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Health financing in fragile and post-conflict states: What do we know and what are the gaps?

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  • Witter, Sophie

Abstract

There has been a growing concern with post-conflict and fragile states over the past decade, both in relation to their high level of health and development needs but also for the risk they pose to the wider international community. This paper presents an exploratory literature review to analyse the themes and findings of recent writing on one important pillar of the health system – health financing – in these countries. It finds that here is a growing but still very limited literature. Most of the insights from existing literature relate to the role of donors. There is a need for more work on access to care and equity over the post-conflict period, the mix and sequencing of financing mechanisms, resource allocation, regulation, public financial management, payment systems and incentives at facility and health worker levels, and on overall health financing strategies and their possible contribution to wider state-building. Topics which have received attention, such as contracting and non-state actors, could benefit from more rigorous analysis with a longer time perspective. A longitudinal approach, which examines how decisions taken in the immediate post-conflict period may or may not influence longer term developments, would provide important insights. As health systems in fragile and post-conflict states are often forced to innovate, they can generate useful lessons for other settings too.

Suggested Citation

  • Witter, Sophie, 2012. "Health financing in fragile and post-conflict states: What do we know and what are the gaps?," Social Science & Medicine, Elsevier, vol. 75(12), pages 2370-2377.
  • Handle: RePEc:eee:socmed:v:75:y:2012:i:12:p:2370-2377
    DOI: 10.1016/j.socscimed.2012.09.012
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    References listed on IDEAS

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    1. Abu-Zaineh, Mohammad & Mataria, Awad & Moatti, Jean-Paul & Ventelou, Bruno, 2011. "Measuring and decomposing socioeconomic inequality in healthcare delivery: A microsimulation approach with application to the Palestinian conflict-affected fragile setting," Social Science & Medicine, Elsevier, vol. 72(2), pages 133-141, January.
    2. Preeti Patel & Bayard Roberts & Samantha Guy & Louise Lee-Jones & Lesong Conteh, 2009. "Tracking Official Development Assistance for Reproductive Health in Conflict-Affected Countries," PLOS Medicine, Public Library of Science, vol. 6(6), pages 1-13, June.
    3. Paul Collier & Anke Hoeffler, 2004. "Greed and grievance in civil war," Oxford Economic Papers, Oxford University Press, vol. 56(4), pages 563-595, October.
    4. Benjamin Loevinsohn, 2008. "Performance-Based Contracting for Health Services in Developing Countries : A Toolkit," World Bank Publications - Books, The World Bank Group, number 6481.
    5. Akashi, Hidechika & Yamada, Takako & Huot, Eng & Kanal, Koum & Sugimoto, Takao, 2004. "User fees at a public hospital in Cambodia: effects on hospital performance and provider attitudes," Social Science & Medicine, Elsevier, vol. 58(3), pages 553-564, February.
    6. Matsuoka, Sadatoshi & Aiga, Hirotsugu & Rasmey, Lon Chan & Rathavy, Tung & Okitsu, Akiko, 2010. "Perceived barriers to utilization of maternal health services in rural Cambodia," Health Policy, Elsevier, vol. 95(2-3), pages 255-263, May.
    7. Ir, Por & Bigdeli, Maryam & Meessen, Bruno & Van Damme, Wim, 2010. "Translating knowledge into policy and action to promote health equity: The Health Equity Fund policy process in Cambodia 2000-2008," Health Policy, Elsevier, vol. 96(3), pages 200-209, August.
    8. Pia Schneider & Kara Hanson, 2006. "Horizontal equity in utilisation of care and fairness of health financing: a comparison of micro‐health insurance and user fees in Rwanda," Health Economics, John Wiley & Sons, Ltd., vol. 15(1), pages 19-31, January.
    9. repec:bla:devpol:v:28:y:2010:i:2:p:131-154 is not listed on IDEAS
    10. Kruk, Margaret E. & Freedman, Lynn P. & Anglin, Grace A. & Waldman, Ronald J., 2010. "Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda," Social Science & Medicine, Elsevier, vol. 70(1), pages 89-97, January.
    11. Trani, Jean-Francois & Bakhshi, Parul & Noor, Ayan A. & Lopez, Dominique & Mashkoor, Ashraf, 2010. "Poverty, vulnerability, and provision of healthcare in Afghanistan," Social Science & Medicine, Elsevier, vol. 70(11), pages 1745-1755, June.
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    1. Bonfrer, Igna & Van de Poel, Ellen & Van Doorslaer, Eddy, 2014. "The effects of performance incentives on the utilization and quality of maternal and child care in Burundi," Social Science & Medicine, Elsevier, vol. 123(C), pages 96-104.
    2. Falisse, Jean-Benoît & Mpanya, Alain, 2022. "Clinical trials as disease control? The political economy of sleeping sickness in the Democratic Republic of the Congo (1996–2016)," Social Science & Medicine, Elsevier, vol. 299(C).
    3. Bertone, Maria Paola & Jowett, Matthew & Dale, Elina & Witter, Sophie, 2019. "Health financing in fragile and conflict-affected settings: What do we know, seven years on?," Social Science & Medicine, Elsevier, vol. 232(C), pages 209-219.
    4. Maria Paola Bertone & Jean-Benoît Falisse & Giuliano Russo & Sophie Witter, 2018. "Context matters (but how and why?) A hypothesis-led literature review of performance based financing in fragile and conflict-affected health systems," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-27, April.

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