Health care in Conflict Settings

  • 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/

https://www.chathamhouse.org/about/structure/global-health-security/healthcare-anatomy-conflict-project

https://assets.publishing.service.gov.uk/media/57a08ad5e5274a27b20007c5/HRHinPostConflictSettings-LiteraturereviewTM.pdf

http://atha.se/blog/not-target-protecting-healthcare-conflict

http://www.whatsinblue.org/2016/09/protection-of-health-care-in-armed-conflict.php

http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001668

https://conflictandhealth.biomedcentral.com/articles

http://currents.plos.org/disasters/article/the-effect-of-armed-conflict-on-the-utilization-of-maternal-health-services-in-uganda-a-population-based-study/

https://tidsskriftet.no/en/2017/09/kronikk/leaving-them-behind-healthcare-services-situations-armed-conflict

http://www.emro.who.int/eha/news/beyond-the-bullets-and-bombs-saving-the-lives-of-chronic-disease-patients-living-in-conflict-settings.html

https://www.usip.org/sites/default/files/SR_301.pdf

https://www.cambridge.org/core/journals/international-review-of-the-red-cross/article/human-rights-approach-to-health-care-in-conflict/53D3C38B76480C2B7142C76AD8ABC401

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656126/

https://rebuildconsortium.com/media/1110/health-systems-in-post-conflict-settings-are-they-different-from-other-low-and-middle-income-countries.pdf

http://blogs.bmj.com/bmj/2016/11/11/seema-biswas-conflict-is-a-global-health-challenge/

https://sph.unc.edu/global-health/gateway-learning-symposium/

https://www.who.int/bulletin/volumes/95/1/15-168328/en/

http://www.healthsystemsglobal.org/blog/180/Research-needs-and-challenges-for-health-systems-strengthening-in-fragile-and-conflict-affected-states.html

https://msf-analysis.org/ihl-counter-terrorism-tensions-challenges-medical-humanitarian-organizations/

https://www.kcl.ac.uk/sspp/departments/warstudies/news/newsrecords/Responding-to-Global-Challenges-Healthcare-in-Conflict-Zones.aspx

http://www.shoklo-unit.com/sites/default/files/reports/special-report/healthcare_in_a_changing_national_landscape_seminar_report.pdf

https://www.asianjournalofpsychiatry.com/action/consumeSharedSessionAction?MAID=ZUJHsnrw%2BZbyzNasEsmoWQ%3D%3D&SERVER=WZ6myaEXBLF%2B9vQ18y9JMw%3D%3D&JSESSIONID=aaaY557Dhof9h5tqgYunw&ORIGIN=92985551&RD=RD

http://www.fmreview.org/detention/abusada-serafini.html

https://www.chathamhouse.org/sites/files/chathamhouse/events/special/NSAGs%20Meeting%20Summary%20in%20template%20-%20final%20edit%20from%20Jo%20-%20ER-%20PKA%2027.10.15.pdf

http://www.mhinnovation.net/innovations/psychosocial-care-children-conflict-areas

http://www.medicusmundi.org/contributions/events/2012/health-systems-strengthening-in-fragile-states.-mmi-ntwork-meeting/collection-of-case-studies/frient-peacebuilding-and-health-in-postconflict.pdf

https://conflictandhealth.biomedcentral.com/articles/10.1186/s13031-018-0152-2

 

 

About Kusum Wagle 214 Articles
Hello and greetings everyone! I am Kusum Wagle, MPH, WHO-TDR Scholar, BRAC James P. Grant School of Public Health, Bangladesh. I have gained profound experiences in public health sector under different thematic areas of health, nutrition, sexual and reproductive health, maternal and newborn health, research etc., targeting diverse audience of different age groups. I have performed diverse roles ranging from lecturer in the public health department of colleges, nutrition coordinator, research coordinator and consultant, in different programs, projects and academic institutions of Nepal. I also hold immense experience in working closely and persistently with government organizations, non-government organizations, UN agencies, CSOs and other stakeholders at the national and sub-national level. I have successfully led and coordinated different projects involving multi-sector participation and engagement. Moreover, I am also regularly involved in the development of different national health related programs and its guidelines.