Technical assistance for health in non‐conflict fragile states: challenges and opportunities

The paper examines how best technical assistance (TA) for health might be implemented in post‐conflict fragile states. It does so in the light of current development trends such as harmonization and alignment and moves towards aid instruments that favour country‐led approaches. A number of key issues are addressed. The first of these considers which core principles for ethical TA might apply in post‐conflict fragile states; the second reviews thematic challenges, such as the need to balance ‘good enough governance’ with effective attention to equity, rights and working with local health capacity. A third area for discussion is how best to plan for, and implement, long‐term health TA inputs in often volatile and insecure environments, while a fourth topic is the engagement of civil society in rebuilding health systems and service delivery post‐conflict. Attention to gender issues in post‐conflict fragile states, including the importance of acknowledging and acting upon women's roles in peacekeeping and maintenance, the necessity to apply and sustain more gender equitable approaches to health in such contexts and how TA might facilitate such participation, represents the fifth issue for debate. Copyright © 2009 John Wiley & Sons, Ltd.