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dc.contributor.authorWitter, Sophie
dc.contributor.authorBertone, Maria Paola
dc.contributor.authorChirwa, Yotamu
dc.contributor.authorNamakula, Justine
dc.contributor.authorSo, Sovannarith
dc.contributor.authorWurie, Haja R.
dc.date.accessioned2018-06-29T22:01:58Z
dc.date.available2018-06-29T22:01:58Z
dc.date.issued2017-01-18
dc.identifierER4648
dc.identifier.citationWitter, S., Bertone, M., Chirwa, Y., Namakula, J., So, S. & Wurie, H. (2017) Evolution of policies on human resources for health: opportunities and constraints in four post-conflict and post-crisis settings, Conflict and Health, vol. 10, , ,
dc.identifier.issn1752-1505
dc.identifier.urihttp://doi.org/10.1186/s13031-016-0099-0
dc.identifier.urihttps://eresearch.qmu.ac.uk/handle/20.500.12289/4648
dc.description.abstractBackground Few studies look at policy making in the health sector in the aftermath of a conflict or crisis and even fewer specifically focus on Human Resources for Health, which is a critical domain for health sector performance. The main objective of the article is to shed light on the patterns and drivers of post-conflict policy-making. In particular, we explore whether the post -conflict period offers increased chances for the opening of 'windows for opportunity' for change and reform and the potential to reset health systems. Methods This article uses a comparative policy analysis framework. It is based on qualitative data, collected using three main tools - stakeholder mapping, key informant interviews and document reviews - in Uganda, Sierra Leone, Cambodia and Zimbabwe. Results We found that HRH challenges were widely shared across the four cases in the post-conflict period but that the policy trajectories were different - driven by the nature of the conflicts but also the wider context. Our findings suggest that there is no formula for whether or when a 'window of opportunity' will arise which allows health systems to be reset. Problems are well understood in all four cases but core issues - such as adequate pay, effective distribution and HRH management - are to a greater or lesser degree unresolved. These problems are not confined to post-conflict settings, but underlying challenges to addressing them - including fiscal space, political consensus, willingness to pursue public objectives over private, and personal and institutional capacity to manage technical solutions - are liable to be even more acute in these settings. The role of the MoH emerged as weaker than expected, while the shift from donor dependence was clearly not linear and can take a considerable time. Conclusions Windows of opportunity for change and reform can occur but are by no means guaranteed by a crisis - rather they depend on a constellation of leadership, financing, and capacity. Recognition of urgency is certainly a facilitator but not sufficient alone. Post-conflict environments face particularly severe challenges to evidence-based policy making and policy implementation, which also constrain their ability to effectively use the windows which are presented.
dc.publisherBioMed Central
dc.relation.ispartofConflict and Health
dc.titleEvolution of policies on human resources for health: opportunities and constraints in four post-conflict and post-crisis settings
dc.typearticle
dcterms.accessRightspublic
dc.description.facultysch_iih
dc.description.volume10
dc.identifier.doihttp://doi:10.1186/s13031-016-0099-0
dc.description.ispublishedpub
dc.description.eprintid4648
rioxxterms.typearticle
refterms.dateAccepted2016-09-20
refterms.dateFCA2017-01-18
refterms.dateFCD2017-01-18
qmu.authorBertone, Maria Paola
qmu.authorWitter, Sophie
qmu.centreInstitute for Global Health and Development
dc.description.statuspub
dc.description.number1


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