Show simple item record

dc.contributor.authorMcPake, Barbara
dc.contributor.authorWitter, Sophie
dc.contributor.authorSsali, S.
dc.contributor.authorWurie, H.
dc.contributor.authorNamakula, Justine
dc.contributor.authorSsengooba, F.
dc.date.accessioned2018-06-29T22:03:49Z
dc.date.available2018-06-29T22:03:49Z
dc.date.issued2015-08
dc.identifierER3969
dc.identifier.citationMcPake, B., Witter, S., Ssali, S., Wurie, H., Namakula, J. & Ssengooba, F. (2015) Ebola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone, Conflict and Health, vol. 9, , ,
dc.identifier.issn1752-1505
dc.identifier.urihttp://dx.doi.org/10.1186/s13031-015-0052-7
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/3969
dc.description.abstractEbola seems to be a particular risk in conflict affected contexts. All three of the countries most affected by the 2014-15 outbreak have a complex conflict-affected recent history. Other major outbreaks in the recent past, in Northern Uganda and in the Democratic Republic of Congo are similarly afflicted although outbreaks have also occurred in stable settings. Although the 2014-15 outbreak in West Africa has received more attention than almost any other public health issue in recent months, very little of that attention has focused on the complex interaction between conflict and its aftermath and its implications for health systems, the emergence of the disease and the success or failure in controlling it. The health systems of conflict-affected states are characterized by a series of weaknesses, some common to other low and even middle income countries, others specifically conflict-related. Added to this is the burden placed on health systems by the aggravated health problems associated with conflict. Other features of post conflict health systems are a consequence of the global institutional response. Comparing the experience of Northern Uganda and Sierra Leone in the emergence and management of Ebola outbreaks in 2000-1 and in 2014-15 respectively highlights how the various elements of these conflict affected societies came together with international agencies responses to permit the outbreak of the disease and then to successfully contain it (in Northern Uganda) or to fail to do so before a catastrophic cost had been incurred (in Sierra Leone). These case studies have implications for the types of investments in health systems that are needed to enable effective response to Ebola and other zoonotic diseases where they arise in conflict- affected settings.
dc.publisherBioMed Central
dc.relation.ispartofConflict and Health
dc.subjectEbola
dc.subjectSierra Leone
dc.subjectNorthern Uganda
dc.subjectHealth System
dc.titleEbola in the context of conflict affected states and health systems: case studies of Northern Uganda and Sierra Leone
dc.typearticle
dcterms.accessRightspublic
dc.description.facultysch_iih
dc.description.referencetext1. Smillie I, Minear L. The charity of nations: humanitarian action in a calculating world. Bloomfield: Kumarian; 2004. 2. Annan N. Violent conflicts and civil strife in West Africa: causes, challenges and prospects. Stability. 2014;3(1):3. http://www.stabilityjournal.org/article/ view/sta.da/173. 3. Bausch DG, Schwarz L. Outbreak of Ebola virus disease in Guinea: where ecology meets economy. PLoS Negl Trop Dis. 2014;8(7):e3056. 4. Kruk ME, Freedman LP, Anglin GA, Waldman RJ. Rebuilding health systems to improve health and promote statebuilding in post-conflict countries: A theoretical framework and research agenda. Soc Sci Med. 2010;70(1):89-97. 5. Ford LB. Civil conflict and sleeping sickness in Africa in general and Uganda in particular. Conflict Health. 2007;1:6. 6. Tong J, Valverde O, Mahoudeau C, Yun O, Chappuis F. Challenges of controlling sleeping sickness in areas of violent conflict: experience in the Democratic Republic of Congo. Conflict Health. 2011;5:7. 7. Bausch DG, Borchert M, Grein T, et al. Risk factors for Marburg hemorrhagic fever, Democratic Republic of the Congo. Emerg Infect Dis. 2003;9(12):1531-7. 8. Spiegel PB, Le P, Ververs M-T, Salama P. Occurrence and overlap of natural disasters, complex emergencies and epidemics during the past decade (1995-2004). Conflict Health. 2007;1:2. 