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Health services and systems in fragile and conflict-affected regions

Guest Editor: Clarissa Giebel

About the collection

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Creator: cloverphoto | Credit: Getty Images/iStockphoto © Creator: cloverphoto | Credit: Getty Images/iStockphotoConflict is a global health issue. Long-term and protracted conflicts, in particular, have consequences not only for casualties but also for the health of entire communities, during and beyond crisis. Over the years, there have been advances in guidelines, frameworks, and structures to improve the delivery of health services in emergencies or humanitarian crises. Despite these advancements, health services and systems in fragile and conflict-affected regions suffer from destroyed infrastructure that can take years to rebuild post-conflict. Many policies and frameworks need to be redesigned, better implementation is needed, and the communities that are impacted in these regions need supportive, sensitive, and good quality care that meets their needs. 

In support of the UN’s Sustainable Development Goal 3, Good Health and Well-beingBMC Health Services Research launched a collection that welcomed submissions that contribute to the health system strengthening in fragile and conflict-affected regions literature. We call upon the health services research community to consider how we can sustainably strengthen health systems and services in these regions and encouraged submissions covering: 

  • Strategies for rebuilding health system infrastructure, implementing new policies, frameworks, and delivery of healthcare in fragile and conflict-affected regions 
  • Studies examining the barriers, facilitators, and opportunities to delivering care in these settings 
  • Strengthening the provision of healthcare to communities in these regions, refugees, and internally displaced people
  • The trialing of telehealth technologies to advance the provision of care in these settings

For more information about the collection, please read our introductory Editorial.  


Meet the Guest Editor

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Dr. Clarissa Giebel, University of Liverpool, UK

Clarissa GiebelDr. Clarissa Giebel is a Senior Research Fellow at the NIHR ARC NWC at the University of Liverpool and her research focuses mostly on inequalities in care for people with dementia, older adults, and carers. She is leading on a number of national and international projects with collaborators in Colombia, India, the Netherlands, Uganda, UAE, and others.

Published collection articles

  1. We explored the impact of medical service fee adjustments on the choice of medical treatment for hypertensive patients in Beijing. We hope to provide decision-making reference to promote the realization of hie...

    Authors: Danhui Li, Jia Yang, Jin Li, Ning Zhao, Wensheng Ju and Moning Guo
    Citation: BMC Health Services Research 2023 23:928
  2. Medically uninsured groups, many of them migrants, reportedly delay using healthcare services due to costs and often face preventable health consequences. This systematic review sought to assess quantitative e...

    Authors: Sophiya Garasia, Valerie Bishop, Stephanie Clayton, Genevieve Pinnington, Chika Arinze and Ezza Jalil
    Citation: BMC Health Services Research 2023 23:427
  3. This paper investigates the factors influencing the decision to enrol in Ghana’s National Health Insurance Scheme (NHIS) among people at risk of statelessness, with emphasis on the individual's demographic and...

    Authors: Theophilus Quartey, Charles Peprah and Anthony Kwame Morgan
    Citation: BMC Health Services Research 2023 23:153
  4. In many contexts, including fragile settings like Afghanistan, the coverage of basic health services is low. To address these challenges there has been considerable interest in working with NGOs and examining ...

    Authors: Diwa Samad, Bashir Hamid, Ghulam Dastagir Sayed, Yueming Liu, Wu Zeng, Alexander K. Rowe and Benjamin Loevinsohn
    Citation: BMC Health Services Research 2023 23:122
  5. Indirect effects of the COVID-19 pandemic on communities in fragile and conflict-affected settings may be severe due to reduced access and use of healthcare, as happened during the 2015 Ebola Virus Disease out...

    Authors: M. A. S. Schots, H. L. S. Coleman, G. W. Lutwama, M. Straetemans and E. Jacobs
    Citation: BMC Health Services Research 2022 22:1559
  6. Refuges and asylum seekers have specific healthcare needs; however there has been insufficient attention and effort to address these needs globally. Furthermore, effective communication between healthcare prov...

    Authors: Bafreen Sherif, Ahmed Awaisu and Nadir Kheir
    Citation: BMC Health Services Research 2022 22:1310
  7. Childhood vaccination is among the most effective public health interventions available for the prevention of communicable disease, but coverage in many humanitarian settings is sub-optimal. This systematic re...

    Authors: Sharif A. Ismail, Sze Tung Lam, Sadie Bell, Fouad M. Fouad, Karl Blanchet and Josephine Borghi
    Citation: BMC Health Services Research 2022 22:1277
  8. The health system in South Sudan faces extreme domestic resource constraints, low capacity, and protracted humanitarian crises. Supportive supervision is believed to improve the quality of health care and serv...

    Authors: George William Lutwama, Lodi Joseph Sartison, James Onyango Yugi, Taban Nickson Nehemiah, Zechreya Micheal Gwang, Barbara Akita Kibos and Eelco Jacobs
    Citation: BMC Health Services Research 2022 22:1249
  9. In Sierra Leone persons with disabilities are at higher risk of living in poverty and have poor access to a fragile healthcare and rehabilitation services. The aim was to explore stakeholders’ perceptions of a...

    Authors: Lina Magnusson, Ismaila Kebbie and Victoria Jerwanska
    Citation: BMC Health Services Research 2022 22:1003
  10. Self-care is the ability of individuals, families, and communities to promote health, prevent disease, maintain health, and manage illness and disability with or without a health care provider. In resource-con...

