NEW! Brief on post-conflict reform in Sierra Leone

One of the challenges when a conflict is over is the balance between emergency aid to save lives and a longer-term approach based on rebuilding the health system. Some researchers believe that the decisions taken shortly after a conflict can influence how the health system will develop and that a political “window of opportunity” for reform exists at this time. To test these two concepts and to understand how reform takes place, it is helpful to analyse how, when and why policy is made after conflict. In order to do this, the ReBUILD Consortium focused on the factors shaping policy on human resources for health in Sierra Leone after the war had ended in 2002. The findings are published in an article which begins by setting the context of the health system in Sierra Leone before the war; explains the methods used to collect information for the study and the difficulties encountered, and looks at how policy on health workers was made from 2002 to 2012. Three stages in policy-making are identified and discussed in detail. The article concludes that decisions taken early on after the war in Sierra Leone did have an impact on the development of human resources for health policy and ultimately the health system. However, the window of opportunity for reform did not open immediately after the end of the conflict but eight years afterwards when a key initiative came into force which introduced free health care at the point of delivery, for mothers and children. This event – propelled by increased political will from high-ranking government officials as well as international pressure and support – sparked off major changes throughout the health system.

Read the brief

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