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Working in Fragile Contexts and Building up Resilient Health Systems

Why Do Community Systems Matter

MMS Symposium

To end preventable child and maternal deaths, create an AIDS-Free Generation, and protect communities against infectious diseases such as Ebola, we need effective, functional health systems that can deliver essential health services to those in need. International health organisations are more and more obliged to work in fragile contexts where the environment is marked by instability, the public structures are weak or quick to collapse and the rule of law is lacking. If we want to achieve the Agenda 2030 we need to come up with smarter and more cost-effective, responsive investments in health that create synergies among people, communities and health systems to achieve resilience.

 Working in Fragile Contexts and Building up Resilient Health Systems

(Photo: United Nations Development Programme /flickr)

The MMS Symposium will address these challenges by reflecting different experiences and by having a closer look on building resilient systems for health in fragile contexts.

Healthcare in fragile and conflict-affected states remains a real challenge even if health services exist people might be too afraid to risk the journey to a health facility or have lost trust in them. What will it take to transform how we design global and national health interventions and channel investments to build resilient health systems that are responsive to clients and communities?

Country contexts vary widely in this group of fragile countries ranging from Haiti to Afghanistan, from Eritrea to Myanmar. There is no standard international definition of fragile statehood. Some are trapped in a vicious cycle of violent conflict and poverty; others face a legacy of poor governance or were affected by natural hazards; many emerging from crisis cannot deliver even the most basic services to their citizens.

Civil Society, local organisations, communities as well as community health workers play a crucial role as they can contribute in reaching out to people, prevent diseases, provide care and support and fill the gap where health professionals are scarce. Little evidence exists on appropriate approaches for health systems strengthening in such settings but innovative approaches to respond to health needs must include local community participation and flexible funding to respond to fast changing environments.

Given the fact that a growing number of countries being affected by fragility, the subject of aid is of growing significance. Standard aid approaches are widely considered inadequate for fragile states, in part because related instruments and processes are too cumbersome and inflexible. Aid agencies who act independently of the state and provide parallel services risk undermining state legitimacy and capacity. So the questions is not on whether to engage but how to do so in ways that do not cause harm and not come at an unacceptable costs.

The MMS Symposium will explore the following questions:

  • What are the elements for strong community systems and how can they be achieved?
  • How can organisations active in international health cooperation strengthen their work in fragile contexts?


The issue working in fragile contexts is part of Medicus Mundi Switzerland's (MMS) main topic 2016. Have a look at the conference Working in Fragile Contexts, which is going to tackle the more techincal aspects of the issue and which MMS is organising together with the Swiss Red Cross and the Swiss Agency for Development Cooperation.

Date & Time

November, 02 2016; 09:30 – 16:30 h


Pullmann Hotel, Basel
Find your way to the conference.


You find the detailled programme of the conference here


Translation will be provided


Carine Weiss, Network Medicus Mundi Switzerland
Phone: ++41 (0)61 383 18 10

The symposium is part of a long-term cooperation agreement with the Swiss Agency for Development and Cooperation SDC.

A special thanks goes to the Swiss Red Cross (SRC) for its generous financial contribution.