When armed conflict/natural calamities break out, communities are affected, disrupting their day-to-day lives and long-term development prospects. Thus, Humanitarian aid comes in to save lives and alleviate suffering during and in the immediate aftermath of emergencies though, this aid is short lived.
Against this drop, Makerere University School of Public Health under the auspices of ReBUILD consortium organised a region symposium on Managing the transition from Humanitarian to Development aid at Serena Hotel, Kampala.
The symposium was structured under the theme “Aid and Aid Effectiveness in Post-Conflict settings: Transitioning from Humanitarian Assistance to Developing Capacity for Health Systems. Deliberations focused on: general financing for health; human resources for health; community livelihoods and how to manage the transition.
Drawing from various studies undertaken in the areas affected by conflicts both in Uganda and other countries, several lessons came up from this symposium. Lessons ranged from 1) the area of human resources, 2) community livelihoods 3) transitioning and the burgeoning the private sector. For each broad lesson, specific issues were pointed out as summarized below;
Transitions in the area of human resources; – in this area, the following issues were emphasised,
1) The need for countries to transition from expert-hires to a stable and local workforce.
2) The need for countries to transit from non-state provisions to government-led provisions
3) Transition from targeted and well financed essential benefits to fairly affordable entitlements and service delivery models.
Transitions in the area of community livelihoods;
1) Encourage community to contribute to the reconstruction and refugee settlement.
2) Use the resource in the different places of conflict to design service delivery models that are sustainable in the long term.
Transition and the burgeoning private sector;
1) The mechanisms to harmonize services provided across public and private sectors
2) Integration of the new growth of private providers into the national service delivery system and purchasing arrangements of local government and non-state fund holders.
Key messages from this symposium
- The region has challenges that continue to create crisis, yet most times, governments are not ready when conflicts emerge.
- Humanitarian needs continue to grow and their drivers are increasingly more complex in the setting of other vulnerabilities such as poverty, climate change natural disasters and diseases outbreaks.
- In conflict, usually there isn’t enough evidence to direct aid actors on what to do. So, it is important to build evidence to inform future programming.
- Funders operate as if they are in stable states and insist on error-free accountability, which might not always be possible during and after conflict.
- The push for government-led systems is well appreciated, but in many cases, governments in conflicts don’t play the desired leadership role. This is usually because there are many humanitarian actors and not so many of state machinery.
- Conflict and post-conflict challenges require collective effort to identify locally-relevant solutions. There is need to address norms and practices that might have significant impact on the outcomes of the project.
- More resources and energies need to be put into reduction and prevention of conflicts and crises since they take a lot of resource
- Countries should plan early during the humanitarian phase, which involves a lot of money, to be able to increase access to services by those who need them long-term.
- During conflict and post-conflict, local capacity become overwhelmed, health workers often become a target and so they run away or withdraw their services.
The implication of the Symposium to attaining of UHC in Uganda
As Uganda and other countries are on a trajectory to attain UHC, there is a need for leaders to ensure the stability of their countries and to mitigate social conflicts and their consequence undermine the general objective of the provision of health care to all citizens as well as attaining the Sustainable Development Goals.