- Dr. Kelvin Meyeyin-Bala
An
overwhelming stress is imposed upon health systems by armed conflict, creating
breakdown of service delivery and destroying infrastructure. Furthermore, it
leads to relocation of health workers, and paralysis of governing structures
essential for coordinated effort. This paper analyzes the resilience of the
health system-the ability of a health system to withstand, react to, and
recover from sudden crises and to provide necessary services by comparing three
conflict-endangered countries: Ukraine, Gaza, and northeastern Nigeria. Based upon an analyzing framework built with
a health systems-building-blocks model, the paper examines how the countries
suffered health service interruption, limited health workforce capabilities,
weak medical supply channels, underdeveloped health information systems,
ineffective financing, and lack of competent governance; and how domestic and
international actors tried to uphold resilience amid acute vs protracted armed
conflict scenarios. Although there are marked contrasts in conflict intensity
and duration and international capacity response between these three regions,
the recurring resilience strategies among them such as tasks division to
community health workers, remote/mobile service provision, telemedicine, and
humanitarian coordination networks, in particular WHO Health Cluster system can
be observed. This paper suggests that resilience should be treated not as an
institutional feature, but as an actor-dependent process driven by interactions
between security contexts, humanitarian accessibility and initial strengths of
systems. The policy implications for governance of global health security, international
human law implementation, and pre-conflict investment for system resilience are
presented.
Keywords: health system resilience, conflict zone, global health security, Ukraine, Gaza, Nigeria, humanitarian health governance.