Making sense of apparent chaos: health-care provision in six country case studies

Pavignani, Enrico, Michael, Markus, Murru, Maurizio, Beesley, Mark E. and Hill, Peter S. (2013) Making sense of apparent chaos: health-care provision in six country case studies. International Review of the Red Cross, 95 889: 41-60. doi:10.1017/S1816383113000726

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Author Pavignani, Enrico
Michael, Markus
Murru, Maurizio
Beesley, Mark E.
Hill, Peter S.
Title Making sense of apparent chaos: health-care provision in six country case studies
Journal name International Review of the Red Cross   Check publisher's open access policy
ISSN 1816-3831
Publication date 2013-03-01
Year available 2014
Sub-type Article (original research)
DOI 10.1017/S1816383113000726
Open Access Status Not yet assessed
Volume 95
Issue 889
Start page 41
End page 60
Total pages 20
Place of publication Cambridge, United Kingdom
Publisher Cambridge University Press
Language eng
Abstract This research examines the impact on health-care provision of advanced state failure and of the violence frequently associated with it, drawing from six country case studies. In all contexts, the coverage and scope of health services change when the state fails. Human resources expand due to unplanned increased production. Injury, threat, death, displacement, migration, insufficient salaries, and degraded skills all impact on performance. Dwindling public domestic funding for health causes increasing household out-of-pocket expenditure. The supply, quality control, distribution, and utilisation of medicines are severely affected. Health information becomes incomplete and unreliable. Leadership and planning are compromised as international agencies pursue their own agendas, frequently disconnected from local dynamics. Yet beyond the state these arenas are crowded with autonomous health actors, who respond to state withdrawal and structural violence in assorted ways, from the harmful to the beneficial. Integrating these existing resources into a cohesive health system calls for a deeper understanding of this pluralism, initiative, adaptation and innovation, and a long-term reorientation of development assistance in order to engage them effectively.
Keyword Health sector
State failure
Health-care provision
Structural violence
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
Official Audit
School of Public Health Publications
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 11 Mar 2014, 04:50:36 EST by Associate Professor Peter Hill on behalf of School of Public Health