Non-state and informal actors in fragile settings

Connecting Citizens to Science

In this episode, we explore the critical role of non-state actors and informal providers in health systems within fragile settings. Our guests share insights on the legitimacy, roles and challenges of informal and non-state actors. This is the fourth episode in the six-part miniseries "Stories of Resilience: Local Lives and Health Systems," brought to you by ReBUILD for Resilience (see ‘useful links’ for links to the other episodes from the series).

Chapters

00:00 Introduction to Connecting Citizens to Science

00:14 Overview of ReBUILD for Resilience

00:31 Non-State Actors and Informal Providers in Health Systems

01:12 Introducing the Guests

02:31 Understanding Non-State and Informal Actors

03:19 Current Situations in Myanmar and Sierra Leone

04:59 Roles and Impact of Informal Providers

07:59 Challenges and Coordination in Crisis Situations

14:02 Advice for Improving Health Systems in Fragile Settings

18:04 Conclusion and Final Thoughts

In this episode:

Dr. Karin Diaconu - Reader, Research Lead, Institute for Global Health and Development

Karin is a health policy and systems researcher interested in how to achieve better health outcomes for disadvantaged groups and persons living in fragile, conflict affected and vulnerable settings. She has been involved with the ReBUILD for Resilience programme since it began and is interested in understanding how communities and health systems can better work together to support health, particularly in situations where communities have often been disempowered due to longstanding crises.

Dr. Kyu Kyu Than - Research Director, Burnet Institute Myanmar

Kyu Kyu is a health system researcher from Myanmar who is passionate about advocating for gender-equitable and inclusive healthcare access for the most vulnerable population. She is currently a Research Director at Burnet Institute Myanmar and is also one of the Principal Investigator for the ReBUILD consortium. Her expertise and leadership in public health have earned her recognition both nationally and internationally, making her a pivotal figure in shaping health policies and initiatives in Myanmar. She is a researcher who is well known for her dedication and courage towards health policy shift for the health care workers in the least developed communities.

Ayesha Idriss - Principal Investigator, ReBUILD for Resilience - Sierra Leone, Institute for Development (IfD)

Ayesha is a seasoned pharmacist, dedicated educator, and accomplished multidisciplinary researcher. As the research lead at the Institute for Development (IfD) for the ReBUILD for Resilience programme, Ayesha focuses on strengthening health systems in fragile and conflict-affected states. Her research addresses critical health challenges in Sierra Leone, including non-communicable disease interventions, Community Health Workers (CHW) motivation and health policy implementation. Pursuing a PhD in Global Health at Queen Margaret University, Edinburgh, her doctoral research enhances healthcare delivery in diverse communities, including the informal health sector, emphasising culturally sensitive approaches. Ayesha’s work bridges research and practice, fostering positive change in healthcare systems and promoting equity in access to healthcare services.

Useful Links;

• The Health Workforce in Times of Crisis - Connecting Citizens to Science - This episode is the third part of the six-part mini-series "Stories of Resilience: Local Lives and Health Systems," brought to you by ReBUILD for Resilience. In this episode, we discuss the challenges faced by the health workforce in fragile settings such as conflict zones and areas hit by political and economic crises. Our guests share their first-hand experiences and insights on how health systems and workers strive to provide care under extreme conditions.
• Gender, health systems resilience and equity - Connecting Citizens to Science - In the second episode of a six-part mini-series by ReBUILD for Resilience, we explore the intersection of gender and health systems in fragile settings. Hosted by Kim and co-hosted by Abriti Arjyal from HERD International, the episode features insights from Dr. Rouham Yamout from the American University of Beirut and Dr. Val Percival from the Norman Paterson School of International Affairs (NPSIA) at Carleton University. The discussion covers the impact of gender dynamics on health systems during crises like the COVID-19 pandemic and armed conflicts, emphasising community-led, participatory approaches to promote gender equality and resilience in health systems.
• Revisiting Resilience in Health Systems Research - Connecting Citizens to Science - This conversation is the first part of a mini-series titled 'Stories of Resilience - Local Lives and Health Systems', powered by the ReBUILD for Resilience research consortium. This podcast episode, hosted by Dr. Kim Ozano and co-hosted by Professor Sophie Witter, engages in an insightful discussion on health systems resilience, particularly in fragile settings affected by violence, conflict, pandemics, and other shocks.
• Introducing ReBUILD for Resilience - health systems researchRebuild Consortium - ReBUILD for Resilience examines health system resilience in fragile settings experiencing violence, conflict, pandemics and other shocks. We are an international research consortium that aims to produce high-quality, practical, multidisciplinary and scalable research which can be used to improve the health and lives of many millions of people. ReBUILD for Resilience is funded by the UK government.

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The podcast cuts across disciplines, including health systems strengthening, gender and intersectionality, tropical diseases (NTD’s, TB, Malaria), maternal and child healthcare (antenatal and postnatal care), mental health and wellbeing, vector-borne diseases, climate change, Participatory Action Research (PAR), co-production and participatory methods - all linked to community inclusion, engagement and shifting power dynamics.   

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