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.

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.

Our Experts

Photo of Barend Gerretsen

Barend Gerretsen

Team Leader Health Systems Strengthening

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Photo of Elisabeth Kleipool

Elisabeth Kleipool

Junior Advisor

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Photo of Lincie Kusters

Lincie Kusters

SRHR Advisor

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Photo of Fernando Maldonado Costa

Fernando Maldonado Costa

Coördinator Education and Head of MIH programme

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Photo of Egbert Sondorp

Egbert Sondorp

Senior Advisor Health Systems Strengthening

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Photo of Prisca Zwanikken

Prisca Zwanikken

Senior advisor

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