£7.68m award helps universities rebuild health systems in fragile and shock-prone areas

By Press Office

A consortium involving Queen Margaret University (QMU), Edinburgh has been awarded £7.68 million by the UK government’s Department for International Development (DFID). ReBUILD for Resilience will look at health systems in fragile contexts experiencing violence, conflict, pandemics and other shocks. The aim is to produce high-quality, practical, multidisciplinary and scalable health system research which can be used to improve the health and lives of many millions of people.

The research consortium, led by Liverpool School of Tropical Medicine (LSTM), will be jointly delivered with the Institute for Global Health and Development at Queen Margaret University, Edinburgh alongside partners working in Lebanon, Myanmar, Nepal, Sierra Leone and the UK, and associate partners at Oxford Policy Management and International Rescue Committee.

LSTM’s Dr Joanna Raven said: “Two billion of the world’s poorest people live in fragile and conflict-affected settings and that figure is rising, fuelled by growing inequality, violence, conflicts and other shocks including the current COVID-19 outbreak. In these shock-prone contexts, and with growing threats from climate change, population displacement and epidemics, the progress towards universal health coverage is slow. This funding will help us to understand how we can develop stronger and more resilient health systems which deliver both local and global health.”

ReBUILD for Resilience will run for six years (2020-26) and in that time the team will address questions such as:

  • How can we use evidence to strengthen health systems and routine and emergency service planning in decentralised contexts?
  • What are the politics of intervention implementation in fragile settings and how do actors and arising powers influence services?
  • What metrics and processes are appropriate for appraising health system resilience?
  • What are the most effective tools to improve monitoring and accountability?
  • How can we build more inclusive and gender transformative models of care?

Building on previous successes

ReBUILD for Resilience builds on the work of the highly successful ReBUILD programme which was also funded by DFID. Over eight years (2011-18), ReBUILD established itself as the leading expertise in health systems research in fragile and conflict-affected settings (FCAS). Partnerships with research collaborators, policy makers, international organisations and networks allowed us to develop an original body of work on issues of health financing design, incentives, the organisation of the post-conflict health workforce, promoting resilience, ensuring gender-equitable health systems and improving aid effectiveness. It also influenced a wide range of actors at national and international levels and built key capacities in research production and uptake. As well as 75 peer-reviewed articles, ReBUILD also contributed to policy and practice changes ranging from redesigning results-based financing for health in Zimbabwe to better gender analysis amongst European Union staff, and more sensitive procedures for ‘challenging operating environment’ applications at the Global Fund.

However, the challenges continue to grow – not least due to the current COVID-19 pandemic - and there is a need for sustained research which focuses on a wider range of shocks and stressors and in a wider range of settings. ReBUILD for Resilience will help meet that need.

Professor Sophie Witter of QMU, who also led on ReBUILD, explained: “The current COVID-19 pandemic demonstrates the fragility of the global health system and the need for evidence-based action to address the growing risk of shocks of various kinds. ReBUILD was the first DFID research consortium to specifically address the effects of conflict on health systems. In ReBUILD for Resilience, we will build on that base but extend our work to a wider range of shocks – including disasters, epidemics and complex emergencies – and also work with partners in new regions, such as the Middle East, which are highly shock-prone. Our work will aim to help districts, countries and the global health system to better prepare and respond in future.”

International partners

The partners involved in ReBUILD for Resilience are key local and national stakeholders who are deeply embedded in networks and communities of practice in their countries, regions and on the global stage. Together, the group has expertise in many areas of health research including public health, epidemiology, social sciences, health economics, political science, research methodologies, gender & equity analysis, research uptake, capacity strengthening and programme management. Dr Sushil Baral of HERD International said:

“I feel very passionate to work with a team led by really experienced, renowned, world-class researchers. It provides opportunities to bring partners like us, from LMICs, together to share experiences, to discuss our contexts, and to create an appropriate model that helps build resilience in health systems across the country as well as beyond. What does it mean to Nepal? It helps our country move forward in terms of enhancing health systems that are more resilient, that leave no one behind, that take care of people who are in need, and successfully deliver services despite the context that we are experiencing virtually on a daily basis. Evidence matters a lot and we need more evidence that is contextually tailored which can be used by the policy makers in our context.”


The ReBUILD for Resilience partners are:

Liverpool School of Tropical Medicine, UK
Institute for Global Health and Development at Queen Margaret University, Edinburgh, Scotland, UK
American University of Beirut, Lebanon
College of Medicine and Allied Health Sciences, Sierra Leone      
Burnet Institute Myanmar, in collaboration with the Department of Medical Research
HERD International, Nepal

They will be supported by research associates International Rescue Committee and Oxford Policy Management.

For more information, visit the ReBUILD for Resilience web page and follow us on twitter @ReBUILDRPC

For enquiries contact programme CEO, Mark Lutton - Mark.Lutton@lstmed.ac.uk 

Notes to Editor

If you require further media information please contact Lynne Russell, Communications Manager at Queen Margaret University, on E: lrussell@qmu.ac.uk, m: 07711 011239.

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