TY - JOUR PY - 2017// TI - Leaving no one behind: lessons on rebuilding health systems in conflict- and crisis-affected states JO - BMJ global health A1 - Martineau, Tim A1 - McPake, Barbara A1 - Theobald, Sally A1 - Raven, Joanna A1 - Ensor, Tim A1 - Fustukian, Suzanne A1 - Ssengooba, Freddie A1 - Chirwa, Yotamu A1 - Vong, Sreytouch A1 - Wurie, Haja A1 - Hooton, Nick A1 - Witter, Sophie SP - e000327 EP - e000327 VL - 2 IS - 2 N2 - 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.

Language: en

LA - en SN - 2059-7908 UR - http://dx.doi.org/10.1136/bmjgh-2017-000327 ID - ref1 ER -