Journal of Refugee Studies
Volume 19, Issue 2, 2006, Pages 158-186

Protracted refugee situations: Parallel health systems and planning for the integration of services (Article)

Rowley E.A.* , Burnham G.M. , Drabe R.M.
  • a Center for Refugee and Disaster Response, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States
  • b Center for Refugee and Disaster Response, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Baltimore, MD 21205, United States
  • c Department of Health Services, Adjumani District, Uganda

Abstract

The international community typically responds to refugee situations by establishing 'care and maintenance' programmes specifically for refugees. Limited resources may also be directed to hosting communities, but donors often channel the bulk of funding through UNHCR and its implementing partner NGOs, who in turn create service delivery structures that are operated in parallel to local structures. Although there may be cause for this approach in a short-term emergency phase, particularly if the host country systems are very weak, this eventually becomes financially problematic if refugees continue to live in exile for years at a time. In the short term, it can also engender an inequitable and inefficient use of scarce resources. This paper traces the evolution and impact of implementing refugee health services in parallel to local systems using observations from Uganda, and offers Quality Design as a model for planning the local integration of services. © 2006 Oxford University Press.

Author Keywords

Protracted refugee situations Health service delivery Integration of services Northern Uganda Southern Sudan

Index Keywords

Africa refugee Sub-Saharan Africa East Africa health services Uganda health care Sudan
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-33645891141&doi=10.1093%2fjrs%2ffej019&partnerID=40&md5=f0d5c508eff42bd723189263bcd893b7
DOI: 10.1093/jrs/fej019
ISSN: 09516328
Cited by: 13
Original Language: English