Health Diplomacy as a Tool to build resilient health systems in Conflict Settings – A Case of Sudan

Pattanshetty, Sanjay; Bhatt, Kiran; Inamdar, Aniruddha; Dsouza, Viola Savy; Chattu, Vijay Kumar; Brand, Helmut

doi:10.20944/preprints202307.1701.v1

Cited by 1 publication

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“…At the moment there are emergency ad-hoc/monthly/bi-weekly 'National Health Sector Partners' Forum/Cluster' meetings between FMOH/SMOH, primarily led by development and humanitarian partners working from various locations inside and outside of the country. This is a good strategy to coordinate collective efforts and prevent duplication, that can be leveraged post-conflict by instituting biweekly/monthly cross-sectoral health management committees but this must be led by the Planning Directorate at FMOH-and include SMOH, development partners, and civil society-to ensure ownership and integrated, streamlined processes (60).These committees will regularly review national policies and oversee implementation progress. o Strong governance for health.…”

Section: Strengthening Policy Implementationmentioning

confidence: 99%

Health financing in Sudan: key informant interviews in the wake of the 2023 conflict

Bashir,

Allen

2023

Preprint

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BackgroundSudan is a large, landlocked, African country with a population of 46 million. It is considered a ‘least developed’ country, and coverage of essential health services is low. In April 2023 fighting broke out between the Sudanese Armed Forces and the paramilitary Rapid Support Forces. The conflict quickly escalated and has claimed 9,000 lives so far, with hundreds of thousands of people internally displaced. It is unclear exactly how the war has impacted Sudan’s already fragile health financing system.MethodsWe conducted one-to-one semi-structured interviews with a purposive sample of experienced health financing policymakers and policy advisors working in- or with the Sudanese government. Five senior key informants were recruited using snowball sampling. Interview transcripts were analysed using thematic analysis, with reference to the WHO national health financing framework and Sparkes and colleagues’ political economy framework.FindingsConflict has undoubtedly undermined Sudan’s ability to mobilise, allocate, and distribute financial resources. However, the existing health infrastructure was already so weak, and state funds so meagre, that the challenges posed by fighting were overshadowed by themes around Sudan’s underlying structural issues: out of pocket payments account for over 70% of all health expenditure; the existing national insurance scheme only covers a minority of the population; and there is unclear delineation of responsibilities between purchasers and providers and between the federal and state ministries of health. Major themes emerged around governance, revenue raising, risk pooling, purchasing and service delivery, and external donor funding.ConclusionsInvestment in developing health financing capacity at the state level, implementation planning, blended financing for the national health insurance fund, donor coordination, and community mobilisation to agitate for greater risk pooling were identified as essential steps. Without robust mechanisms to pool risk and diversification of financing sources, it will not be possible to extend financial risk protection or basic health services to large sections of Sudan’s population.

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Section: Strengthening Policy Implementationmentioning

confidence: 99%