Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states.

Martineau, Tim ORCID: https://orcid.org/0000-0003-4833-3149, McPake, Barbara, Theobald, Sally ORCID: https://orcid.org/0000-0002-9053-211X, Raven, Joanna ORCID: https://orcid.org/0000-0002-4112-6959, Ensor, TiM, Fustukian, Suzanne, Ssengooba, Freddie, Chirwa, Yotamu, Vong, Sreytouch, Wurie, Haja, Hooton, Nick and Witter, Sophie (2017) 'Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states.'. BMJ Global Health, Vol 2, Issue 2, e000327.

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Abstract

Conflict and fragility are increasing in many areas of the world. This context has been referred to as the 'new normal' and affects a billion people. Fragile and conflict-affected states have the worst health indicators and the weakest health systems. This presents a major challenge to achieving universal health coverage. The evidence base for strengthening health systems in these contexts is very weak and hampered by limited research capacity, challenges relating to insecurity and apparent low prioritisation of this area of research by funders. This article reports on findings from a multicountry consortium examining health systems rebuilding post conflict/crisis in Sierra Leone, Zimbabwe, northern Uganda and Cambodia. Across the ReBUILD consortium's interdisciplinary research programme, three cross-cutting themes have emerged through our analytic process: communities, human resources for health and institutions. Understanding the impact of conflict/crisis on the intersecting inequalities faced by households and communities is essential for developing responsive health policies. Health workers demonstrate resilience in conflict/crisis, yet need to be supported post conflict/crisis with appropriate policies related to deployment and incentives that ensure a fair balance across sectors and geographical distribution. Postconflict/crisis contexts are characterised by an influx of multiple players and efforts to support coordination and build strong responsive national and local institutions are critical. The ReBUILD evidence base is starting to fill important knowledge gaps, but further research is needed to support policy makers and practitioners to develop sustainable health systems, without which disadvantaged communities in postconflict and postcrisis contexts will be left behind in efforts to promote universal health coverage.

Item Type:	Article
Subjects:	WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Health Administration and Organization > WA 525 General works WA Public Health > Health Administration and Organization > WA 540 National and state health administration WA Public Health > Health Administration and Organization > WA 546 Local Health Administration. Community Health Services
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjgh-2017-000327
SWORD Depositor:	JISC Pubrouter
Depositing User:	Stacy Murtagh
Date Deposited:	10 Nov 2017 15:49
Last Modified:	13 Sep 2019 17:44
URI:	https://archive.lstmed.ac.uk/id/eprint/7807

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