Post-conflict health sectors: the myth and reality of transitional funding gaps

Post-conflict health sectors: the myth and reality of transitional funding gaps

Funding flows for health services in fragile states

During the transition from conflict to peace, the limited health services that exist, mainly provided by humanitarian non-governmental organisations, often come under threat of contraction. The most commonly cited reason is the so-called transitional funding gap, defined as a net reduction in monies available to the health sector during the transition from relief to development which may affect the delivery of health services. This paper was commissioned by the Health and Fragile States Network to examine these issues. The authors examine funding flows to the health sector during the transition to establish if gaps in funding and services actually occur or if, and how, they are averted. The paper then identifies obstacles to funding, and examines whether the aid instruments used in these settings hinder funding, or whether the problems are caused by a poor policy environment which undermines donor trust and thus funding allocations.

This study assessed six recent post-conflict settings: Afghanistan, Democratic Republic of the Congo (DRC), Liberia, Sierra Leone, Southern Sudan, and Timor Leste (formerly East Timor). The question of transitional funding is analysed as part of the broader question of aid effectiveness in post-conflict countries. It is argued that aid effectiveness is particularly important in these settings given the lack of government capacity and often extreme poverty. Furthermore, a reduction in services as a result of a funding gap could be an indicator of aid ‘ineffectiveness’. The authors conclude that it is important to overcome transitional funding gaps, both for the health of the populations involved, and to assist with the broader goals of state-building, where delivery of basic services such as health are integral to the social compact between a state and society. Given the recent initiatives on aid effectiveness, there is a possibility that transitional funding gaps will be alleviated in the future.

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