Fragile states

Fragile states are rising up the political agenda as their importance in reaching the MDGs and their relevance to geopolitical stability is realised. There are many classifications of fragile states by different actors, but real world examples tend to fall into four fragile environments: deteriorating states; post conflict transition; arrested development; and early recovery. The basic parameters of these environments include state and societal capacity, state legitimacy, political will for delivery services, and experience with violence (OECD 2005). The international development community is increasingly aware that the challenges of fragile states are too big to ignore and we are seeing more engagement and potential support to different sectors. However, achieving health outcomes in these environments is challenging. Despite additional resources, international consensus on the most effective ways to intervene remains elusive. HLSP has considerable experience of working in fragile states. Over the last decade we have worked in fragile states in Europe, Africa, South Asia, and South East Asia. Our work supports international bodies such as the UN in carrying out their mandates. Our experience includes sector analysis and sector planning (developing frameworks for health systems in the early stages of reconstruction e.g. Kosovo), strengthening financial management systems (Albania), support to contracting with the private sector (Cambodia and Afghanistan), and facilitating harmonisation (Bangladesh). In addition, we are currently managing a long term DFID funded health systems development programme in Nigeria where we work at federal level and have a presence and programmes in five states. more