Health non-governmental organizations (NGOs) amidst civil unrest: Lessons learned from Nicaragua

ABSTRACT

The community-based disaster risk management (CBDRM) framework recognises the crucial role that small- and medium-sized NGOs play during adverse events, particularly in marginalised communities. Despite the global frequency of civil unrest, its effect on NGOs’ programmatic, administrative, and operational capabilities is poorly understood. To this end, we completed in-depth semi-structured interviews with eight key informants representing seven health NGOs in Nicaragua several months after widespread and persistent civil unrest erupted in April 2018. Data analysis revealed that all NGOs experienced notable disruptions in community education and health promotion, healthcare provision, fundraising, and strategic planning. Further, NGOs experienced several key challenges in responding to crises, including mobility within and between communities, diminishing financial resources, and safety concerns for staff and volunteers. Several NGOs anticipated long-term adverse impacts. In light of these challenges, we propose that health NGOs create a plan of action to mitigate adverse impacts of civil unrest and promote population health. Specifically, a plan of action should address institutional planning, communication strategies, and partnerships and coalitions. We also propose important ways in which future research could build on this preliminary study.

KEYWORDS:

• Social conflict
• civil unrest
• nongovernmental organization (NGO)
• community-based disaster risk management (CBDRM)
• public health
• Nicaragua

Acknowledgements

We are grateful to the study participants who shared their time and perspectives. Two anonymous reviewers and Richard Parker provided valuable feedback. Jason Kaloudis provided assistance formulating the literature review search criteria. Angela DeRosa contributed to the literature review. Kaitlin Castro-Gonzalez and Paige Jelenik assisted in transcribing interviews.

Disclosure statement

No potential conflict of interest was reported by the author(s).