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

Health workforce

Showing 1-10 of 12 results

  • Health worker experiences of and movement beetween public and private not-for-profit sectors

    BioMed Central, 2016
    Northern Uganda suffered 20 years of conflict which devastated lives and the health system. Since 2006, there has been investment in reconstruction, which includes efforts to rebuild the health workforce....
  • An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone

    Elsevier, 2015
    The need for evidence-based practice calls for research focussing not only on the effectiveness of interventions and their translation into policies, but also on implementation processes and the factors influencing them, in particular for complex health system policies....
  • From drought to deluge: How information overload saturated absorption capacity in a disrupted health sector

    Oxford University Press, 2011
    Provision of technical assistance is a common form of support to health sectors emerging from prolonged conflicts. But what actions signal that the Ministry of Health (MoH) is, or is not, actively analysing and digesting the output of this assistance? Where are the boundaries between doing with and doing for?This article presents a qualitative description of an early post-conflict policy process in southern Sudan, which represented an opportunity to test these boundaries. The methodology of provision of technical assistance to the MoH in the formulation of a human resource plan is reviewed....
  • Mapping Sierra Leone's plural health system and how people navigate it

    Secure Livelihoods Research Consortium, 2014
    This briefing paper maps the actors that constitute the plural health system in Sierra Leone and the relationships between them. Second, it examines the factors that influence health-seeking behaviour before setting out some recommendations on ways forward when developing appropriate interventions to address malnutrition....
  • Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: A systems dynamics analysis using group model building

    Conflict and health, 2015
    Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response and adaptation.Structured interviews were conducted with 39 stakeholders from three local government areas selected to represent the diversity of conflict experience across the state: Damaturu, Fune and Nguru, and with four officers of the PRRINN-MNCH program providing technical assistance for primary care development in the state....
  • Health system resilience: Lebanon and the Syrian refugee crisis

    Journal of Global Health, 2016
    Between 2011 and 2013, the Lebanese population increased by 30% due to the influx of Syrian refugees. While a sudden increase of such magnitude represents a shock to the health system, threatening the continuity of service delivery and destabilising governance, it also offers a unique opportunity to study resilience of a health system amidst ongoing crisis.We conceptualised resilience as the capacity of a health system to absorb internal or external shocks (for example prevent or contain disease outbreaks and maintain functional health institutions) while sustaining achievements....
  • 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....
  • Community health workers of Afghanistan: A qualitative study of a national program

    BioMed Central, 2014
    Afghanistan is a country that has been in conflict for decades, resulting in the destruction of much of its social infrastructure including the health system. In 2003, after the intervention of US-led NATO forces, the new government with support from its international partners designed a Basic Package of Health Services to provide services to the majority rural population; its specific focus is on women and children. The workforce to deliver these services consists of Community Health Workers (CHWs)....
  • 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....

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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.