Health systems in fragile and conflict-affected states

Healthcare in fragile and conflict-affected states (FCAS) remains a real challenge, with poor performance on many health-related goals. But little evidence exists on appropriate approaches for health systems strengthening in such settings. The Thematic Working Group on Health Systems in Fragile and Conflict Affected States (TWG-FCAS), part of Health Systems Global.

One of the key objectives of the TWG-FCAS is to support the awareness and dissemination of current and new knowledge, and to support its translation into policy and practice. This collection of resources on the Eldis platform and associated Key Issue Guides are supporting these objectives.

For more information and to join the TWG-FCAS, visit our web-page.

This resource has been developed for the TWG-FCAS by the ReBUILD Research Programme, funded by UK Aid from the Department for International Development.

The TWG-FCAS is a working group of Health Systems Global, bringing together researchers, policy-makers, funders and implementers working in fragile and conflict affected states (FCAS), to promote and support the creation, identification and sharing of knowledge, and the translation of this knowledge into policy and practice.

The ReBUILD Research Programme Consortium is an international research partnership whose purpose is to contribute towards improved access of the poor to effective health care and reduced health costs burdens, through the production and uptake of high quality, policy-relevant research on health systems settings affected by conflict and crisis. ReBUILD is funded by UK Aid from the Department for International Development.

In this collection


Showing 21-30 of 46 results

  • Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: A case study

    Conflict and health, 2015
    Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments....
  • State-building and human resources for health in fragile and conflict-affected states: exploring the linkages

    Human Resources for Health, 2015
    Human resources for health are self-evidently critical to running a health service and system. There is, however, a wider set of social issues which is more rarely considered. One area which is hinted at in literature, particularly on fragile and conflict-affected states, but rarely examined in detail, is the contribution which health staff may or do play in relation to the wider state-building processes....
  • Availability of essential health services in post-conflict Liberia

    Bulletin of the World Health Organization : the International Journal of Public Health, 2010
    The aim of this paper is to describe the availability of essential health services in rural Liberia five years after the end of the civil war....
  • Social protection and basic services in fragile and conflict-affected situations

    Overseas Development Institute, 2012
    Places affected by fragility and conflict perform consistently worse against a range of development indicators compared to their more stable counterparts. Yet, it is in these contexts that data are most limited, that evidence is of the poorest quality, and that programming and policy making tend to be least informed....
  • Application of social network analysis in the assessment of organizational infrastructure for service delivery: A case study from post-conflict northern Uganda

    Oxford University Press, 2017
    In post-conflict settings, service coverage indices are unlikely to be sustained if health systems are built on weak and unstable inter-organization infrastructures. The objective of this study was to identify and examine the organization-level infrastructure that supports the provision of selected health services in post-conflict northern Uganda....
  • International support to post-conflict transition: Rethinking policy, changing practice

    OECD DAC Guidelines and Reference Series, 2012
    1.5 billion people live in countries affected by repeated cycles of violence and insecurity. These countries face tremendous challenges as they transition from conflict to peace. International support can play a crucial role in these contexts, but has so far struggled to deliver transformative results. This volume presents clear policy recommendations for better practice in order to improve the speed, flexibility, predictability and risk management of international support during post-conflict transition....
  • Promoting health equity in conflict-affected fragile states

    London School of Hygiene and Tropical Medicine, 2007
    This paper was commissioned by the Health Systems Knowledge Network of the WHO Commission on the Social Determinants of Health in response to their conclusion that a lack of data from conflict-affected fragile states made it difficult to delineate pragmatic ways of creating better social conditions for health for vulnerable populations.The key questions we focused on were as follows:What are the main factors that threaten health equity and health care equity in conflict and post-conflict fragile states?...
  • Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: A study of policy barriers and opportunities in Cambodia

    Elsevier, 2013
    Reaching out to the poor and the informal sector is a major challenge for achieving universal coverage in lesser-developed countries. In Cambodia, extensive coverage by health equity funds for the poor has created the opportunity to consolidate various non-government health financing schemes under the government's proposed social health protection structure. This paper identifies the main policy and operational challenges to strengthening existing arrangements for the poor and the informal sector, and considers policy options to address these barriers....
  • The war wounded and recovery in northern Uganda

    Secure Livelihoods Research Consortium, 2014
    In 2012/13, SLRC implemented the first round of an original sub-regional panel survey in northern Uganda aimed to produce data on livelihoods, access to and experience of basic services, exposure to shocks and coping strategies, people’s perceptions of governance, and the impact of serious crimes committed during the Government of Uganda and Lord’s Resistance Army conflict on households’ livelihoods, access to services, exposure to crimes, and perceptions of governance....
  • Perceptions and experiences of access to public healthcare by people with disabilities and older people in Uganda

    BioMed Central, 2014
    In the year 2000, a set of eight Millennium Development Goals (MDGs) were presented as a way to channel global efforts into the reduction of poverty and the promotion of social development. A global discussion regarding how to renew these goals is underway and it is in this context that the Goals and Governance for Global Health (Go4Health) research consortium conducted consultations with marginalized communities in Asia, Latin America, the Pacific and Africa as a way to include their voices in world’s new development agenda....


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