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Post-Conflict Health Care Start Up and Health Systems Strengthening in Fragile States: MSF Experience in DRC

Author(s): M. Philips*1, E. Lampaert2, L. Luycfassel3, J. Janssen4, C. Vanoverloop5
Affiliation(s): 1Analysis and Advocacy Unit, Médecins Sans Frontières, Brussels, Belgium, 2Pool d’urgence, 3Pool d’urgence, 4Medical coordination, Médecins Sans Frontières, 5Medical coordination, Médecins Sans Frontières, Kinshasa, Democratic Republic of the Congo
Keywords: Post-conflict, fragile states, health impact, mortality, access to health care

Health care delivery in post conflict countries faces many challenges. Discussion on how best to tackle high mortality rates and weak health systems is ongoing. There are important differences in opinion what approach yields best results in terms of improved health status and restarting of essential health services. In spite of the existence of specific budget lines for most donor agencies, the question on necessary adaptations to classic development approaches remains highly topical. Humanitarian assistance is seen as temporary and important tensions exist between development and humanitarian approaches during this transition period.Evidence on outputs and outcomes is scarce in literature.


A comparative analysis will be made of basic indicators both in terms of health care offer and utilisation. Where available measures of impact at population level will be added. The experience of MSF supporting health care delivery in the isolated rural district of Lubutu will be discussed. Also indicators of health care offer and access will be shown in other districts and health facilities, supported by traditional development approaches. The latter information is based on field visits to these facilities by the MSF emergency teams when called in for crisis situations.


Evolution of utilisation data in health facilities previously supported by MSF in Equateur province will be presented. Data on availability of essential services in Equateur during the transition period will also be shown. Trends in utilisation of health care, population based measures of access and mortality in Lubutu district show rapid decrease of mortality. Detailed analysis of data is ongoing at present.

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