Approximately two billion people live in fragile and conflict-affected situations (FCAS), according to recent figures from the World Bank. None of these low-income, fragile countries was able to achieve a single Millennium Development Goal and progress towards achieving the Sustainable Development Goals set in 2015 remains elusive.
The share of extreme poor living in conflict-affected situations is expected to rise from 17% of the global total today to almost 50% by 2030. Conflicts also drive 80% of all humanitarian needs, while they reduce gross domestic product (GDP) growth by two percentage points per year, on average, the Bank estimates.
Health in fragile and conflict-affected situations
Fragile states are generally defined as states with a weak capacity to carry out basic state functions such as service delivery. They lack the ability or political will to develop mutually constructive relations with society. This impairs the functioning of a country’s health system, its ability to change, and its capacity to extend access to health care services to its whole population.
In order to be effective, health programming in fragile situations must take context into account. Health governance can be improved and relations between the state and its citizens strengthened through, for example, social accountability mechanisms.
Like KIT, most development agencies now give more priority to fragile states and increasingly realise that standard approaches to development do not yield sufficient results. Policy and practice in this area are still evolving and our health professionals monitor developments continuously in order to enhance the effectiveness of our interventions, in tandem with our partners.
WHO Collaborating Centre
The World Health Organisation (WHO) has designated KIT Health as WHO Collaborating Centre for health systems in fragile and conflict affected contexts.
KIT’s assistance on behalf of fragile countries and situations takes several forms:
- We provide technical expertise to governments and international agencies on strengthening health systems in fragile states
- We conduct operational research with an eye towards improved practices and innovation in health programming
- We coordinate the integration of service delivery with health system strengthening and operational research, translating into improved policies and practices
- We engage in networks to share ideas for context-specific solutions for fragile states
These experiences inform KIT’s health education activities, which include the training of higher-level management and policy staff in fragile states, as well as our tailor-made training programmes.