[Easttimorstudies] Article on the Health System

Jennifer Drysdale jenster at cres10.anu.edu.au
Wed May 24 11:37:40 EST 2006

Health Policy Plan. 2006 May;21(3):206-16. Epub 2006 Mar 24.

Rehabilitating the health system after conflict in East Timor: a 
shift from NGO to government leadership.

Health Policy Unit, London School of Hygiene and Tropical Medicine, 
Keppel Street, London, WC1E 7HT, U.K. E-mail: alvaro.alonso at lshtm.ac.uk.
Efforts to rehabilitate health systems after periods of prolonged 
conflict have often been characterized by poor coordination of 
external actors - multilateral agencies, donors and non-governmental 
organizations (NGOs). This paper describes the process and analyses 
the roles of the different stakeholders in the establishment of a 
government-led district health system in East Timor, between 1999 and 
2002, after decades of chronic conflict and Indonesian occupation. 
Future East Timorese policy-makers and health professionals began to 
mobilize in May 1999, in preparation for independence. During the 
emergency phase, from September 1999, when violence erupted, to March 
2000, NGOs played a major role in the provision of relief to the 
population, coordinated by United Nations agencies. An Interim Health 
Authority, led by local Timorese, was established in March and the 
major donors began to shift funding from NGOs to the newly 
established Ministry of Health. A rapid phasing-out of NGOs, 
accompanied by a sequence of steps to build the capacity of Timorese 
to manage the new district health system, was implemented. Early 
evidence shows that health service utilization continued to grow 
during and after implementation.

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