Traditionally, NGOs (Non- Governmental Organisations) have been at the forefront of
bringing new issues to thepeople. Currently, in the context of RCH (Reproductive and Child Health) Programme, the following activities are carried out by NGOs :

• IEC and community mobilization
• Awareness programmes with referrals
• Service delivery
• Monitoring the programme
• Activism

As per the RCH programme, the role of NGOs has been very clear. This includes advocacy of maternal and childhealth interventions, promotion of small healthy family, improving community participation, counseling and motivating adolescents to delay age of marriage and delay first pregnancy for young couples, in addition to acting as a link between community and healthcare providers.

In addition, the country’s 10th five year Plan lists activities relating to RCH, particularly safe motherhood programme, which can be taken up by NGOs, especially in under-served and unserved areas. It is hoped that, in areas where public sector has not been optimally effective or is underutilized, NGOs will take on additional activities. Hence, gender-sensitivity and advocacy - care for the girl child, baby-friendly hospital initiatives, promotion of exclusive breast-feeding for 6 months and introduction of semi-solids at the right time, social marketing of contraceptives and ORS, and most importantly sensitizing the community regarding theadverse consequences of sex-determination and sexselective abortions are some of the activities listed for NGOs to take up.

Government of India has further facilitated NGO structure by funding and nurturing smaller NGOs through Mother NGO - Field NGO structure. This scheme has been operational for three years now and is in the process of decentralization. The focus of MNGOFNGO work is predominantly on RCH programme implementations in a specific area. The funding is decentralized and flexible and monitoring is by MNGOs. This has improved access and quality of IEC programme besides strengthening NGO structure. It isexpected that, in the second phase, FNGOs will take up clinical services also.

In this backdrop, the role of NGOs vis-à-vis medical abortion can be multilevel.

Advocacy – In the present context of MTP Act, provision of Medical Abortion needs to be discussed. NGOs, particularly at the National level, need to advocate and mobilize a debate for rethinking on present legislation. This is also an excellent opportunity to advocate decentralized abortion services.

Services – IEC on the availability and safety of medical abortion, where the services are available and the issue of trained providers. Providing high quality services, for those NGOs with service- delivery capacity, promoting early referrals (before 8 weeks), awareness programmes on legality, safety and availability of medical abortion, promoting acceptance of postabortion contraception, ensuring proper follow-up, particularly, the second follow-up for taking misoprostol and the third follow-up after two weeks, involving community-based organizations and community itself are very important programmatic issues that can be taken up effectively.

Networking – Liaise with other service-delivery organizations, such as the government and private sector, for services and follow-up. Strengthening referral linkages for emergency care is one important aspect of care related to medical abortion.

Monitoring of service provision – One of the important roles of NGOs is to monitor any programme and intervention closely at the grassroots and ensure that the clients/users are not shortchanged by the system. Reflecting the true picture of reality is oneimportant role the NGOs bring up to the nation’s consciousness.

NGOs are links between government and people, technology and implementation, plans and reality. Involving them effectively remains key to the success of effective medical abortion service delivery.

FPAI (Family Planning Association of India) is the largest and oldest service delivery NGO in the country. It provides reproductive and sexual health services through various clinics and outreach service outlets.