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But in both, elections will result in winners and losers  how the losers react will determine the future2Z  .All Post-Conflict Settings Have Major Problems//( Poor information Weak human resources (quantity and quality) Low absorptive capacity Uncertain political, economic, and social future Unpredictable external support High rates of conflict recidivism Need to address immediate, humanitarian needs Need to show peace dividendZ #Problems Mean Challenges for Donors$$ V How to negotiate the transition from emergency (humanitarian) assistance to development How to  hedge donor investments, and to what extent, without crippling a government that needs support Competing priorities  both internal and imposed; especially, state-building vs. health service delivery$,P+. Short and Long-routes to Health  !( 1All Post-Conflict Settings Present Opportunities22(For a fresh start For increased donor funding, even if hedged For legitimacy at first, for effectiveness later on For at least temporary return of skilled health personnel 7A Fresh Start Means Opportunities for the Health Sector88( Donor harmonization and alignment Experiment with new models (public management of private service delivery, like performance-based contracting in Cambodia, Afghanistan, Haiti, DRC) Rationalization of health system (E. Timor) &')How Can These Opportunities Be Realized?4*   n Be realistic and have modest ambitions Recognize that some changes are irreversible  if the public sector couldn t deliver before conflict, it is unlikely that it will be able to now Allow, even oblige, harmonization (and alignment) through lending/granting instruments: be part of the solution& Pay special attention to visible and tangible elements of the health system, such as facilities and drugs But don t focus only on service delivery  financial and personnel management, procurement, training, etc. are all crucial to longer-term recovery and stability $8P6/    *,/23  ` 33` Sf3f` 33g` f` www3PP` ZXdbmo` \ғ3y`Ӣ` 3f3ff` 3f3FKf` hk]wwwfܹ` ff>>\`Y{ff` R>&- {p_/̴>?" dd@,|?" dd@   " @ ` n?" dd@   @@``PR    @ ` ` p>> (    6\  `}  T Click to edit Master title style! !  0   `  RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S  0 ^ `  X*  0 ^   Z*  0T ^ `  Z*B  s *޽h ? 3380___PPT10.HpE Default Design 0 zr( (  ( ( 0" P   " P*   ( 0L"    " R*  d ( c $ ?  " ( 0l"  0 " RClick to edit Master text styles Second level Third level Fourth level Fifth level!     S ( 6P" _P  " P*   ( 6" _  " R*  H ( 0޽h ? 3380___PPT10.H$  $(  r  S H{"> " r  S |" `   " H  0޽h ? 3380___PPT10.HpE   aY`(  r  S ]"@  " r  S ^" ` "    <_"wb^ BCoghlan B, Brennan RJ, Ngoy P et al. Lancet 367:44-51, Jan 7, 2006CC$(  <a"GE Edeaths/1000/monthH  0޽h ? 3380___PPT10.XҴ$  p$(  r  S " `}  " r  S " ` " H  0޽h ? 3380___PPT10.HP |p(    <,"P"Z  p & reductions in crude mortality [and child mortality are closely associated with reductions In violence and, by extension, improvements in security&   & these trends& provide compelling evidence that improvements in security represent perhaps the most effective means to reduce excess mortality&  (Coghlan B, Brennan RJ, Ngoy P et al.)  War-related violence remains the most important public health risk&  (Toole MJ, Galson S, Brady W. Are war and public health compatible? 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