Coalition of NGOs Child Protection – KOMF, which represents 34 non-governmental organizations, has addressed to the Minister of Health, the challenges of non-governmental organizations in providing health services as a result of not adjusting their status in providing health services.

For over 20 years, the majority of services for children and persons with disabilities have been provided by nongovernmental organizations at no cost, primarily supported by international donors. These services are offered through specialized day centers managed by non-governmental organizations, which provide daily rehabilitative health services such as physiotherapy, occupational therapy, speech therapy, and individual or group psychological sessions for children and adults with disabilities.92 On the other hand, a range of healthcare services is provided by non-governmental organizations for children and adults who use narcotic substances, children in street situation, children from marginalized communities, and others. These services are provided by non-governmental organizations with extensive experience, appropriate infrastructure, and qualified professionals in the field of healthcare.93

It is estimated that around 50 non-governmental organizations provide integrated health and social services. However, these organizations are not licensed as healthcare service providers due to perceived legal deficiencies in frame of the Law on Health Law. Within the Law on Health, there are considered to be contradictory provisions regarding the provision of healthcare services by non-governmental organizations and their licensing.

• Article 15, paragraph 2, of the Health Law states that “Healthcare services are provided by public, private, and public-private health institutions.”
• Meanwhile, Article 38 “Health Institutions within Civil Society” specifies that “Healthcare services in humanitarian health institutions and other forms of civil society organization in the health field are regulated by a sub-legal act issued by the Ministry.” It is noteworthy that this sub-legal act has not been issued by the Ministry of Health, and so far, no nongovernmental organization has been licensed to provide healthcare services.

Articles 15 and 38 are considered to have created confusion and legal uncertainty for the law enforcement agencies. This situation is damaging the status and sustainability of health services provided by non-governmental organizations (NGOs) and can even be seen as discriminatory towards the non-governmental sector. There are numerous cases where NGOs, in addition to their status as non-governmental organizations, have been forced to license themselves as private health institutions to enable the provision of health services, even though all the services provided are free of charge.

Regulating the status of NGOs as providers of health services will increase access to specialized care for vulnerable populations, will impact the sustainability of services and enhance accountability.

It is worth mentioning that these services are not provided by the public sector, especially when it comes to specialized services for children and adults with disabilities.

Taking into account the facts elaborated above as well as the interest of the beneficiaries of health services who are mainly vulnerable groups, KOMF requests the regulation of the status of non-governmental organizations as providers of health services, through the following steps:

• Issuing a legal interpretation to clarify whether the provisions of the current Health Law enable the provision of health services by non-governmental organizations. If this is possible, proceed with issuing the legal act for the licensing of non-governmental organizations for the provision of health services, as defined in Article 38 of the Law on Health.
• In contrast, it is proposed that Article 15, paragraph 2 of the Law on Health (which is in the process of being amended), be amended to include non-governmental organizations as providers of health services. KOMF considers it important to include and contribute to the process of completing the amendment of the Law on Health.

The involvement of NGOs as providers of health services will increase access to specialized care for the vulnerable population and will influence the increase in sustainability of services and increase accountability. The Ministry of Health must take measures to show its commitment to accessible and equal health care for all service providers, public, private and non-governmental.

KOMF remains committed to cooperating with the Ministry of Health in this process.