The role of the diaspora in supporting health system resilience in fragile and shock-prone settings

Partners: Queen Margaret University (UK), HERD International (Nepal), Burnet Institute (Myanmar), American University of Beirut (Lebanon), Institute for Development (Sierra Leone), and Alaa Dafallah [opens new tab] at University of Oxford

Study objective

The capacity of health systems in fragile and conflict-affected states is compromised by brain drain of populations and medical talent, lack of infrastructure investment, and overreliance on external aid, amongst many other factors. However, diaspora populations originating from fragile states may contribute significantly to rebuilding health system capacity and resilience through various engagement pathways, which we believe are under-explored in the published literature. This study aims to elucidate the specific mechanisms through which diaspora human capital, social capital, financial capital, among others, and policy engagement can strengthen local health system functioning in fragile contexts, contributing to overall resilience. Understanding these diaspora-health system impact pathways can inform policy interventions targeting diasporas to promote health system resilience, pandemic response and service access for vulnerable groups.

Methodology

This research will map and categorise existing mechanisms through which several types of diaspora migrants engage with national and local health systems in order to strengthen the system capacities and shock-responsiveness in fragile and shock-prone settings. Through a literature review, global and national data review, followed by key informant interviews across the four ReBUILD core countries (Lebanon, Nepal, Myanmar and Sierra Leone) and at the global level (eg health system experts, diaspora association leaders where they exist, and government or ex-government health officials at global, national and sub-national levels), we will map and identify those mechanisms.

The research will map pathways by which different forms of diaspora assistance – ranging from medical knowledge transfer to teleconsultation services – help modify and bolster health service delivery to populations in need. It will elucidate the different forms of capital that diaspora populations can provide (including in-kind such as drugs, financial, social, professional), creating an understanding of how a diaspora’s inputs influence critical health system capabilities related to care quality, service access, pandemic response, medical training, and health infrastructure during and after shocks.

Image: An optometrist examines a man’s eyes in a MAPS health facility in Beqaa, Lebanon. MAPS (Multi-Aid Programs) is a humanitarian, community-based, non-profit organisation focused on refugees and vulnerable populations. Its four programs, one of which is healthcare, seek to empower displaced Syrians, with the majority of programs designed and implemented by Syrian refugees themselves. MAPS is partly supported through donations from the Syrian diaspora. More on MAPS here [opens new tab]