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NGOs and the transfer of global maternal health policies – NGOMA (completed)

The primary aim of this study is to investigate the transfer of global maternal health policies approached through the actions of international NGOs.

About the project

NGOMA: Analyzing the rise of non-state actors

One of the clearest trends in recent history of global health is the stronger role for non-state actors, whether corporations, philanthropic foundations, public-private partnerships or non-governmental organisations and civil society groups.

The NGOMA project addresses this trend by examining the role of health-related NGOs in ‘transferring’ or diffusing global norms, policies and programmes targeting women’s and adolescent’s health to the national health and education system and local communities in Malawi.

The project has developed a unique research focus on the role of such actors, applying critical ethnographic methods to understand their impact on policy, governance and practice. Through a multi-sited ethnographic study, the project examines how policies and programmes made by global communities of practice work themselves out, and to what effect, within national policy circles and local practice.

Maternal Health: a field increasingly relying on NGOs

The maternal health field has recently been going through a rapid policy shift. At the end of the MDG era, the focus in maternal health was primarily on skilled birth attendance. At the end of 2014, the policy discourse had narrowed down to teenage pregnancies and how to prevent them – through keeping girls in school. The influx of NGOs in health development enabled this profound rapid shift, by bypassing the time consuming and bureaucratic process of going through national policy channels.

NGOs, on the other hand, as channels for these global norms are faced with the reality of competing for short-term funding, within an increasingly competitive environment. NGOs find themselves under constant pressure to produce success, which hinders a more critical view of learning and the fault lines in the implementation process.

This was further intensified when the newly elected President Trump reinstated and expanded the Mexico City Policy, or the global gag rule, banning foreign NGOs from providing abortion services, lobbying for abortion or even informing women about abortion.

This lead to a further shrinking of the political space for civil society that heavily affects the ability of civil society to have a distinct political voice. In local communities, the vast number of NGOs implementing all kinds of small-scale projects is met with distrust and resistance. 

The changing role of NGOs

NGOs are at present unable to voice needs of communities, but are instruments for the implementation of global policies. As such, they have lost the profound role of civil society as intermediaries between policy makers, be they governmental or global, and local communities.

The fact that donors bypass governmental structures, favoring NGOs as implementing actors, further weakens already fragile national health and education systems.

Research outcomes

The NGOMA project has clear policy relevance, given that bilateral donors, including Norway, direct substantial funding to non-governmental organisations, primarily international NGOs. Today, the information of these implementing practices is produced by NGOs themselves that is heavily limited by a strict reporting system and the pressure to produce success. The NGOMA project is very timely as we are at the forefront in describing and analyzing these profound changes in the health development field.

The NGOMA project takes note of this timeliness by publishing in leading social science and public health journals in order to engage both the social sciences as applied to health, and public health research, policy and practice.

In addition, the project is committed to knowledge exchange beyond the academic sphere, by providing scientific input at policy-related conferences, panels of donors and nongovernmental organisations and popular press.  


The project is funded by the Research Council of Norway’s GLOBVAC Programme (2014-2018).


The project is a collaboration between the Centre for Development and the Environment at the University of Oslo and Chancellor College at University of Malawi.


  • Hanneke Pot (2019). Public Servants as Development Brokers: The Shaping of INGOs’ Reducing Teenage Pregnancy Projects in Malawi’s Primary Education Sector. Forum for Development Studies.  ISSN 0803-9410.  46, s 23- 44
  • Maren Olene Kloster (2019). Why it hurts – Save the Children Norway and the Dilemmas of ‘Going Global’. Forum for Development Studies.  ISSN 0803-9410.  46, s 109- 130
  • Judith Daire; Maren Olene Kloster & Katerini Tagmatarchi Storeng (2018). Political Priority for Abortion Law Reform in Malawi: Transnational and National Influences. Health and Human Rights: An International Journal.  ISSN 1079-0969.  20, s 225- 236
  • Katerini Tagmatarchi Storeng; Jennifer J Palmer; Judith Daire & Maren Olene Kloster (2018). Behind the scenes: International NGOs’ influence on reproductive health policy in Malawi and South Sudan. Global Public Health.  ISSN 1744-1692.  14, s 555- 569
  • Hanneke Pot; Bregje de Kok & Gertrude Finyiza (2018). When things fall apart: local responses to the reintroduction of user-fees for maternal health services in rural Malawi. Reproductive Health Matters: An international journal on sexual and reproductive health and rights.  ISSN 0968-8080.  s 1- 11

