Where are the nongovernmental organizations and why? Mapping and exploring the distribution of NGO activity in Bolivia

The presence and influence of NGOs in the landscape of global health and development has dramatically proliferated since the 1980s. However, little is known about the distribution of NGO activity. This paper explores the distribution of NGO activity, using Bolivia as a case study, and examines the question: what factors are related to the distribution of NGO activity across municipalities in Bolivia? A geographic information system (GIS) and a multiple regression analysis of count data are utilized to answer the questions at hand. These analyses show that NGO activity is uneven distributed across municipalities and that NGO activity is related to population size, extent of urbanization, size of the indigenous population, and health system coverage. The literature and the case study results inform three main recommendations: 1) Create and implement national NGO Codes of Conduct, 2) Improve surveillance of NGO activity, and 3) Re-focus and re-orient NGO related research.