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1. Providing Healthcare in Armed Conflict: The Case of Nigeria

Author:
Alice Debarre
Publication Date:
01-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
The humanitarian situation in Nigeria’s northeast is deteriorating, with more than 5 million people in need of healthcare and over 800,000 out of the reach of humanitarian actors. Given this level of need and the poor state of the healthcare system in northeastern Nigeria, humanitarian and other nongovernmental health actors play an important role. This issue brief maps the challenges these health actors face and assesses their response. It accompanies a policy paper published in 2018 entitled “Hard to Reach: Providing Healthcare in Armed Conflict,” as well as another case study on provision of healthcare in Mali. These papers aim to assist UN agencies, NGOs, member states, and donor agencies in providing and supporting the provision of adequate health services to conflict-affected populations. This issue brief concludes with recommendations for how health actors can improve delivery of health services in northeastern Nigeria: Humanitarian health actors should improve coordination both with each other and with global health actors working in northeastern Nigeria. Relevant UN agencies, local and international health NGOs, donors, and the Ministry of Health should scale up the response to under-prioritized health services. Humanitarian and development NGOs, donors, and the Ministry of Health should focus efforts to implement the humanitarian-development nexus for health services on areas where it is relevant and feasible. Humanitarian health actors should improve their accountability for the health services they provide. Humanitarian donors need to ensure that counterterrorism clauses in their funding contracts are not overbroad and do not impede neutral, independent, and impartial aid.
Topic:
Health, Humanitarian Aid, and Conflict
Political Geography:
Africa and Nigeria

2. Safeguarding Humanitarian Action in Sanctions Regimes

Author:
Alice Debarre
Publication Date:
06-2019
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
There are currently fourteen UN sanctions regimes, which member states are legally required to implement. Many of these are implemented in the context of armed conflict, where international humanitarian law outlines obligations to protect the provision of and access to principled humanitarian action. But despite efforts to make sanctions regimes more targeted, they continue to have unintended consequences, including impeding or preventing the provision of humanitarian assistance and protection—particularly when they coexist with counterterrorism measures. This issue brief explains the various ways in which sanctions regimes can impact humanitarian action. Acknowledging that this is not a new issue—though one that may be of increasing concern—it identifies several factors that make it challenging to resolve. Finally, it lays out some avenues for progress, pointing to existing efforts and highlighting where more could be done. Given that sanctions regimes are mostly targeted and that member states are bound to uphold the principles in the UN Charter and international humanitarian law (where it applies), sanctions should protect and not inhibit humani­tarian action. Where sanctions hinder aid, the impact on civilian populations is immediate, and efforts to backtrack will always come too late. Going forward, member states, the UN, financial institutions, and humanitarian actors should proactively and preventively tackle this problem. While the most effective courses of action will require political will, stakeholders at all levels can take incremental steps to help mitigate the impact.
Topic:
Humanitarian Aid, International Law, Sanctions, Conflict, and UN Security Council
Political Geography:
Global Focus

3. Hard to Reach: Providing Healthcare in Armed Conflict

Author:
Alice Debarre
Publication Date:
12-2018
Content Type:
Policy Brief
Institution:
International Peace Institute
Abstract:
Armed conflict is a global health issue. Long-lasting and protracted conflicts in particular have consequences not only for the war-wounded but also for the health of entire communities. Over the years, global health actors and humanitarian health actors have developed health policies, guidelines, frameworks, and structures to improve delivery of health services in emergencies or humanitarian crises. Despite these advancements, however, the international health response in conflict-affected settings still faces gaps and challenges. Some policies and frameworks need to be rethought or redesigned, while others need to be better implemented. This paper explores challenges to healthcare provision in conflict-affected settings. These challenges are broadly broken down into three categories: constraints related to the health system and damaged health infrastructure, difficulty for health workers to access populations in need, and restrictions to healthcare provision intentionally or accidentally placed by donors or states engaged on humanitarian and health issues (e.g., through the securitization of healthcare). Tackling these challenges will have a direct impact on the lives of people in conflict-affected settings. However, doing so requires a radical shift in mindsets and the incentives that guide the actions of international health actors. Even so, more incremental changes can also be beneficial. To that end, this report puts forth the following recommendations: Improve coordination between and among humanitarian, development, and global health actors; Respond to context-specific needs; Hold health actors accountable to affected populations for their performance, and; Make responses sustainable. This work is based on a combination of desk research, interviews with more than seventy key informants, and an expert meeting bringing together key stakeholders and experts on global and humanitarian health.
Topic:
Health, Humanitarian Aid, and Conflict
Political Geography:
Global Focus