Healthcare in Conflict: Implementing Reform during Reconstruction

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Social uprising is the new normal. This is evident to anyone with access to a television within the past few years. From Occupy Wall Street to the wonders of the Arab Spring, people all over the world are demanding changes to a status quo where a small minority seemingly reaps all benefits the world has to offer while leaving the majority to fight for remaining crumbs. In these movements, the central ideology being fought for is the idea of justice. The faces of these unjust societies range from authoritarian regimes to unchecked capitalist powerhouses. As the process of reconstruction takes place (whether it be physical or mental), a common demand is the reform of health care systems. This is not surprising considering the intertwined nature of the right to health with the mechanisms through which they are disseminated.

A common hallmark of pre-conflict nations’ is an inequitable distribution of health care goods and services. In the case of the Arab Spring, democratization of governments creates an interesting opportunity to renovate their health care systems from the ground up. “The framing of social issues into a rights-based framework allows the world to see the marginalized as protagonists rather than subjects of oppressive systems. That gives them the agency to make social change, as opposed to when they were labeled as passive recipients of generosity” (2). New demands call for new ways of ensuring people’s right to health.

So how is this done? For starters, certain factors have to be taken into consideration. They include:

  1. Health status of the nation
  2. Acute and future health care needs of the population
  3. State of health care infrastructure post conflict
  4. How was health care delivered prior to conflict
  5. Availability and capabilities of the health workforce

Once you know what you are actually working with, a plan can be set in motion. Health care redevelopment is another stage driven process with many overlapping actions which includes:

  1. Development of a national policy framework,
  2.  Reliable financial plan
  3. Equitable service allocation plan
  4. Institutional and human capacity building
  5. Infrastructure redevelopment
  6. Community development and engagement with civil society

 As we continue to witness countries make these transitions, special attention will be paid to the manner in which health reform is implemented. The reprogramming of people’s expectations requires incoming governments to take heed if peace is what is sought. In this respect, it could be stated that the success of reform implementation is an indicator of long term stability since it is accepted that an “…early commitment to reform is one of the most effective tools new governments can use to prove their legitimacy” (2). 

References

1. http://www.dowton.com/journal/2011/09/health-reconstruction-after-the-arab-spring-libya-an-emerging-opportunity-2/

2. http://www.hcs.harvard.edu/~hghr/wp-content/uploads/2012/11/12S-Issue.26.pdf

3. http://www.who.int/bulletin/volumes/89/11/11-041111/en/

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