Protracted Refugee Situations: Parallel Health Systems and Planning for the Integration of Services |
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Authors: | Rowley Elizabeth A; Burnham Gilbert M; Drabe Rabbin M |
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Institution: | 1 Center for Refugee and Disaster Response, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore MD 21205, USA erowley{at}jhsph.edu
2 District Director of Health Services, Adjumani District, Uganda |
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Abstract: | The international community typically responds to refugee situationsby establishing care and maintenance programmesspecifically for refugees. Limited resources may also be directedto hosting communities, but donors often channel the bulk offunding through UNHCR and its implementing partner NGOs, whoin turn create service delivery structures that are operatedin parallel to local structures. Although there may be causefor this approach in a short-term emergency phase, particularlyif the host country systems are very weak, this eventually becomesfinancially problematic if refugees continue to live in exilefor years at a time. In the short term, it can also engenderan inequitable and inefficient use of scarce resources. Thispaper traces the evolution and impact of implementing refugeehealth services in parallel to local systems using observationsfrom Uganda, and offers Quality Design as a model for planningthe local integration of services. |
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Keywords: | protracted refugee situations integration of services health service delivery northern Uganda southern Sudan |
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