• Health system strengthening approaches

Health system strengthening approaches

This background paper for the High Level Forum on Health MDGs (Millennium Development Goals) examines the challenge of investing in the development of health services in post-conflict countries. It outlines a number of problems, including poor information; knowledge gaps; uncertain financial, political and administrative future; and uncertain external support. However, potential opportunities include a wave of new energy and enthusiasm; expanded aid flows; establishment of a legitimate government; and the return of people, skills and resources.

The authors outline principles to be adopted. International actors need to reorganise individual and collective ways of working in post-conflict environments in order to contribute successfully to restoration of health services and ensure sustained resources and capacity of health services. Understanding the health sector and the context within which health services are being delivered is also critical. Once the main difficulties affecting delivery are identified, it is generally easier to identify key priorities, based on what is actually possible. Finally, where there is low capacity and poor governance, it may be best to pursue modest ambitions. Such a minimalist approach may only result in limited benefits, but, in the long term, continuous progress may attract further resources and increased capacity. [adapted from author]

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