Health planning and management in the transition from humanitarian emergencies to development This Special Issue of the journal covers a vital but neglected area of health planning and management-the wide gap that exists between 'emergency' and 'development' healthcare.
Janet Gruber examines the vexed problem of how technical health assistance can best be implemented in post-conflict fragile states. A key and commonly stated principle is the need to maximize coordination and collaboration between donors themselves on one hand and donors, national governments and civil society stakeholders who receive technical assistance on the other hand. This is meant to be achieved by giving emphasis to harmonization and alignment agendas. In a fragile state, however, the key concern is with whom or what to harmonize and align, given the weakness or absence of policy, human resource capacity and institutions. Donors may find themselves working with isolated individual programmes or projects, or partnering with national NGOs in the absence of coherent national frameworks and structures. Whilst this may meet some immediate health needs, it runs the risks of creating dependency and undermining the imperative for national policies and structures to develop sustainably.
Tim O'Dempsey and Barry Munslow provide a broad overview of the key issues that have to be addressed to 'mind the gap' that exists between emergency and development healthcare. Separate funding windows exist and distinct organizations with their specific and narrow mandates covering humanitarian emergencies and the same applies to the health development sector. In the politically complex post-Cold War era since 1989, a huge gap has emerged in delivering effective healthcare planning and management in many weak and fragile states, who hover in a 'lost world' between emergency and development in which millions attempt to survive. They are left hanging in a healthcare void.
To address this 'gap' successfully will require a major rethink of emergency and development healthcare provision. Instead of seeing the problem as a linear issue moving from emergency to development, a continuum approach, we need to address both simultaneously and better prepare each for a more seamless integration. This requires a contiguum approach.