Institutions for strong and equitable health systems after conflict and crisis – lessons from ReBUILD research

This brief outlines the findings from ReBUILD’s phase 1 research informing the theme of institutions in post-conflict health systems.

You can download the brief here.

Health systems institutions – the organisations, rules and relationships that apply to the health system – become more complex post conflict and post crisis. The rapid influx of actors and resources means decision making can be uncoordinated, and resources can be inefficiently used, duplicated and fail to deliver the right services.

A key issue in post-conflict health systems institutions is the lack of ownership of national actors during the immediate post-conflict period and afterwards, which coupled with the uncoordinated approach can make long-term health system strengthening more difficult. Decisions made at this time can impact long into the future.

Several components of ReBUILD’s research have informed our findings on this theme, including our research into policy evolution on health financing and human resources for health, as well as the specific project on aid effectiveness, which looked at relationships between agencies implementing health programmes in northern Uganda, using social network analysis. This project also analysed the major dynamics in aid-relationships and aid-effectiveness within the district-level network of health-related agencies.