NPO performance in reproductive health sector of low and middle income countries: what is the influence of the wider policy context

Non-ProfitOrganizations (NPOs) are increasingly being promoted as preferred providers toreplace weak government services in Low and Middle Income Countries (LMIC) butresults on ground show mixed performance. The variation in national policycontexts is one explanation for uneven NPO performance but has beenunder-explored in reproductive health literature. This paper collates gray andpublished literature providing an overview of how policy context impacts on NPOperformance in reproductive health. Socio-political context, state policies anddonor dependency indirectly influence NPO working by shaping operational space,autonomy, networking and mandate. These influences need to be recognized andmodified so as to enable NPOs to better achieve their attributedcharacteristics of client responsive and quality services aimed at marginalizedpopulations. Policy measures are needed to build better policy space and regulatoryframeworks for NPOs, state-NPO collaboration forums, and greater reliance oninternal funding.