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Rebuilding public health and health care delivery systems has been an important component of nation-building efforts conducted after major conflicts. However, few studies have attempted to examine a comprehensive set of cases, compare the quantitative and qualitative results, and outline best practices. The study assesses seven cases of nation-building operations following major conflicts: Germany and Japan immediately after World War II; Somalia, Haiti, and Kosovo in the 1990s; and Afghanistan and Iraq since 2001. It concludes that two factors increase the likelihood of successful health outcomes: planning and coordination, and infrastructure and resources. In addition, the study argues that health can have an independent impact on broader political, economic, and security objectives during nation-building operations.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Germany

  • Chapter Three

    Japan

  • Chapter Four

    Somalia

  • Chapter Five

    Haiti

  • Chapter Six

    Kosovo

  • Chapter Seven

    Afghanistan

  • Chapter Eight

    Iraq

  • Chapter Nine

    Evaluating Health Reconstruction

  • Appendix A

    Methodology

  • Appendix B

    Factor Analysis

Book Review Excerpts

"The [authors] set about systematically reviewing the efforts that have been undertaken by international organizations and/or various government agencies to re-establish (or in some cases actually establish) national health systems in post-conflict countries. The post-conflict states surveyed in this book range from the post-Second World War examples of Japan and Germany, through to case studies of present-day Afghanistan and Iraq. The contributors scrutinize the various programs and policies in each of the countries surveyed, prior to summarizing the relative success and/or failures of each case, and arriving at a number of generalized conclusions or 'lessons learned'…'Securing Health' is unquestionably of interest to policymakers in the health-development field, and quite possibly should be considered required reading for every bureaucrat and/or government agency contemplating post-conflict reconstruction work"

- Journal of Intervention and Statebuilding, March 2008

Research conducted by

The research described in this report was carried out under the auspices of the RAND Center for Domestic and International Health Security, a program within RAND Health. Primary funding for the project was provided by a generous gift from David and Carol Richards.

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