with government, "advocacy by example" works best.
In practice, this means that instead of adopting the stance of instructing government on what it should do and talking about the need for human rights, development actors should start with action.
“I think even the Chinese government has good intentions and they want better health outcomes, but sometimes they don’t have the tools or they don’t know they best way to change a situation,” explained Liu. “If we can provide them with examples that illustrate what can be done and how it can be achieved, this works much more effectively as officials can more easily see how they can learn from our approach.”
2. Form partnerships to enable scalability
For iNGOs working in China, just the sheer size of the country means there’s a limit to what can be achieved alone.
“We always try to work in partnership, whether it be working with government to build more centers or companies to reach more migrants,” says Liu. “When you work in partnerships everyone brings a different area of expertise so if we can pool our resources together it makes scaling up much more achievable.”
When MSI launched a youth center in Chengdu, it served as a model example of how improvements can be made in delivering SRHR services to an often neglected group. The simple infrastructure of the project, a provincial government invited MSI to advise them on how they could use the organization’s infrastructure to increase impact of health services for young people in their region.
After collaborating on the model, which included everything from training to the monitoring and evaluation framework, the provincial government decided to extend that model to a further 1,000 centers within that province.
“As an NGO, that’s an impact we are happy to see as there is no way we would ever have the resources to achieve something of that scale,” Liu said.
3. Localization is key.
While drawing from international best practice is important, understanding China’s unique context has proven key to ensuring that the organization has been able to adapt its approach to deliver programs that are suited the local population’s needs.
In fact, given that MSI’s staff is entirely Chinese, the organization regards itself very much as a local NGO, and Liu suggests this may be one of the reasons they have experienced few difficulties in collaborating working with local partners.
For the country director, the value of localization lies in the fact that the sustainability of projects is strengthened by local people's understanding of the challenges to be addressed, combined with a passion for finding lasting solutions. Her advice to other international organizations that would like to work in China is to tap in as much as possible to local leadership and national intelligence.
“Of course international people have a lot of expertise, but I would suggest international staff might be better placed as technical advisers rather than directly managing a project,” she said. “It takes time to understand the local situation. Often, by the time an expat fully understands the situation they are working in, it’s time for them to leave. For international staff it’s a job, whereas for local people it’s a passion.”
4. Include the private sector.
In China, as in many countries, the stigma around HIV and AIDS is a significant barrier to progress. MISC has found that tackling discrimination at the point where its impact is felt most strongly felt has been effective. The organization works directly with a range of multinational corporations including Adidas, Levi Strauss and their supply chains.
They introduced a training program in their supply factories, where employees talk about sexual and reproductive health issues, as well as family planning and HIV prevention.
“By 2013 they had visited 23 factories, each employing between 1,000 and 10,000 workers,” Liu said. “Once the program has finished, the factory will mainstream it into their existing on-the-job training system, so the learning can continue even after our work has ended.”
Healthy Means is an online conversation hosted by Devex in partnership with Concern Worldwide, Gavi, GlaxoSmithKline, International Federation of Pharmaceutical Manufacturers & Associations, International Federation of Red Cross and Red Crescent Societies, Johnson & Johnson and the United Nations Population Fund to showcase new ideas and ways we can work together to expand health care and live better lives.