La « normalité de l’anormal » : recomposer le quotidien en situation de guerre civile

Gayer, Laurent

doi:10.3917/crii.080.0181

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…Organisational routines and health systems were disrupted by COVID-19. After the emergency, health systems regained their habits—normality or abnormality7—when considering their low performance and daily challenges. We are here at the heart of the contemporary debate on the resilience of health systems and health insurance organisations, their ability to cope, adapt and even transform in the face of a shock,8 9 such as the Ebola outbreak in Guinea in 2014,10 a terrorist attack in Burkina Faso in 201611 and the COVID-19 pandemic in the Sahel 1.…”

Section: Introductionmentioning

confidence: 99%

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Ridde

Kane

Mbow³

et al. 2022

BMJ Glob Health

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BackgroundIn its pursuit of solutions for universal health coverage (UHC), Senegal has set up two departmental health insurance units (UDAMs) since 2014. Few studies on the resilience of health systems in Africa have examined health insurance organisations. This article aims to understand how these two UDAMs have been resilient during the COVID-19 pandemic and the restrictive measures imposed by the State to maintain services to their members and reimbursements to healthcare providers.MethodsThis study was a multicase study with multiple levels of analysis using a conceptual framework of resilience and analysis of organisational configurations. Empirical data are derived from document analysis, observations for 6 months and 17 qualitative in-depth interviews.ResultsThe results identified three main configurations concerning (1) safety and hygiene, (2) organisation and planning and (3) communication for sustainable payment. The UDAM faced the pandemic with resilience processes to absorb the shock and maintain service to their members. The UDAM learnt positive lessons from crisis management, such as remote work or the ability to support members in their care in hospitals away from their headquarters. They have innovated (transformative resilience) with the organisation of electronic payment and the use of social networks to raise funds and communicate with members. Strengthening their effectiveness after the shock of the departure of the donors in 2017 contributed to the adaptation and even transformation from the pandemic shock of 2020 and 2021. The study shows that leadership, team dynamics and adaptation to contexts are drivers of resilience processes.ConclusionBoth UDAMs adapted to the shocks of the pandemic and government measures to maintain the services of their members and their organisational routine. This resilience confirms that UDAMs are one of the possible solutions for UHC in the Sahel.

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Section: Introductionmentioning

confidence: 99%

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Ridde

Kane

Mbow³

et al. 2022

BMJ Glob Health

View full text Add to dashboard Cite

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Minimal resilience and insurgent conflict: qualitative analysis of the resilience process in six primary health centres in central Mali

et al. 2023

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BackgroundIn the context of universal health coverage in the Sahel, the study focuses on primary health centres and the difficulties of their implementation in the context of insurgency conflicts in central Mali.MethodsThis is qualitative research through a multiple case study. We selected six health centres according to a reasoned choice to bring together contrasting situations. We conducted 96 semistructured interviews and consulted secondary quantitative data on attendance. By focusing on community health centres, the conceptual approach focuses on the process of resilience that unfolds in a dual context of chronic health system dysfunctions and armed conflict.ResultsThe resilience strategies deployed by health professionals were relatively basic and uncoordinated. In the end, it was the individuals who showed absorption. However, their room for manoeuvre was limited. In the most isolated health centres, resilience was based on subordinate, poorly trained staff, often from the locality. Degraded working conditions and fear caused a form of resignation among health workers.ConclusionThe strategies and resources used showed a form of minimal resilience. This form is unfolding in a context marked by two structuring features. On the one hand, the Malian health system was relatively dysfunctional before the crisis, and on the other hand, the type of conflict was relatively low intensity that allowed health centres to remain open.

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2021

Violences Politiques

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La « normalité de l’anormal » : recomposer le quotidien en situation de guerre civile

Cited by 6 publications

References 3 publications

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

The resilience of two departmental health insurance units during the COVID-19 pandemic in Senegal

Minimal resilience and insurgent conflict: qualitative analysis of the resilience process in six primary health centres in central Mali

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