Recommended readings
Delivering health services in fragile states and difficult environments: 13 key principles
Principles for policymakers to improve health service delivery in fragile states
Authors:
S. Oswald; J. Clewett
Publisher:
Health Unlimited, 2007
This report by Health Unlimited draws out key policy recommendations and operational implications for stakeholders involved in delivering health services in fragile states and difficult environments. Drawing on examples and case studies from six countries (Burma/Myanmar, Cambodia, Ethiopia, Guatemala, Peru and Somaliland), the paper highlights 13 key principles for policy makers and implementers which improve the delivery of health services in fragile states and difficult environments.
These principles are to: understand the context; build trust; share information and evidence; provide long-term support; take a rights-based approach; reach marginalised communities; build on what exists; develop accountability mechanisms;facilitate an appropriate mix of aid modalities; focus on health systems as a whole; address human resource constraints; utilise appropriate communication approaches; promote co-operation rather than competition.
The report concludes that the benefits of supporting health systems as a whole in developing countries – rather than disease specific vertical interventions – are increasingly recognised, and this is particularly crucial in fragile states and difficult environments where capacity is limited. Given that governments in fragile states and difficult environments are unable or unwilling to deliver core services to their entire population, the paper offers recommendations that focus on the roles of international donors and NGOs.
