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.

Documents

Showing 31-40 of 44 results

  • Living through conflict and post-conflict: Experiences of health workers in northern Uganda and lessons for people-centred health systems

    Health Policy and Planning, 2014
    Providing people-centred health systems—or any systems at all—requires specific measures to protect and retain healthcare workers during and after the conflict. This is particularly important when health staff are themselves the target of violence and abduction, as is often the case. This article presents the perspective of health workers who lived through conflict in four districts of northern Uganda—Pader, Gulu, Amuru, and Kitgum. These contained more than 90% of the people displaced by the decades of conflict, which ended in 2006....
  • Evolution of policies on human resources for health: Opportunities and constraints in four post-conflict and post-crisis settings

    BioMed Central, 2017
    Few studies look at policy making in the health sector in the aftermath of a conflict or crisis and even fewer specifically focus on Human Resources for Health, which is a critical domain for health sector performance. The main objective of the article is to shed light on the patterns and drivers of post-conflict policy-making. In particular, we explore whether the post -conflict period offers increased chances for the opening of ‘windows for opportunity’ for change and reform and the potential to reset health systems. This article uses a comparative policy analysis framework....
  • Impact of health financing policies in Cambodia: A 20 year experience

    Elsevier, 2017
    Improving financial access to services is an essential part of extending universal health coverage in low resource settings. In Cambodia, high out of pocket spending and low levels of utilisation have impeded the expansion of coverage and improvement in health outcomes. For twenty years a series of health financing policies have focused on mitigating costs to increase access particularly by vulnerable groups....
  • Supporting statebuilding in situations of conflict and fragility: Policy guidance

    OECD DAC Guidelines and Reference Series, 2011
    Functioning states are essential for reducing poverty, sustaining peace and achieving agreed development goals. Despite receiving growing international attention in recent years, fragile states are falling behind other low-income countries in human development. Fragility – and its negative consequences – can destabilise entire regions and have global repercussions. Tackling the challenges associated with fragility requires a concerted international effort to support sustainable statebuilding processes, based on robust state-society relations....
  • Impact of health financing policies in Cambodia: A 20 year experience

    Elsevier, 2017
    Improving financial access to services is an essential part of extending universal health coverage in low resource settings. In Cambodia, high out of pocket spending and low levels of utilisation have impeded the expansion of coverage and improvement in health outcomes. For twenty years a series of health financing policies have focused on mitigating costs to increase access particularly by vulnerable groups....
  • Have post-conflict development policies addressed horizontal inequalities?

    Department for International Development, UK, 2017
    New research by CRISE reveals important gaps and inconsistencies in post-conflict reconstruction policies on Horizontal Inequalities. Based on in-depth studies of eight diverse post-conflict countries and four cross-cutting thematic studies, the findings provide a framework that helps to explain sources of success, and failure, and points to policy requirements and constraints in this area. In evaluating and explaining the sources of differences in outcomes, this In Brief identifies three key factors that explain success in tackling HIs....
  • Effects of a community scorecard on improving the local health system in Eastern Democratic Republic of Congo: Qualitative evidence using the most significant change technique

    Conflict and health, 2017
    More than a decade of conflict has weakened the health system in the Democratic Republic of Congo and decreased its ability to respond to the needs of the population. Community scorecards have been conceived as a way to increase accountability and responsiveness of service providers, but there is limited evidence of their effects, particularly in fragile and conflict-affected contexts. This paper describes the implementation of community scorecards within a community-driven reconstruction project in two provinces of eastern Democratic Republic of Congo....
  • Afghanistan's Basic Package of Health Services: Its development and effects on rebuilding the health system

    Taylor and Francis Group, 2014
    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding.The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening....
  • A basic package of health services for post-conflict countries: Implications for sexual and reproductive health services

    Taylor and Francis Group, 2008
    Health systems in countries emerging from conflict are often characterised by damaged infrastructure, limited human resources, weak stewardship and a proliferation of non-governmental organisations. This can result in the disrupted and fragmented delivery of health services....
  • A comprehensive framework for human resources for health system development in fragile and post-conflict states

    PLoS Medicine, 2011
    Responding to the global human resource crisis requires systems thinking if a more comprehensive approach to human resource management and development is to be achieved. We present a comprehensive and visible framework for human resource system development. This has been derived from the lessons learned in supporting human resource system development in three fragile and post-conflict health systems in Afghanistan, the Democratic Republic of Congo, and Cambodia....

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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.