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Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict

Peace-through-health has emerged as a promising concept but with variable evidence of success. Cooptation of health initiatives in conflict is believed to be a major challenge undermining peacebuilding potential. We examine the role that existing power structures and health initiative characteristic...

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Autores principales: AlGhatrif, Majd, Darwish, Mohammad, Alzoubi, Zedoun, Shawar, Yusra Ribhi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534776/
https://www.ncbi.nlm.nih.gov/pubmed/36210065
http://dx.doi.org/10.1136/bmjgh-2021-007745
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author AlGhatrif, Majd
Darwish, Mohammad
Alzoubi, Zedoun
Shawar, Yusra Ribhi
author_facet AlGhatrif, Majd
Darwish, Mohammad
Alzoubi, Zedoun
Shawar, Yusra Ribhi
author_sort AlGhatrif, Majd
collection PubMed
description Peace-through-health has emerged as a promising concept but with variable evidence of success. Cooptation of health initiatives in conflict is believed to be a major challenge undermining peacebuilding potential. We examine the role that existing power structures and health initiative characteristics play at various levels of a conflict in peacebuilding outcomes. Using the Syrian conflict as a case study, we assess healthcare initiatives’ characteristics and their peacebuilding tendencies accounting for power dynamics at the (1) state citizen, (2) interbelligerents and (3) intercommunity conflict levels, drawing on the WHO’s framework for health and peace initiatives. Healthcare interventions at state citizen and interbelligerent levels generally addressed combat-related and material-dependent health needs, relied on large-scale international funding and centralised governance structures, and bestowed credit to specific agencies with political implications. These characteristics made such initiatives prone to cooptation in conflict with limited peacebuilding capacity. Healthcare initiatives at the community level addressed more basic, service-dependent needs, had smaller budgets, relied on local organisations and distributed credit across stakeholders, making them less amenable to cooptation in the conflict with more propeace potential. A pilot peacebuilding health initiative designed to leverage these propeace attributes navigated the political environment, minimised cooptation and fostered community collaboration, resulting in peacebuilding potential. In summary, peacebuilding health initiatives are more likely to materialise at the community as compared with higher political levels. Further studies, accounting for conflict power structures, are needed to examine the effectiveness of such initiatives and identify methods that maximise their peacebuilding outcomes.
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spelling pubmed-95347762022-10-06 Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict AlGhatrif, Majd Darwish, Mohammad Alzoubi, Zedoun Shawar, Yusra Ribhi BMJ Glob Health Analysis Peace-through-health has emerged as a promising concept but with variable evidence of success. Cooptation of health initiatives in conflict is believed to be a major challenge undermining peacebuilding potential. We examine the role that existing power structures and health initiative characteristics play at various levels of a conflict in peacebuilding outcomes. Using the Syrian conflict as a case study, we assess healthcare initiatives’ characteristics and their peacebuilding tendencies accounting for power dynamics at the (1) state citizen, (2) interbelligerents and (3) intercommunity conflict levels, drawing on the WHO’s framework for health and peace initiatives. Healthcare interventions at state citizen and interbelligerent levels generally addressed combat-related and material-dependent health needs, relied on large-scale international funding and centralised governance structures, and bestowed credit to specific agencies with political implications. These characteristics made such initiatives prone to cooptation in conflict with limited peacebuilding capacity. Healthcare initiatives at the community level addressed more basic, service-dependent needs, had smaller budgets, relied on local organisations and distributed credit across stakeholders, making them less amenable to cooptation in the conflict with more propeace potential. A pilot peacebuilding health initiative designed to leverage these propeace attributes navigated the political environment, minimised cooptation and fostered community collaboration, resulting in peacebuilding potential. In summary, peacebuilding health initiatives are more likely to materialise at the community as compared with higher political levels. Further studies, accounting for conflict power structures, are needed to examine the effectiveness of such initiatives and identify methods that maximise their peacebuilding outcomes. BMJ Publishing Group 2022-10-05 /pmc/articles/PMC9534776/ /pubmed/36210065 http://dx.doi.org/10.1136/bmjgh-2021-007745 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Analysis
AlGhatrif, Majd
Darwish, Mohammad
Alzoubi, Zedoun
Shawar, Yusra Ribhi
Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title_full Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title_fullStr Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title_full_unstemmed Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title_short Power dynamics and health initiative design as determinants of peacebuilding: a case study of the Syrian conflict
title_sort power dynamics and health initiative design as determinants of peacebuilding: a case study of the syrian conflict
topic Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9534776/
https://www.ncbi.nlm.nih.gov/pubmed/36210065
http://dx.doi.org/10.1136/bmjgh-2021-007745
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