Hosted by Makerere University College of

Health Sciences

ReBUILD Launch

Research for Building Pro-poor Health Systems during the

Recovery from Conflict

Serena Hotel, Kampala

28 July 2011

Meeting objective

Increase the relevance of the ReBUILD programme to stakeholders involved in health programmes in post-conflict northern Uganda:

Share ReBUILD objectives among key agencies working in post-conflict northern Uganda;

Receive stakeholders’ views related to ReBUILD research questions and overall purpose.

Mother and baby at the mass immunisation campaign in ConerKilk Camp in Pader District

Northern UgandaPETER BUSOMKE

Key messages about ReBUILD Decisions made in the early post-conflict period can set the

direction of development for the system There are particular opportunities to set health systems in a

pro-poor direction in the immediate post-conflict period The partner countries enable us to look from distance

(Cambodia and Sierra Leone) and up close (Northern Uganda and Zimbabwe) at the post-conflict period

Main body of health systems research has tended to neglect post-conflict settings

Affiliate strategy enables us to gain from wider expertise than the consortium’s partner institutions

ReBUILD partners Liverpool School of Tropical Medicine Queen Margaret University, Edinburgh School of Public Health and Department of

Gender and Women’s Studies, Makerere The Biomedical and Training Institute, Harare The College of Medicine and Allied Health

Sciences, Freetown, Sierra Leone The Cambodian Development Research

Institute, Phnom Penh

Overall purpose and research themes of ReBUILD

Purpose: to deliver new knowledge to inform the development and implementation of pro-poor health systems in countries recovering from political and social conflict

Research themes: Health financing Human resources

Development of ReBUILD

DFID call for research on health systems (1+5 yrs) Selection of post-conflict perspective; planning workshop

in Liverpool (Jan 2010) Project inception year starts (Feb 2011) First consortium workshop to select initial projects

(March 2011) Country-level stakeholder meetings (July-Sep 2011) Draft research plans and strategies (affiliate, research

uptake and capacity building) reviewed at second consortium workshop in Kampala (Oct 2011)

ReBUILD in Uganda

Dynamic situations in post conflict reconstruction phase

• Resettlements of the population from IDP (Internally Displaced Persons) camps;

• Re-institutionalisation of community structures– Markets & production– Civic leadership – Community level

organisations – Collective governance and

accountable systems to the communities vs. to funding agencies.

Multiple funding opportunities • $133 million – Northern Uganda Social Action Fund (NUSAF-I)

• $ 100 million – Northern Uganda Social Action Fund (NUSAF-II)

• $98.2 million – Northern Uganda Rehabilitation program (NUREP) from 1992-1998

• $606.5 million - Peace Recovery and Development Plan (PRDP)

• £91.5 million – Post-conflict development in Northern Uganda (DFID)

• € 20 million from European Union

• Others include mainstream programs such as

– NUMAT (Northern Uganda Malaria, AIDS and TB program

– National Agricultural Advisory Services (NAADS),

– Universal Primary Education (UPE) and

– Universal Secondary Education (USE)

New power structures and inter-dependences for service delivery • Donors and government relationships

– More project support with multilateral leadership• UNICEF leads the response from UN family• World Bank initiates to support local Govt. and CBOs• DIFD Programmes (health, microfinance, etc)

• Donor-donor relationships and coordination– Pooling of funds – UN family – Also multiple charitable NGOs

• Local governments and different partners – Decision space for local leadership may broaden

• Opportunity to assess the governance of health systems within dynamic power relationships

Research topics in Uganda1. How have the incentive environments evolved in

the shift away from conflict?

2. How do state and non-state system get and keep staff in post conflict settings?

3. What post conflict implications arise from changes in the health financing policy and expenditure patterns?

4. How effective are the program designs, mechanisms and benefits in addressing health system development in post conflict setting?

www.rebuildconsortium.com