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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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Subject: search.filters.subject.Post-conflict

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    Navigating the tension between fatherhood ideals and realities of a post-conflict setting: A phenomenological study of former child soldiers in Sierra Leone
    (Elsevier, 2023-01-27) Klein, Elizabeth K; Bond, Laura; McLean, Kristen E; Feika, Mahmoud; Bah, Abdulai Jawo; Betancourt, Theresa S
    The concept of “fatherhood” in many African countries has traditionally been understood in terms of instrumental support to one's family, most notably, financial provision. However, in Sierra Leone and elsewhere, this narrow understanding of fatherhood is changing as a result of shifting demographic trends and in response to crises such as civil war and the recent Ebola outbreak in west Africa. Little is understood about how males formerly associated with armed forces and armed groups during childhood (Children Associated with Armed Forces and Armed Groups/CAAFAG) are navigating fatherhood as young adults. This study uses a phenomenological approach to understand 1) the meaning and importance of fatherhood for CAAFAG and war-affected fathers, 2) what fatherhood looks like normatively and ideally, with attention to norms about nurturing care and violence, and 3) how ideals of fatherhood may or may not be in tension with socioeconomic circumstances. We find that CAAFAG and war-affected fathers are committed to providing emotional support, encouragement, and a loving upbringing in addition to striving to provide financially for their families. Fathers experienced the greatest tension between their ideals of fatherhood and their structural circumstances; in other words, they felt inhibited in becoming the types of fathers they hoped to be due to the realities of living in a post-conflict, resource-constrained environment.
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    Factors influencing the retention of secondary midwives at health centres in rural areas in Cambodia: The role of gender—a qualitative study
    (BMC, 2021-11-19) Abe, Kimiko; Ros, Bandeth; Chea, Kimly; Tung, Rathavy; Fustukian, Suzanne
    Background: Retention of skilled midwives is crucial to reducing maternal mortality in rural areas; hence, Cambodia has been trying to retain at least one secondary midwife who can provide basic emergency obstetric care at every health centre even in rural areas. The factors influencing the retention of midwives, but not solely secondary midwives, have been identified; however, the security issues that affected female health workers during the conflict and the post-conflict years and gender issues have been unexplored. This study explores these and other potential factors influencing secondary midwife retention and their significance. Methods: Sequential two-stage qualitative interviews explored influential factors and their significance. The first stage comprised semi-structured interviews with 19 key informants concerned with secondary midwife retention and in-depth interviews with eight women who had deliveries at rural health centres. Based on these interview results, in-depth interviews with six secondary midwives who were deployed to a rural health centre were conducted in the second stage. These midwives ranked the factors using a participatory rural appraisal tool. These interviews were coded with the framework approach. Results: Living with one’s parents or husband, accommodation and security issues were identified as more significant influential factors for secondary midwife retention than current salary and the physical condition of the health centre. Gender norms were entrenched in these highly influential factors. The deployed secondary midwives who were living apart from one’s parents or spouse requested transfer (end of retention) to health centres closer to home, as other midwives had done. They feared gender-based violence, although violence against them and the women around them was not reported. The health workers surrounding the midwives endorsed the gender norms and the midwives’ responses. The ranking of factors showed similarities to the interview results. Conclusions: This study suggests that gender norms increased the significance of issues with deployments to rural areas and security issues as negative factors on female health workforce retention in rural areas in Cambodia. This finding implies that further incorporating gendered perspectives into research and developing and implementing gender-responsive policies are necessary to retain the female health workforce, thereby achieving SDGs 3 and 5.
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    ‘They say we are money minded’ exploring experiences of formal private for-profit health providers towards contribution to pro-poor access in post conflict Northern Uganda
    (Taylor & Francis, 2021-05-13) Namakula, Justine; Fustukian, Suzanne; McPake, Barbara; Ssengooba, Freddie
    Background: The perception within literature and populace is that the private for-profit sector is for the rich only, and this characteristic results in behaviours that hinder advancement of Universal health coverage (UHC) goals. The context of Northern Uganda presents an opportunity for understanding how the private sector continues to thrive in settings with high poverty levels and history of conflict.
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    Health financing in post-conflict states: What do we know and what are the gaps?
    (Elsevier, 2012-09-20) Witter, Sophie
    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.