Resources from ReBUILD’s work on health financing in conflict-affected and post-conflict settings

Below are details of all outputs from ReBUILD's work on health financing in post-conflict and post-crisis settings. Updated versions will be posted as further resources are added.

Download a PDF version of the resource list here or view the list below.

You can sort for specific ReBUILD health financing resources by country, resource type and year in our resources section.

The list below is complete as of January 2019. Further information and resources are available via the regularly updated resources page. There are further resources from ReBUILD’s work on .

For more information on ReBUILD’s work on health financing, contact:

• Sophie Witter or

• Barbara McPake

We also have separate set of resources from ReBUILD’s research on human resources for health and health worker incentives and deployment in post-conflict and post-crisis settings.

 

Introduction: ReBUILD’s research on health financing in conflict-affected & post-conflict settings

ReBUILD’s research started with an overview literature review on health financing in post-conflict states, which fed into the development of research projects to fill some identified gaps, including:

• The changes in health financing policies in four countries and how they affected household access and expenditure

• A four-country study on health worker incentives post-conflict

• Social network analysis of aid actors in northern Uganda

• A review of contracting mechanisms in Cambodia

• A review of purchasing mechanisms in Zimbabwe

• A literature review and expert consultation on health financing and gender

 

During ReBUILD’s extension phase additional projects are looking at:

• Performance-based financing (PBF) in fragile and conflict-affected settings, and how contextual factors influence adoption, adaption, implementation and integration of PBF, and how PBF programmes could be improved and ultimately strengthen health systems in FCAS.

• Demographic and distributional impacts of conflicts and implications for health systems. Building on the phase 1 research on health financing, this project aims to understand the implications of conflict-related demographic change for health financing and social protection policies intended to ensure access to healthcare without impoverishing effects. 

 

Resources:

Initial literature review

• Witter, S. (2012) Health financing in post-conflict states: what do we know and what are the gaps? Social Science and Medicine, vol. 75, p.2370-2377.

Health financing policies and household effects

• Ensor, S. Chhun, C., Kimsun, T., McPake, B and Edoka, I. Impact of health financing policies in Cambodia: A 20 year experience Social Science & Medicine, Volume 177, March 2017, Pages 118–126

• Ros, B., Le, G., McPake, B. and Fustukian, S. The commercialization of traditional medicine in modern Cambodia Health Policy and Planning, 2017, 1 - 8, czx144

• Ensor, T., So, S. and Witter, S. (2016) Exploring the influence of context and policy on health district productivity in Cambodia. Cost effectiveness and resource allocation, 14:1.

• Edoka, I., Ensor, T., McPake, B., Amara, R., Tseng, FM and Edem-Hotah, J Free health care for under-fives, expectant and recent mothers? Evaluating the impact of Sierra Leone’s free health care initiative Health Economics Review (2016) 6:19 DOI 10.1186/s13561-016-0096-4

• Edoka, I., McPake, B., Ensor, T., Amara, R., Edem-Hotah, J. (2017) Changes in Catastrophic Health Expenditure in Post-Conflict Sierra Leone: An Oaxaca-Blinder Decomposition Analysis. International Journal for Equity in Health 16:166

• Buzuzi, S., Chandiwana, B., Munyati, S., Chirwa, Y., Mashange, W., Chandiwana, P., Fustukian, S. and McPake, B. (2016). Impact of user fees on health care seeking behaviour and financial protection during the crisis period in Zimbabwe: A life history approach. ReBUILD RPC Working Paper

• A strong public health sector key for health system resilience in Gulu district, northern Uganda ReBUILD RPC Brief (Uganda)

• ReBUILDing Health Systems Beyond Health Facilities ReBUILD RPC Brief (Uganda)

 

Performance-based financing

• Bertone, MP., Wurie, HR., Samai, M. & Witter, S. (2018) The bumpy trajectory of performance-based financing for healthcare in Sierra Leone: agency, structure and frames shaping the policy process Globalization and Health 14:99

• Bertone, M., Falisse, J-B., Russo, G. and Witter S. (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 13(4): e0195301

• Bertone, M., Jacobs, E., Toonen, J., Akwataghibe, N. and Witter S. (2018) Performance-based financing in three humanitarian settings: principles and pragmatism Conflict and Health 12:28

• Performance-based financing in fragile and conflict-affected settings - a summary Witter, S. & Bertone M. (2018) ReBUILD Briefing paper

• Bertone MP, Lagarde M, Witter S, (2016) Performance-Based Financing in the context of the complex remuneration of health workers: findings from a mixed-method study in rural Sierra Leone.  BMC Health Services Research 16:286

Performance-based financing videos

• Introduction to performance-based financing - Sophie Witter looks at performance-based financing as a way to build strategic purchasing in fragile and conflict-affected states - potentials and pitfalls. 

• Health financing in fragile and conflict-affected states - insights from preparatory work by Professor Witter and Dr Maria Bertone for a World Health Organization paper.

• The bumpy trajectory of performance-based financing in Sierra Leone: unpacking the role of external actors - by Maria Bertone.