9. Sunderlin WD, Anglesen A, Belcher B, Burgers P, Nasi R. Livelihoods, forests, and conservation in developing countries: An overview. World Dev. 2005;33(9):1383-140211. 10. Bennett EL, Blencowe E, Brandon K, Brown D, Burn RW, Cowlishaw G, et al. Hunting for consensus: reconciling bushmeat harvest, conservation, and development policy in West and Central Africa. Conserv Biol. 2007;21(3):884-7. 11. Kalra S, Kelkar D, Galwankar SC, Papadimos TJ, Stawicki SP, Arquilla B, et al. The emergence of Ebola as a global health security threat: from 'lessons learned' to coordinated multilateral containment efforts. J Global Infect Dis. 2014;6(4):164-77. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4265832/ #ref63. 12. DFID. Why we need to work more effectively in fragile states. London: Department for International Development; 2005. http://www.jica.go.jp/ cdstudy/library/pdf/20071101_11.pdf. 13. OECD. Principles for good international engagement in fragile states and situation. Paris: Organisation for Economic Cooperation and Development; 2007. available at: http://www.oecd.org/dacfragilestates/43463433.pdf. 14. Stewart F, Brown G. Fragile states, CRISE Working Paper No 51. Oxford: CRISE; 2009. 15. Moseley A. A Philosophy of War. New York: Algora Publishing; 2007. 16. Brown, G., Langer, A., and Stewart, F (2011). A typology of post-conflict environments, Centre for Research on Peace and Development, Working Paper, No. 1 at: https://soc.kuleuven.be/web/files/12/80/wp01.pdf 17. Collier P, Hoeffler A. Aid, policy and growth in post-conflict societies. Eur Econ Rev. 2003;48(2004):1125-45. 18. Newbrander W, Waldman R, Shepherd-Banigan M. Rebuilding and strengthening health systems and providing basic health services in fragile states. Disasters. 2011;43(4):639-60. 19. Tulloch, O., Raven, J. and Martineau, T. (2011) Human Resources for Health in post-conflict settings, ReBuild consortium at: http://www.rebuildconsortium.com/ resources/research-reports/human-resources-for-health-postconflict-lit-review/ 20. Witter S. Health financing in post-conflict states: what do we know and what are the gaps? Soc Sci Med. 2012;75:2370-7. http://www.sciencedirect.com/ science/article/pii/S0277953612006752. 21. Pavignani E, Colombo S. Module 5 Understanding Health Policy Processes in Analysing disrupted health sectors: A modular manual. Geneva: World Health Organization; 2009. http://www.who.int/hac/techguidance/tools/ disrupted_sectors/adhsm_en.pdf. 22. Lowicki-Zucca M, Spiegel P, Ciantia F. AIDS, conflict and the media in Africa: risks in reporting bad data badly. Emerg Themes Epidemiol. 2005;2:12. 23. Lamunu M, Lutwama JJ, Kamugisha J, Opio A, Nambooze J, Ndayimirije N, et al. Containing a haemorrhagic fever epidemic: the Ebola experience in Uganda (October 2000 - January 2001). Int J Infect Dis. 2004;8:27-37. 24. Lane J, Nicoll A. Outbreak of Ebola fever in Uganda officially over. Eurosurveillance. 1793;5:10. http://www.eurosurveillance.org/ ViewArticle.aspx?ArticleId=1793. 25. Kinsman J. A time of fear-: local, national and international responses to a large Ebola outbreak in Uganda. Global Health. 2012;8:15. 26. Chin C-S et al. The origin of the Haitian cholera outbreak strain. New Engl J Med. 2011;364(1):33-42. 27. CDC. Outbreak of Ebola Hemorrhagic Fever -Uganda, August 2000-January 2001. Atlanta: Centres for Disease Control; 2001. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5005a1.htm. 28. Okware SI, Omaswa FG, Zaramba S, Opio A, Lutwama JJ, Kamugisha J, et al. An outbreak of Ebola in Uganda. Trop Med Int Health. 2002;7(12):1068-75. 29. Hewlett BS, Amola RP. Cultural contexts of Ebola in Northern Uganda. Emerg Infect Dis. 2003;9(10):1242-9. 30. Legros D, McCormick M, Mugero C, Skinnider M, Bek'obita DD, Okware SI. Epidemiology of cholera outbreak in Kampala. Uganda: East African Medical Journal; 2000. p. 347-9. 31. Hewlett BL, Hewlett BS. Providing care and facing death: nursing during Ebola outbreaks in Central Africa. J Transcult Nurs. 2005;16(4):289-97. 32. Namakula J, Witter S, Ssengooba F, Ssali S. Health worker's career paths, livelihoods and coping strategies in conflict and post-conflict Northern Uganda. A research report. Kampala: ReBUILD Consortium and Makerere University School of Public Health; 2013. 