This working group is focused on developing guidance for coordination and health systems strengthening in countries faced with a fragile or challenging operating environment. The guidelines will have specific considerations for three scenarios. Firstly low capacity in the health system, secondly a lack of meaningfully representative government, and thirdly countries experiencing conflict or emergencies. 

The guidelines will promote and facilitate situation analysis, coordination of development and humanitarian partners and coordinated support for health systems strengthening. This will be piloted in two to three countries with fragile or challenging environments.

A first step is a literature review of health systems strengthening, health service delivery and coordination between different actors in countries under stress, with a synthesis of lessons on coordination of partners and health systems interventions. The literature review was after a competitive process awarded to Institute of Tropical Medicine, Antwerp, and is expected to be finalised by mid October 2017. Please see a preliminary list of relevant literature in the TOR for the working group below. See also the Methodological Inception Report.


The working group will:

1. Develop guidance for improved coordination of development and humanitarian partners and other agencies around resilient health systems strengthening in countries characterised by fragility, conflict, emergencies and/or a challenging operational environment, developed and promoted. 

2. Situation analysis and assessment as well as coordination of Development and Humanitarian Partners and support for health systems strengthening piloted in two to three countries with fragile or challenging environments.

Terms of reference


Literature review

First face-to-face meeting November 2017

Read about the first face-to-face meeting of this group here.

Meeting notes for the record

14 September 2017

7 July 2017

27 February 2017

21 January 2017 

21 December 2016

6 December 2016

Members are: 

UHC2030 Core Team:

Lara Brearley, Technical Officer, HGF, WHO; providing the secretariat. 

Bilateral and multilateral development partners: 

Manuel Couffignal, International Aid/Cooperation Officer , DEVCO B4, EC 

Ian van Engelghem, Global Health Advisor, ECHO, EC 

Taraneh Shojaei, Head of Global Health Policy Division, French Ministry of Foreign Affairs and International Development Emergency/humanitarian agencies 

Judith Kallenberg, Head of Policy, GAVI 

Olga Bornemisza, Technical Advisor, Health Systems, GFATM 

Thorsten Behrendt, Advisor, GIZ 

Montasser Kamal, Program Leader, International Development Research Centre, Canada 

Noriko Fujita, Director Division of Global Health Programs, National Center for Global Health and Medicine, Japan 

Satoko Horii, Senior Researcher, NIPH, Japan 

Rachel Scott, Team Leader Conflict, Fragility & Resilience, OECD 

Claudia Vivas, Health Specialist, Health Systems Strengthening, UNICEF 

Amelia Peltz, Senior Gender Advisor, Bureau of Global Health, USAID – Co-Chair 

Amy Kay, Senior Health Advisor, Middle East Bureau USAID 

Tekabe Belay, Senior Economist, WB 

Andre Griekspoor, Technical Officer, ERM, WHO 

Anshu Banerjee, Director (Global Coordination), FWA, WHO 

Denis Porignon, Technical Officer, HGF, WHO 

Dirk Horemans, Programme Officer, SDS, WHO 

Humanitarian assistance organisations 

Julie Hall, Director Health Care, IFRC

Lara Ho, Senior Technical Advisor for Health Research, International Rescue Committee

Mit Philips, Analysis & Advocacy Unit- Health Access Team, MSF (Observer) 

Other organisations: 

Egbert Sondorp, Senior Advisor Health Systems, KIT (representing the Health Systems Global Thematic Working Group on Fragile and Conflict Affected States) 

Holly Greb, MPH, Global Health Officer, Polio & Cross-Cutting Initiatives, United Nations Foundation

Countries with fragile or challenging environment:

Abdul Qadir, General Director for Policy and Planning, Ministry of Public Health, Afghanistan 

Benedict Harris, Asst. Minister, MoH Liberia 

Joy Waya, NPO HSS, South Sudan WCO 


Kaosar Afsana, Director HNP, BRAC – Co-Chair

Maarten Oranje, Technical Advisor HSS, Cordaid 

Guy Aho Tete Benisan, Regional Coordinator, REPAOC


Enrico Pavignani, Public Health Consultant 

For further information please contact: 

Lara Brearley, UHC2030 Core Team