Conflict prevention in fragile contexts

Desai, Harsh

doi:10.1787/041cbaf0-en

Cited by 3 publications

(2 citation statements)

References 24 publications

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“…This has been observed, for example, with natural disasters, political instabilities, and civil unrest, as well as the COVID-19 pandemic [5,9,10]. Fragile states are highly susceptible to humanitarian crises, which can be either total or partial in their impact on the system; they are also vulnerable to domestic and international conflicts and shocks [11]. Often, humanitarian crises precede armed conflicts, epidemics, famines, natural disasters, and other major emergencies [12].…”

Section: Introductionmentioning

confidence: 99%

Health system strengthening in fragile and conflict-affected states: A review of systematic reviews

Bogale,

Scambler,

Mohd Khairuddin

et al. 2024

PLoS ONE

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Background Globally, there is growing attention towards health system strengthening, and the importance of quality in health systems. However, fragile and conflict-affected states present particular challenges. The aim of this study was to explore health system strengthening in fragile and conflict-affected states by synthesising the evidence from published literature. Methods We conducted a review of systematic reviews (Prospero Registration Number: CRD42022371955) by searching Ovid (Medline, Embase, and Global Health), Scopus, Web of Science, and the Cochrane Library databases. Only English-language publications were considered. The Joanna Briggs Institute (JBI) Critical Appraisal Tool was employed to assess methodological quality of the included studies. The findings were narratively synthesised and presented in line with the Lancet’s ‘high-quality health system framework’. Results Twenty-seven systematic reviews, out of 2,704 identified records, considered key dimensions of health systems in fragile and conflict-affected states, with the ‘foundations’ domain having most evidence. Significant challenges to health system strengthening, including the flight of human capital due to safety concerns and difficult working conditions, as well as limited training capacities and resources, were identified. Facilitators included community involvement, support systems and innovative financing mechanisms. The importance of coordinated and integrated responses tailored to the context and stage of the crisis situation was emphasised in order to strengthen fragile health systems. Overall, health system strengthening initiatives included policies encouraging the return and integration of displaced healthcare workers, building local healthcare workers capacity, strengthening education and training, integrating healthcare services, trust-building, supportive supervision, and e-Health utilisation. Conclusion The emerging body of evidence on health system strengthening in fragile and conflict-affected states highlights its complexity. The findings underscore the significance of adopting a comprehensive approach and engaging various stakeholders in a coordinated manner considering the stage and context of the situation.

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