Ensuring continuity of health services in fragile and conflict-affected settings

Ensuring continuity of health services in fragile and conflict-affected settings

Ensuring continuity of health services in fragile and conflict-affected settings

This webinar is organized by the Health Systems in Fragile and Conflict-Affected States (FCAS) Thematic Working Group (TWG) and hosted by the Private Sector in Health TWG, Health Systems Global mutual learning series platform, and is an additional session of the virtual mutual learning series on ‘Unlocking Private Enterprise for Public Good -Redesigning Health Systems during COVID-19 and beyond’.


On September 27th 2019, before the COVID-19 pandemic took over the world and dominated much of the global health preoccupations, the FCAS TWG and PSIH TWG organized a joint webinar that explored the role of local businesses in achieving UHC in frontier economies. COVID-19 has yet again elevated the concerns about weak health systems in the face of a major event such as a pandemic, thus how do we address the systemic weaknesses that have been revealed during the past nine months since the onset of COVID-19. Such glaring gaps signal the need for major investment by both public and private sector. We also see the need to integrate global health security into the health system as a cornerstone and not an afterthought. Investing in preparedness and mitigation is too late when faced with major threats.

Private sector providers (both for profit and not for profit), play a major role in all areas of healthcare provision including direct service delivery, production of drugs and commodities and related supply chain and key support functions, such as finance, transportation, and information technology services. Nevertheless, as a recent study commissioned by WHO in the EMRO region stressed, there is a lack of data and documentation about the private sector service delivery contributions, and the difficulty to factor it into innovative and sustainable health systems strengthening strategies.

Why do frontier economies matter in the pursuit of increased understanding of private sector engagement in health? Despite the absence of a public sector strategy to engage the private sector in the health system in most FCAS contexts, flourishing private sector activities tend to organically fill gaps left by a clearly dysfunctional or distressed public system.

Between June and August 2020, the HSG PSIH TWG held a digital unconference series, which pointed to similar reality in much of the COVID-19 world: new forms of private sector engagement and public-private partnerships were born (many of them in the Global South) as pragmatic solutions were needed urgently to respond to the pandemic threat and related health care needs. Finding pragmatic solutions to unexpected shocks, rapidly adapting to uncertainties, and navigating permanent flexible thinking, are attitudes familiar to FCAS. Therefore, the fragilities exposed worldwide as a result of the unfolding global pandemic create an opportunity for looking at FCAS with a new lens, one that moves its focus away from chronic failure.

This webinar proposes to explore promising working practices, as well as empirical knowledge acquired through trial and error approaches in FCAS contexts, and opens a discussion about how better documentation and learning from these experiences can be achieved to the benefit of a broader UHC agenda.

Key questions we will focus on for this webinar session:

  • How do we build public/private partnership in FCAS contexts to unite around common challenges we are facing – and ensure the continuity of essential health services?
  • What mechanisms have shown success in FCAS so far?
  • What main challenges require additional analysis?


  • Barbara Profeta, a Steering Committee member for the FCAS TWG, will open and welcome participants and speakers.
  • Dr Nigel Pearson provides an overview of main findings from a recent study on private sector role in the Middle East region (WHO EMRO).
  • Michael Chommie provides an overview of PSI’s work on developing a social enterprise model for health service delivery in various contexts from a multi country perspective with Dr. Moh Moh Lwin, PSI Myanmar speaking about the Sun Quality Health Network.
  • Dr Harry Jeene explores the efforts to ensure the continuity of drugs supply chain during COVID in Afghanistan.
  • Dr Bothania Attal speaks about the roles and challenges of informal networks for service delivery in Yemen.
  • Dr Abdi Dalmar recounts his experiences establishing and scaling a franchised service delivery model in Somalia.
  • Dr David Clarke leads the advisory group supporting WHO to elaborate a strategy to support private sector engagement, and will reflect back on the cases presented during the panel discussion, conveying the key message to the academic community.

There will be an opportunity for participants to ask questions during the Q&A session at the end of the webinar.

Leaflet with information about the webinar

Banner image credit: Nigel Pearson