• Performance-based financing in fragile and post-conflict states - a summary of ReBUILD's work by Maria Bertone.

 

Contracting in Cambodia

• Vong, S., Raven, J. and Newlands, D. (2018) Internal contracting of health services in Cambodia: drivers for change and lessons learned after a decade of external contracting BMC Health Services Research 18:375

• Vong, S., Raven, J. and Newlands, D. 2015. Understanding contracting in Cambodia: the performance of contracting and non-contracting districts in extending primary health coverage: analysis of secondary data. ReBUILD RPC Research Report

• Vong, S., Raven, J. and Newlands, D. 2015. Understanding contracting in Cambodia: findings from interviews with key informants and health service managers and providers. ReBUILD RPC Research Report

 

Financing for universal health coverage in Zimbabwe

• MoHCC, TARSC, Atchison, KIT, Zeparu (2015) Evidence and proposals for advancing equity and universal coverage of health services in Zimbabwe Policy Brief, TARSC/MoHCC, Harare. (This policy brief outlines the main findings and proposals from the project conducted by ReBUILD's partners in Zimbabwe on Rebuilding the foundations for universal health coverage with equity in Zimbabwe.)

• MoHCC, NIHR, TARSC (2015) National Research Forum: Evidence for advancing Universal Health Coverage in Zimbabwe, Conference Report, 19 -20 March 2015, Harare

• Gwati G MoHCC (2013) Desk Review for Purchasing Arrangements for Public Health Services in Zimbabwe Harare, MoHCC, with TARSC Zimbabwe

• ZEPARU (2014) Desk Review of institutional arrangements for health financing in Zimbabwe,

  ZEPARU, TARSC, MoHCC, EQUINET in the ReBUILD project: Harare

• Vaughan K, Toonen J, Berghuis-Mutubuki E, Dieleman M (2014) Desk Review of institutional arrangements for health financing in selected African countries, KIT Netherlands with TARSC, MoHCC Zimbabwe

 

Health financing and gender

• Witter, S., Govender, V., Ravindran, S. and Yates, R. (2017) Minding the gaps: health financing, universal health coverage and gender. Special edition on gender and ethics, Health Policy and Planning.

• Ssali, S. and Theobald, S. (2016) Using life histories to explore gendered experiences of conflict in Gulu District, northern Uganda: Implications for post-conflict health reconstruction South African Review of Sociology Volume 47, Issue 1, 2016

 

Cross-cutting materials

• Briefs on priority research topics for health systems in crisis-affected contexts, ReBUILD, 2017/18.

• Resilience of health systems during and after crises – what does it mean and how can it be enhanced?

• Developing inclusive health systems in crisis-affected settings

• How to move towards universal health coverage in crisis-affected settings: lessons from research

• How do different types of provider affect access to effective and affordable healthcare during and after crises?

• The political economy of crisis-affected settings: what does it mean for investments in health systems?

• Do health systems contribute to reduced fragility and state-building during and after crises?

• Sustainability of health systems in crisis-affected settings: lessons for practice

• Developing health system research capacity in crisis-affected settings: why and how?

• What do we know about how to respond to humanitarian crises in ways that also contribute to subsequent stronger health systems?

• Performance-based financing in fragile and conflict-affected settings: what are the opportunities and challenges?

  See also: Establishing a responsive and equitable health workforce post conflict and post crisis: lessons from ReBUILD research.
  

 

• Ager, A., Lembani, M., Mohammed, A., Ashir, GM., Abdulwahab, A., de Pinho, H., Delobelle, P. and Zarowsky, C. (2015) Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building. Conflict and Health 2015 9:30

• Martineau, T., McPake, B., Theobald, S., Raven, J., Ensor, T., Fustukian, S., Ssengooba, F., Chirwa, Y., Vong, S., Wurie, H, Hooton, N and Witter, S. (2017) Leaving no one behind: lessons on rebuilding health systems in conflict and crisis-affected states. BMJ Global Health Jul 2017, 2 (2)

• Health financing policy in conflict-affected settings: lessons from ReBUILD research. ReBUILD briefing paper (2016)

• Woodward, A., Sondorp, E., Witter, S. and Martineau, M. (2016) Health systems research in fragile and conflict affected states: a research agenda-setting exercise. Health Research Policy & Systems.

• Universal health coverage amid conflict and fragility: ten lessons from research. (Witter, S., Dec 2015, Lancet Global Health blog)

• McPake, B., Witter, S., Ssali, S., Wurie, H., Namakula, J. and 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; 9; 23.

• Percival, V., Richards, E., MacLean, T. and Theobald, S. (2014) Health systems and gender in post-conflict contexts: building back better? Conflict and Health 2014, 8:19

• McPake, B., Witter, S., Ensor, T., Fustukian, S., Newlands, D., Martineau, T. and Chirwa, Y. (2013) Removing financial barriers to access reproductive, maternal and newborn health services: the challenges and policy implications for human resources. Human Resources for Health, 11(1):46.