Perspectives on Rebuilding Health System Governance in Opposition-Controlled Syria: A Qualitative Study
Background<br /> Ongoing conflict and systematic targeting of health facilities and personnel by the Syrian regime in opposition-controlled areas have contributed to health system and governance mechanisms collapse. Health directorates (HDs) were established in opposition-held areas in 2014 by...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Kerman University of Medical Sciences
2019-04-01
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| Series: | International Journal of Health Policy and Management |
| Subjects: | |
| Online Access: | https://www.ijhpm.com/article_3588_0c56fa17714f1dfbb05132d0868484f4.pdf |
| Summary: | Background<br /> Ongoing conflict and systematic targeting of health facilities and personnel by the Syrian regime in opposition-controlled areas have contributed to health system and governance mechanisms collapse. Health directorates (HDs) were established in opposition-held areas in 2014 by the interim (opposition) Ministry of Health (MoH), to meet emerging needs. As the local health authorities responsible for health system governance in opposition-controlled areas in Syria, they face many challenges. This study explores ongoing health system governance efforts in 5 opposition-controlled areas in Syria.<br /> <br /> Methods<br /> A qualitative study design was selected, using in-depth key informant interviews with 20 participants purposely sampled from HDs, non-governmental organisations (NGOs), donors, and service-users. Data were analysed thematically.<br /> <br /> Results<br /> Health system governance elements (ie, strategic vision, participation, transparency, responsiveness, equity, effectiveness, accountability, information) were considered important, but not interpreted or addressed equally in opposition-controlled areas. Participants identified HDs as primarily responsible for health system governance in opposition-controlled areas. Main health system governance challenges identified were security (eg, targeting of health facilities and personnel), funding, and capacity. Suggested solutions included supporting HDs, addressing health-worker loss, and improving coordination.<br /> <br /> Conclusion<br /> Rebuilding health system governance in opposition-controlled areas in Syria is already progressing, despite ongoing conflict. Local health authorities need support to overcome identified challenges and build sustainable health system governance mechanisms. |
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| ISSN: | 2322-5939 2322-5939 |