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  • Maren Olene Kloster (2018). Efforts to change Malawi's abortion law: The role of NGOs.
  • Maren Olene Kloster (2018). Abortion rights in Africa: law - policy - practice. Panel discussion..
  • Maren Olene Kloster (2018). Why it hurts – introduction to dilemmas of being part of an INGO.
  • Hanneke Pot & Marielle L.J. le Mat (2018). Unschooling development: girls’ and sexuality education as neutral development goals?.
  • Hanneke Pot (2018). Confronting local realities in project implementation – translations and brokerage.
  • Maren Olene Kloster (2018). Behind the scenes: International NGOs’ influence on reproductive health policy in Malawi and South Sudan.
  • Hanneke Pot (2018). The Yao strongly hold on to their culture’: culturalism and teenage pregnancies in Malawi.
  •  (2018). About Stereotypes, Traditional Practices and Culture: Experiences from Fieldwork in Malawi (NRSGH blog).
  •  (2018). Når folket blir fienden.
  • Maren Olene Kloster & Katerini Tagmatarchi Storeng (2017). An alliance of invisible partners: international actors’ legitimacy seeking practices in the Malawian abortion law reform.
  • Katerini Tagmatarchi Storeng & Maren Olene Kloster (2017). A struggle for legitimacy – international NGOs’ role in liberalising Malawi’s abortion law.
  • Hanneke Pot (2017). Preliminary research findings and fieldwork experiences from Mangochi, Malawi.
  • Hanneke Pot (2017). Shifting blame: NGOs' behavioral interventions to reduce teenage pregnancies in rural Malawi.
  • Hanneke Pot (2017). Primary schools as arenas for improving reproductive health: experiences of Malawian teachers in dealing with aid fragmentation.
  • Hanneke Pot (2017). The girl effect in local realities: Malawian girls’ (im)mobility (with Gertrude Finyiza).
  •  (2017). Hadde hun 'the time of her life'? Dirty Dancing og retten til trygg abort.
  • Sidsel Roalkvam & Maren Olene Kloster (2016). State practices or studying up?.
  • Maren Olene Kloster (2016). Global policies, local realities – changing role of NGOs.
  • Sidsel Roalkvam; Hanneke Pot & Maren Olene Kloster (2016). Global policies, local fragmentation: the impact of International NGOs on health development.
  • Sidsel Roalkvam & Hanneke Pot (2016). Global policies, local fragmentation: the impact of International NGOs on health development.
  • Hanneke Pot (2016). Intersectoral approaches to adolescent reproductive health: local complexities in a donor dependent state.
  • Sidsel Roalkvam & Maren Olene Kloster (2016). NGOs and the transfer of global maternal health policies (NGOMA)..
  • Sidsel Roalkvam; Katerini Tagmatarchi Storeng; Joseph Chunga; Peter Mvua; Hanneke Pot; Maren Olene Kloster & Blessings Chinsinga (2016). NGOs and the transfer of global maternal health policies.
  • Maren Olene Kloster & Katerini Tagmatarchi Storeng (2016). A struggle for legitimacy – liberalizing the abortion law in Malawi.
  • Maren Olene Kloster (2016). IPAS: an invisible change agent in the Malawian abortion law reform?.
  •  (2016). Dealing with aid fragmentation (SUM blog).
  •  (2016). 12 NGO’er drev bistand på én skole.
  • Sidsel Roalkvam; Maren Olene Kloster & Hanneke Pot (2015). The Girl Effect - What Happened to Gender and Development?.
  • Maren Olene Kloster; Hanneke Pot & Sidsel Roalkvam (2015). NGOMA - an overview.
  • Maren Olene Kloster (2015). Producing Evidence. The Role of NGOs in Health Development.

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Tags: Global South, Malawi
Published Mar. 27, 2015 11:02 AM - Last modified June 22, 2020 1:57 PM