    Authors: Angela Dawson, Hannah Tappis and Nguyen Toan Tran
    Citation: BMC Health Services Research 2022 22:757
  11. We report findings of a qualitative evaluation of fixed-dose combination therapy for patients with established atherosclerotic cardiovascular disease (ASCVD) attending Médecins Sans Frontières (MSF) clinics in...

    Authors: Adrianna Murphy, Ruth Willis, Éimhín Ansbro, Sahar Masri, Nour Kabbara, Tonia Dabbousy, Sola Bahous, Lucas Molfino, Pablo Perel and Philippa Boulle
    Citation: BMC Health Services Research 2022 22:744
  12. The COVID-19 pandemic has acutely affected Rohingya refugees living in camps in Cox’s Bazar, Bangladesh. Reported increases in sexual and gender-based violence (SGBV) were attributed in part to pandemic-relate...

    Authors: Shahanoor Akter Chowdhury, Thomas McHale, Lindsey Green, Ranit Mishori, Chloe Pan and Isabel Fredricks
    Citation: BMC Health Services Research 2022 22:743
  13. Knowledge of medical specialists' numbers and geographical distribution are essential for planning health services and health workforce supply. However, although the distribution of physicians is a significant...

    Authors: Alejandro Rodriguez, Adriana Romero-Sandoval, Bernardo A. Sandoval and Natalia Romero
    Citation: BMC Health Services Research 2022 22:671
  14. Key to the US refugee resettlement effort is the role of non-governmental organizations (NGOs) who receive, place, and provide transitional programs and referrals to new and recently resettled refugees. Yet on...

    Authors: Imelda K. Moise, Lola R. Ortiz-Whittingham, Vincent Omachonu, Ira M. Sheskin, Roshni Patel, Julia Ayumi Schmidt Meguro, Alexia Georgina Lucas, William Bice and Leila Mae Thompson
    Citation: BMC Health Services Research 2022 22:535
  15. In Germany, the 2015 mass displacement and resulting population migration exposed regulatory and structural shortcomings with respect to refugee healthcare provision. Existing research on Germany’s crisis resp...

    Authors: Stephan Brenner and Vincent Lok
    Citation: BMC Health Services Research 2022 22:309
  16. Older adults in Colombia have seen a number of stressful life events – including the Colombian armed conflict, forced misplacement and recently COVID-19. These events likely have had and are having a substanti...

    Authors: Clarissa Giebel, Maria Isabel Zuluaga, Gabriel Saldarriaga, Ross White, Siobhan Reilly, Erica Montoya, Dawn Allen, Ginger Liu, Yeferson Castaño-Pineda and Mark Gabbay
    Citation: BMC Health Services Research 2022 22:253
  17. This paper measures the impact of introducing a 10% co-payment on secondary care hospitalization costs for Palestine refugees living in Lebanon (PRL) in all UNRWA contracted hospitals, except for the Red Cresc...

    Authors: Sara Valente de Almeida, Gloria Paolucci, Akihiro Seita and Hala Ghattas
    Citation: BMC Health Services Research 2022 22:121
  18. Many countries aspiring to achieve universal health coverage struggle with how to ensure health coverage for undocumented migrants. Using a case study of maternal health care in a Thailand-Myanmar border regio...

    Authors: Naomi Tschirhart, Wichuda Jiraporncharoen, Rojanasak Thongkhamcharoen, Kulyapa Yoonut, Trygve Ottersen and Chaisiri Angkurawaranon
    Citation: BMC Health Services Research 2021 21:1315
  19. Language is a barrier to many patients from refugee backgrounds accessing and receiving quality primary health care. This paper examines the way general practices address these barriers and how this changed fo...

    Authors: Shoko Saito, Mark F Harris, Katrina M Long, Virginia Lewis, Sue Casey, William Hogg, I-Hao Cheng, Jenny Advocat, Geraldine Marsh, Nilakshi Gunatillaka and Grant Russell
    Citation: BMC Health Services Research 2021 21:921
  20. Understanding the differential utilization of healthcare services is essential to address the public health challenges. Through the migration process, refugees move from one set of health risk factors to anoth...

    Authors: Jasmin Haj-Younes, Elisabeth Marie Strømme, Jannicke Igland, Eirik Abildsnes, Bernadette Kumar, Wegdan Hasha and Esperanza Diaz
    Citation: BMC Health Services Research 2021 21:572
  21. In response to the rising global NCD burden, humanitarian actors have rapidly scaled-up NCD services in crisis-affected low-and-middle income countries. Using the RE-AIM implementation framework, we evaluated ...

    Authors: Éimhín Ansbro, Tobias Homan, Jamil Qasem, Karla Bil, Mohammed Rasoul Tarawneh, Bayard Roberts, Pablo Perel and Kiran Jobanputra
    Citation: BMC Health Services Research 2021 21:381
  22. The August 2020 explosion in Lebanon resulted in casualties, injuries, and a great number of internally displaced persons. The blast occurred during an economically and politically complex time in the country....

    Authors: Michel D. Landry, Mohamad Alameddine, Tiago S. Jesus, Saydeh Sassine, Elie Koueik and Sudha R. Raman
    Citation: BMC Health Services Research 2020 20:1040

    The Correction to this article has been published in BMC Health Services Research 2020 20:1117