LSTM Home > LSTM Research > LSTM Online Archive

State-building and human resources for health in fragile and conflict-affected states: exploring the linkages

Downloads

Downloads per month over past year

Witter, Sophie, Falisse, Jean-Benoit, Bertone, Maria Paola, Alonso-Garbayo, Alvaro, Martins, João S, Salehi, Ahmad Shah, Pavignani, Enrico and Martineau, Tim ORCID: https://orcid.org/0000-0003-4833-3149 (2015) 'State-building and human resources for health in fragile and conflict-affected states: exploring the linkages'. Human Resources for Health, Vol 13, e33.

[img]
Preview
Text
Human_Res_Health_13_33.pdf - Published Version
Available under License Creative Commons Attribution.

Download (886kB) | Preview

Abstract

Background

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. This article aims to explore that relationship, developing a conceptual framework to understand what linkages might exist and looking for empirical evidence in the literature to support, refute or adapt those linkages.

Methods

An open call for contributions to the article was launched through an online community. The group then developed a conceptual framework and explored a variety of literatures (political, economic, historical, public administration, conflict and health-related) to find theoretical and empirical evidence related to the linkages outlined in the framework. Three country case reports were also developed for Afghanistan, Burundi and Timor-Leste, using secondary sources and the knowledge of the group.

Findings

We find that the empirical evidence for most of the linkages is not strong, which is not surprising, given the complexity of the relationships. Nevertheless, some of the posited relationships are plausible, especially between development of health cadres and a strengthened public administration, which in the long run underlies a number of state-building features. The reintegration of factional health staff post-conflict is also plausibly linked to reconciliation and peace-building. The role of medical staff as part of national elites may also be important.

Conclusions

The concept of state-building itself is highly contested, with a rich vein of scepticism about the wisdom or feasibility of this as an external project. While recognizing the inherently political nature of these processes, systems and sub-systems, it remains the case that state-building does occur over time, driven by a combination of internal and external forces and that understanding the role played in it by the health system and health staff, particularly after conflicts and in fragile settings, is an area worth further investigation. This review and framework contribute to that debate.

Item Type: Article
Additional Information: This article is part of the series Investment in human resources for health: impact on health outcomes and beyond. The electronic version of this article is the complete one and can be found online at: http://www.human-resources-health.com/content/13/1/33
Subjects: WA Public Health > WA 20.5 Research (General)
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Administration and Organization > WA 540 National and state health administration
WA Public Health > Health Administration and Organization > WA 590 Health education, Health communication
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12960-015-0023-5
Depositing User: Lynn Roberts-Maloney
Date Deposited: 09 Oct 2015 10:44
Last Modified: 13 Sep 2019 10:12
URI: https://archive.lstmed.ac.uk/id/eprint/5352

Statistics

View details

Actions (login required)

Edit Item Edit Item