33. Namakula J, Witter S. Living through conflict and post-conflict: experiences of health workers in northern Uganda and lessons for people-centred health systems. Health Policy Plann. 2014;29:ii6-ii14. http://heapol.oxfordjournals.org/ cgi/reprint/czu022?ijkey=YnaTJ5KrPqEnjEA&keytype=ref. 34. Hauser E. Ugandan relations with Western donors in the 1990s: what impact on democratisation? J Modern Afr Stud. 1999;37(4):621-41. 35. Okidi JA, Ssewanyana S, Bategeka L, Muhumuza F. Operationalizing Pro-Poor Growth: Uganda Case Study. Kampala: Economic Policy Research Centre, Makerere; 2005. http://siteresources.worldbank.org/INTPGI/Resources/ 342674-1115051237044/oppgUganda(June2005).pdf. 36. Appleton S. Regional or national poverty lines? The case of Uganda in the 1990s. J Afr Econ. 2003;12(4):598-624. 37. Baize S et al. Emerge of Zaire Ebola Virus Disease in Guinea. New Engl J Med. 2014;371:1418-25. 38. Briand S, Bertherat E, Cox P, Formenty P, Kien MP, Myhre JK, et al. The International Ebola Emergency. N Engl J Med. 2014;371(13):1180-3. 39. Lind J, Ndebe J. Return of the rebel: legagies of war and reconstruction in West Africa's Ebola epidemic. Sussex: Institute for Development Studies, Practice Paper in Brief; 2015. http://opendocs.ids.ac.uk/opendocs/bitstream/ handle/123456789/5852/ID560%20Online. pdf;jsessionid=12DFE0335D13760EE2E8646708A2BF9B?sequence=1. 40. Witter, S., Wurie, H. And Bertone, M. The Free Health Care Initiative: how has it affected health workers in Sierra Leone? Health Policy Plan. 2015. [Epub ahead of print] 41. Wurie, H. And Witter, S. Serving through and after conflict: life histories of health workers in Sierra Leone. Report for ReBUILD. 2014. http://www.rebuildconsortium.com/resources/research-reports/servingthrough- and-after-conflict-life-historiesof-health-workers-in-sierra-leone/ 42. Witter S, Bertone M, Wurie H, Edem-Hotah J, Samai M. Health worker incentives post-conflict: survey report from Sierra Leone. Report for ReBUILD. 2015a. 43. Scott K et al. Navigating multiple options and social relationships in plural health systems: a qualitative study exploring healthcare seeking for sick children in Sierra Leone. Health Policy Plan. 2013;29(3):292-301. 44. SLRC. Understanding malnutrition and health choices at the community level in Sierra Leone. London: Secure Livelihoods Research Consortium; 2014. 45. Hanlon J. Is the international community helping to recreate the preconditions for war in Sierra Leone? Round Table. 2007;94(381):459-72. 46. Gberie L. A Dirty War in West Africa. The RUF and the Destruction of Sierra Leone. Bloomington: Indiana University Press; 2005. 47. Bertone M, Samai M, Edem-Hotah J, Witter S. A window of opportunity for reform in post-conflict settings? The case of Human Resources for Health policies in Sierra Leone, 2002-2012. Conflict Health. 2014;8:11. http:// www.conflictandhealth.com/content/pdf/1752-1505-8-11.pdf. 48. O'Neill K, Takane M, Sheffel A, Abou-Zahr C, Boerma T. Monitoring service delivery for universal health coverage: the service availability and readiness assessment. Bull World Health Organ. 2013;91:923-31. 49. Bertone M, Witter S. An exploration of the political economy dynamics shaping health worker incentives in three districts in Sierra Leone. Submitted to Social Science and Medicine. 2015 50. Abramowitz SA. How the Liberian Health Sector Became a Vector for Ebola. Cult Anthropol Online (Fieldsights - Hot Spots). 2014 51. Lancet. WHO AFRO: in need of new leadership, Editorial. Lancet. 2014;384:1550. 52. Sthreshley L, Duberstein S, Craciunoiu S. Stopping Ebola in its tracks: maximimizing a health system approach for an improved epidemic response, Recommendations from IMA's experiences containing Ebola outbreaks in DRC, IMAWorld Health. 2015. imaworldhealth.org/wp-content/ uploads/2015/03/IMA_EbolaStudy_030415.pdf
dc.description.volume9
dc.identifier.doihttp://doi:10.1186/s13031-015-0052-7
dc.description.ispublishedpub
dc.description.eprintid3969
rioxxterms.typearticle
refterms.dateFCA2016-11-02
refterms.dateFCD2016-11-02
qmu.authorWitter, Sophie
qmu.authorMcPake, Barbara
qmu.centreInstitute for Global Health and Development
dc.description.statuspub
dc.description.number1


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record