Health and Education in fragile states: shared challenges

In a recent blog, Alice Albright of the Global Partnership for Education wrote about the close relationship between health and education in international development. She highlighted the mutually reinforcing benefits between health and education: educated mothers have healthier children, healthier children learn better. But the relationship between health and education is not just one of shared benefits, it is also one of shared challenges, especially when working in crisis and conflict affected contexts.

Over the last few years the INEE working group on Education and Fragility has been working together with the Health and Fragile States Network to examine how the two sectors could enhance collaboration for service delivery in fragile states. The two groups have sought to learn from each and identify common strategies in order to overcome key challenges. During a roundtable discussion on health and education in conflict affected and fragile context , held in Washington in 2013, three shared challenges were identified where collaboration between the two sectors could enhance service delivery in fragile contexts: governance, human resources and protection.


In fragile contexts the State governance in both sectors can often be weak. In some cases development projects focus only on technical solutions without sufficient attention to long term governance issues. As a result interventions may fail or falter as soon as the funding dries up. But there are also cases where development partners are so fixated on getting the governance “right” and not bypassing the State, that support to the sectors gets stalled, and communities continue to miss out on vital services. Education appears more prone to this, as it is not always seen as an essential service. But education, just like health, cannot wait.

Human resources

Both sectors rely on a vast workforce of frontline professionals to deliver services, often in remote and difficult settings. Recruiting sufficient numbers of well educated and motivated individuals is major challenge in contexts where access to education has been limited by decades of conflict and neglect. Getting a good gender balance in the workforce, with sufficient numbers of female staff is essential to ensure that women and girls can access services. Yet in many countries, the pool of school graduates to recruit from is very limited. For example, according to a report by UNESCO, in 2011 there were only 400 girls in the final grade of secondary school in South Sudan.


Sadly, a third uniting factor between the two sectors is that they have both been targets of attacks. In Nigeria and Pakistan, polio workers have been shot down, students and teachers killed and schools destroyed. The roundtable in Washington brought together the Global Coalition to Protect Education from Attackand Safeguarding Health in Conflict . These organisations have been working to document attacks in their respective sectors and develop tools and guidelines such as the Draft Lucens guidelines for protecting schools and universities from Military Use. The UN has recently published a guidance note on Security Council Resolution 1998 to protect schools and hospitals from attack.

Given the common benefits and challenges facing both health and education when planning for and delivering services in fragile contexts, there is great potential for collaboration and cross-sectoral learning. It is unfortunate that the current relationship between these two development sectors tends to be at best, one of segregation, or at worst, one of competition over resources. Sharing tools, lessons learned and conducting joint research are potential first steps for promoting greater collaboration between the sectors.

By Ruth Naylor, CfBT with INEE Working Group on Education and Fragility

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