Executive Summary
This document was prepared under contract with the USAID Bureau for Africa, Complex
Emergency Response and Transition Initiative (CERTI). The CERTI project is composed of a
large network of organizations seeking to establish broad-based consensus on best
practices for providing public health services in advance of, during, and following
complex humanitarian emergencies, with the aim of strengthening response capabilities of
organizations involved in public health interventions during these critical periods.
The purpose of this technical report is to examine the concept and practice of
"Health as a Bridge for Peace" and how it is translated into an approach to
providing health inputs before, during, or after crises.
In order to analyze Health as a Bridge for Peace (HBP) experiences retrospectively,
four main methodologies have been utilized. First, we have attempted to analyze and
synthesize available reports, books, studies, and proceedings from HBP meetings held over
the past 15 years. Second, a review and comparative analysis of published and unpublished
cases of specific HBP interventions was conducted. Third, individual semi-structured
and unstructured interviews were conducted with key informants in order to verify findings
from international meetings and case studies, identify gaps in knowledge, and determine
practitioner and policy-makers’ views on the utility of the HBP approach in
contemporary Sub-Saharan Africa. Finally, intermediate and final drafts of this
document have been peer-reviewed by a multidisciplinary team of health, conflict, and
development experts.
Experiences to date have included successful, as well as unsuccessful HBP operations.
The findings from research on HBP activities suggest that the presence of certain critical
elements in any given conflict situation may increase the chances of a successful HBP
operation. These elements include 1) political will of national governments;
2) support and facilitation of an international health organization, such as WHO; 3)
investment of resources, including financial, material, and human; health personnel
properly training in skills such as conflict analysis, negotiation, and diplomacy; and 4)
the implementation of HBP activities tailored to the specific contextual situation.
Health personnel are in the unique position to be able to leverage something
universally important, irrespective of the details of any given conflict: the
promise of good health. This makes the international health community a potentially
powerful force in peace efforts throughout the world, and one that should be tapped
further through expanded HBP initiatives and continued research, evaluation, and training
activities.
Accordingly, the following strategies, skills, and tools as related to future HBP work
in the context of contemporary Sub-Saharan Africa are recommended:
- Training programs for health personnel in skills relevant to peace building.
- Further evaluative research of HBP initiatives to date. Such continued research
efforts should support further development of the theory behind Health as a Bridge for
Peace.
- Commitment to health as a bridge for peace on the part of national governments, civil
societies, international organizations, and the global health community.
Recommendations for next steps for the Health as a Bridge for Peace component of the
CERTI project include: 1) Develop evaluation indicators and criteria, and 2) Capacity
building and tools development. In the development of evaluation indicators and
criteria, a situation analysis of 2 – 3 countries where health was used as a bridge
for peace will be conducted in conjunction with USAID representatives. From this
analysis protocols and indicators will be conceptualized.
This will lead to the second phase of activities, that of capacity building and tools
development. This component will initially involve the conceptualization of a HBP
Toolbox succinctly outlining options for training and tools development. This
toolbox will consist of one-page fact sheets detailing impact evaluation indicators and
criteria and outlining tools and capacity building programs. Fact sheets describing
tools and capacity building options will cover topics such as early warning systems,
negotiation, conflict management, forecasting skills, risk communication, conflict
communication, working with stakeholders, working with the media, problem resolution,
institutional reconstruction, and crisis assessment. Fact sheets detailing training
programs designed specifically for clinical personnel will include topics such as
emergency preparedness, assessing and managing disaster/risk relief, managing for reduced
loss, and conflict impact reduction.
Once the toolbox has been developed, we will craft an information-sharing strategy,
which will allow the toolbox to serve as a stimulus in the cooperative development with
local partners of in-depth training programs and tools tailored specifically to African
populations. We believe that for training programs and tools to be relevant to the
people of Sub-Saharan Africa, African input into their content and design is crucial on an
on-going basis. The toolbox will also serve as an informational tool with which to
elicit input from USAID Missions, NGOs, and civil societies. This will allow all
partners the opportunity to analyze and provide feedback on the relevance and importance
of each component within their community and/or country context. To facilitate this,
information-sharing seminars will be organized in Washington along with one field trip to
the region. Once this valuable input has been received, the development of training
programs and tools may proceed in a way consistent with the real needs of the African
nations served.
