Short Abstract:

This study applied the concept of collective capabilities and the 3C-model on the reproductive health field. Analysing the work of two Ugandan NGOs, it explored how NGOs promote individual and community’s agency to advocate for reproductive justice. The findings show that local NGOs play a vital role to address community issues and concerns and to deliver the necessary information and referral.

Long Abstract:

Background and research context

Information and access to reproductive health is a human right and targets regarding universal access to reproductive health care information and services are included in SDGs 3 and 5. Reproductive health is defined as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes’ and ‘implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so’ (UN General Assembly, 1995). However, access to reproductive rights is not guaranteed in many countries in the world, and this is even more evident when it comes to access to safe abortion. Evidence and previous studies show that local NGOs play a huge role in making progress with the SDGs and in promoting locally led changes. However, little is known on how such organisations propose or implement projects oriented towards bringing changes to improve reproductive rights.

Research objectives

The objectives of this study were to:

• Explore the role of Ugandan NGOs in translating the SDGs targeted at reproductive health into local action.

• Explore the role of Ugandan NGOs in advocating for the implementation of policies aimed at addressing reproductive health.

• Elaborate the role of Ugandan NGOs in promoting individual and community agency to advocate for reproductive justice.

Methodology

The original contribution is made by analysing how two Ugandan NGOs work to improve information and access to reproductive health care services and how they are guided by the SDGs in this process. Their work is analysed using the concept of collective capabilities and applying the 3C-model developed by Ibrahim (2017) and aiming to ‘demonstrate how individual and collective acts of agency can generate new collective capabilities at the grassroots’ (p. 202). For this study, the model allows analysis of how the two NGOs propose or implement projects oriented towards bringing changes.

The methodology takes the form of an in-depth qualitative case study. The study focuses on two organisations that work on reproductive health and rights in Uganda: Fabs Organisation (hereafter Fabs) and COHERINET – The Community Health Rights Network (hereafter COHERINET). Data collection took place online between September 2021 and May 2022 and comprised two main methods: document analysis and 21 semi-structured interviews with NGOs members, complemented, where possible, by the photo elicitation technique. Themes and sub-themes were identified by conducting a thematic analysis (Braun and Clarke, 2006).

The 3C-model identifies three main processes for successful change: (1) conscientisation at individual level; (2) conciliation at communal level; and (3) collaboration at institutional level. Thanks to the 3C-model, this study analysed how Fabs and COHERINET propose or implement projects oriented to bring changes.

Analysis and conclusion

The findings suggest that local NGOs play a vital role to address community issues and concerns, to assess the specific needs and to deliver the necessary information and referral. This is even more crucial when working on topics such as reproductive health and abortion, which are often considered sensitive and controversial in certain communities. Therefore, it is recommended that local NGOs and networks of NGOs are considered central and are involved in all stages of the planning and implementation of reproductive health services and in the promotion of reproductive rights.

This study applied the concept of capabilities on the reproductive health field. It focused particularly on collective capabilities, defined by Ibrahim (2006, p. 404) as “newly generated capabilities attained by virtue of their engagement in a collective action or their membership in a social network that helps them achieve the lives they value”. It employed a recent model, the 3C-model (Ibrahim, 2017), and contributed to its testing in analysing grass roots-led change. As the 3C-model is quite recent, there are only a few studies that have applied this model to other research except for the ones used by Ibrahim to develop the model itself (Ibrahim, 2016; Ward et al., 2022). Thus, this study makes an important contribution to its application, and to study the role of NGOs in improving reproductive healthcare access.

The 3C-model provided a clear and useful framework to design the study, and it was straightforward to analyse the work of Fabs and COHERINET following the three processes and the three evaluative qualities. The data from both the interviews and the documents fitted well in that scheme. It is important to note though that for this study the work of the two NGOs was yes analysed following this model, but the model was only used as a framework to analyse their work, to guide the thematic analysis and to reply to the research questions. And this process was carried out by the researcher, an external person to the NGOs. Also, the work that Fabs and COHERINET do is not based on the three processes of the model. It would be useful for future studies to see the 3C-model applied by NGOs themselves and how this is different than when it is applied by outsiders.