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Securing Health

Lessons from Nation-Building Missions

by Seth G. Jones, Lee H. Hilborne, C. Ross Anthony, Lois M. Davis, Federico Girosi, Cheryl Benard, Rachel M. Swanger, Anita Datar Garten, Anga R. Timilsina

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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

"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

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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