Health System Strengthening in Fragile States
Approximately two billion people live in fragile and conflict-affected situations, 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 remains elusive.
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Cash and Voucher Assistance for Sexual and Reproductive Health and Rights in Humanitarian Settings and Fragile States
Cash and voucher assistance (CVA) refers to programs where cash or vouchers, exchangeable for goods or services, are directly provided to community members. CVA can help improve access to and the utilisation of health services, by reducing direct and indirect financial barriers and incentivising the use of free preventive services. There is also a growing body of evidence which shows that CVA should always be considered alongside other supply- and demand-side interventions rather than as a stand-alone action.
Read more about Cash and Voucher Assistance for Sexual and Reproductive Health and Rights in Humanitarian Settings and Fragile States -
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Health Pooled Fund
South Sudan has experienced significant levels of fragility, conflict and violence for nearly half a century. It is estimated that over 400,000 lives have been lost since 2013 due to conflict and millions more have been displaced. With limited access to basic health services, it has some of the worst health indicators in the world, with mainly women and children affected.
Read more about Health Pooled Fund -
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Sexual Violence in Humanitarian Settings: Nigeria, Yemen and Haiti
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Psychological First Aid: A Crash Course
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Helping Rohingya Refugees in Bangladesh
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STRENGTHS Project: Scaling Up Psychological Interventions with Syrian Refugees
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South Sudan Health Action and Research Project (SHARP)
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Addressing Governance, Gender and Disasters in a Fragile Health System
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Afghan Health: Monitoring and Evaluation
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.
Our Services
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.
