Health care in Conflict Settings - Public Health Notes

The first principle of health is life. Conflict takes life.
Conflict and fragility are referred as ‘New Normal’ as these things are increasing in many parts of the world. Moreover, it also affects the health care setting brutally.
Conflict in health care settings refer to any threat, obstacle, armed conflict, internal disturbance, loot and force close of the health facilities or health system.
It also includes generalized state of insecurity where function of health facilities is disrupted or impeded while health workers are restricted to perform their duties fully.
Conflict in health care settings includes attack to the health workers, health facilities and patients
These have become very common these days. It is considered and used as the most convenient way to threaten state authority for fulfilling irrational demands
However, different conventions and international laws like Geneva Conventions, customary international humanitarian law and other treaties clearly recognized attack on health workers and patients as a violation of international law, although none of them being enforced strongly

Health Care Challenges in Conflict Settings:

Worst health indicators
Weak health system
Health workers becoming target of violent activities
Growth of informal private practices
Limited resources and capacity to provide effective health services
Lack of competent human resource for effective and efficient functioning
Limited or poor performance of health workers due to psychological and emotional breakdown
Shaky professional conscience and decreased motivation
Disrupted information system
Reduced work productivity
Reduced supervision and monitoring from the higher level which ultimately reduces quality and motivation to work
Higher dependence on foreign aid
Stock out of health commodities and medicines
Damaged infrastructure
Feeble policy making system
Limited government capacity for uplifting health care system
Population displacement
Increased morbidity and mortality
Disruption in supply chain
Workload escalation to health workers which ultimately reduces the quality of work
Increased inequity in health service utilization as the remote areas population may not have good access to health services and facilities
Amplified chances of outbreak and epidemic of diseases
Increase in corruption and misuse of authority
Reduced capacity building systems
Inadequate planning and coordination

Mitigation Measures for Stronger Health Care System in Conflict Settings:

Strong information collection mechanisms to track about the effect of conflict in health care system
Mechanisms to record threat and attack against health care
Interlinking or partnership between health facilities in conflict areas with health facilities in non-conflict areas
Health system research of conflict and post conflict durations
Researches to address health care problems during conflict situations through strong relationship between humanitarian organizations and academic institutions
Global governance efforts to address health care in conflict

References and for more information:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4527929/