A typical health response in settings affected by armed conflict is usually initiated by local responders well before the international humanitarian response sets in. Humanitarian health interventions, in these settings, are aimed at saving lives and responding to increased health needs. However, these interventions often establish a parallel arbitrary health system which can present significant challenges that often exacerbate pre-crisis health system gaps. Studying this relationship between humanitarian health interventions and local health systems as they evolve through several stages (early conflict, acute conflict, conflict recidivism and early post-conflict) is vital for more effective health systems strengthening in conflict settings. Strikingly, there is very little attention in the literature to studying these dynamics. There is a dearth of health system understanding in conflict settings and an absence of a specific framework for health systems in these settings. My thesis investigates this fundamental relationship by exploring these dynamics and how humanitarian health interventions and health systems interact with each other positively and negatively.
To unpack this relationship academically, my thesis investigates a case study of a hybrid health system in northwest Syria during a time of protracted armed conflict. The health system in Syria was profoundly affected by the protracted conflict that also had a devastating impact on all aspects of life in the country. However, despite the enormous challenges of this brutal conflict, there have been innovative approaches to building a bottom-up health system in northwest Syria. I analyse this system using primary …