A triple burden for health sector reform: ‘Post’-conflict rehabilitation in Uganda

doi:10.1016/0277-9536(95)00338-X

Social Science & Medicine

Volume 42, Issue 7, April 1996, Pages 1095-1108

https://doi.org/10.1016/0277-9536(95)00338-X Get rights and content

Abstract

While conflict continues to threaten health development in many countries, relative peace has been secured in others. The transition from war to peace carries important political and economic opportunities for the reappraisal of social policy in general, and of health policy in particular. The health systems of countries recovering from prolonged periods of conflict often carry a double burden: the inheritance of an inappropriate and unaffordable health system developed in the pre-conflict era, and the particular, long-term effects of conflict on health and health services. This paper reports on the particular policies designed to rehabilitate the Ugandan health system, and argues that they exacerbated, rather than alleviated, the health crisis inherited in 1986. In this way they posed a third burden. By analyzing the context and process of policy formulation in the immediate post-conflict period, it explores the rationale which lay behind the adoption of these policies and identifies potential strategies for strengthening policy development in these unstable, resource-poor and health-deprived situations.

References (62)

L. Gilson et al.
Health sector reforms in sub-Saharan Africa
Lessons of the last 10 years
Hlth Policy
(1995)
A.B. Zwi et al.
Towards an epidemiology of political violence in the Third World
Soc. Sci. Med.
(1989)
C. Dodge
Uganda—Rehabilitation or redefinition of health services?
Soc. Sci. Med.
(1986)
S.B. Rifkin et al.
Why health improves: defining the issues concerning ‘comprehensive primary health care’ and ‘selective primary health care’
Soc. Sci. Med.
(1986)
C. Taylor et al.
The straw men of primary health care
Soc. Sci. Med.
(1988)
O. Gish
Selective primary health care: old wine in new bottles
Soc. Sci. Med.
(1982)
P. Berman
Selective primary health care: is efficient sufficient?
Soc. Sci. Med.
(1982)
M. Segall
Planning and politics of resource allocation for PHC: promotion of meaningful national policy
Soc. Sci. Med.
(1983)
L.E. Sabo et al.
Political violence and Eritrean health care
Soc. Sci. Med.
(1989)
The politics of health service reform in developing countries: 3 cases of pharmaceutical policy

M.S. Grindle et al.

Public Choices and Policy Change

A.B. Zwi et al.

Health policy in less developed countries: Past trends and future directions

J. Int. Dev.

(1995)

S. Mogedal et al.

Health sector reform and organizational issues at the local level: lessons from selected African countries

J. Int. Dev.

(1995)

A. Cassels

Health sector reform: Key issues in less developed countries

J. Int. Dev.

(1995)

A Healthy Peace?: Post-Conflict Rehabilitation in Uganda

(1994)

E.T. Brett

Providing for the rural poor: Institutional decay and transformation in Uganda

R.L. Sivard

World Military and Social Expenditures 1993

(1993)

Rehabilitation and Development Plan 1987/88–1991/92

(1992)

Uganda: Growing out of Poverty

(1993)

I. Burkey

People's Power in Theory and Practice: The Resistance Council System in Uganda

Mimeo

(1991)

K.S. Lateef

Structural adjustment in Uganda: the initial experience

Children and Women in Uganda: A Situation Analysis

(1989)

J. Kyakulaga

A review of current knowledge on IMR and its trends in Uganda

M. Smallman-Raynor et al.

Civil war and the spread of AIDS in central Africa

Epidemiol. Infect. Dis.

(1991)

G. Bond et al.

Living on the edge: changing social structures in the context of AIDS

A.B. Zwi et al.

High risk situations for AIDS prevention

Br. Med. J.

(1991)

A. Welbourn

Report on the social and economic dimensions of ill-health among Uganda households

(1990)

J. Bennett

A comparison of community health in Uganda with its two East African neighbours in the period 1970–1979

Financing Health Services in Developing Countries: An Agenda for Reform

(1987)

Cited by (0)

^☆: The achievement of peace is typically a relative process: the main body of a conflict may be over, but violence may persist intermittently at a national level, and/or within particular geographical areas. The term ‘post’-conflict is used to indicate that the ‘end’ of conflict is often not absolute.

^†: Current address: Overseas Development Institute, London.

View full text

A triple burden for health sector reform: ‘Post’-conflict rehabilitation in Uganda☆

Abstract

Hlth Policy

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

Soc. Sci. Med.

The politics of health service reform in developing countries: 3 cases of pharmaceutical policy

Public Choices and Policy Change

Health policy in less developed countries: Past trends and future directions

J. Int. Dev.

Health sector reform and organizational issues at the local level: lessons from selected African countries

J. Int. Dev.

Health sector reform: Key issues in less developed countries

J. Int. Dev.

A Healthy Peace?: Post-Conflict Rehabilitation in Uganda

Providing for the rural poor: Institutional decay and transformation in Uganda

World Military and Social Expenditures 1993

Rehabilitation and Development Plan 1987/88–1991/92

Uganda: Growing out of Poverty

People's Power in Theory and Practice: The Resistance Council System in Uganda

Mimeo

Structural adjustment in Uganda: the initial experience

Children and Women in Uganda: A Situation Analysis

A review of current knowledge on IMR and its trends in Uganda

Civil war and the spread of AIDS in central Africa

Epidemiol. Infect. Dis.

Living on the edge: changing social structures in the context of AIDS

High risk situations for AIDS prevention

Br. Med. J.

Report on the social and economic dimensions of ill-health among Uganda households

A comparison of community health in Uganda with its two East African neighbours in the period 1970–1979

Financing Health Services in Developing Countries: An Agenda for Reform