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Health financing in fragile and post-conflict states: What do we know and what are the gaps?

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  • Witter, Sophie
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    Abstract

    There has been a growing concern with post-conflict and fragile states over the past decade, both in relation to their high level of health and development needs but also for the risk they pose to the wider international community. This paper presents an exploratory literature review to analyse the themes and findings of recent writing on one important pillar of the health system – health financing – in these countries. It finds that here is a growing but still very limited literature. Most of the insights from existing literature relate to the role of donors. There is a need for more work on access to care and equity over the post-conflict period, the mix and sequencing of financing mechanisms, resource allocation, regulation, public financial management, payment systems and incentives at facility and health worker levels, and on overall health financing strategies and their possible contribution to wider state-building. Topics which have received attention, such as contracting and non-state actors, could benefit from more rigorous analysis with a longer time perspective. A longitudinal approach, which examines how decisions taken in the immediate post-conflict period may or may not influence longer term developments, would provide important insights. As health systems in fragile and post-conflict states are often forced to innovate, they can generate useful lessons for other settings too.

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    File URL: http://www.sciencedirect.com/science/article/pii/S0277953612006752
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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 75 (2012)
    Issue (Month): 12 ()
    Pages: 2370-2377

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    Handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2370-2377

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    Keywords: Post-conflict; Health financing; Fragile states;

    References

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    1. Trani, Jean-Francois & Bakhshi, Parul & Noor, Ayan A. & Lopez, Dominique & Mashkoor, Ashraf, 2010. "Poverty, vulnerability, and provision of healthcare in Afghanistan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1745-1755, June.
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    7. Richard Batley & Claire Mcloughlin, 2010. "Engagement with Non-State Service Providers in Fragile States: Reconciling State-Building and Service Delivery," Development Policy Review, Overseas Development Institute, vol. 28(2), pages 131-154, 03.
    8. Benjamin Loevinsohn, 2008. "Performance-Based Contracting for Health Services in Developing Countries : A Toolkit," World Bank Publications, The World Bank, number 6481, October.
    9. Collier, Paul & Hoeffler, Anke, 2000. "Greed and grievance in civil war," Policy Research Working Paper Series 2355, The World Bank.
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