Taking the long view: What can we learn about health system resilience in fragile contexts from Afghanistan (1989-2024)?- presentation
This presentation was made at the 8th Global Symposium on Health Systems Research in Japan in November 2024 by Egbert Sondorp on behalf of Natasha Palmer of Queen Margaret University.
Over recent decades, a range of publications has highlighted the relative success of health care reforms initiated in 2003 in Afghanistan. These were based on contracting minimal health care packages to non-state health providers; an approach that is thought to still contribute to the apparent resilience of Afghanistan’s health system today. This case study revisits these conclusions, taking a longer-term perspective and including a wider range of stakeholders. It identifies some possibly undervalued elements in understanding this resilience and concludes that greater attention for longitudinal and context specific understanding of governance in fragile, mixed health systems is warranted.