War and Peace: the Health and Health System Consequences of Conflict in Colombia

Principal Investigators: Dr Rodrigo Moreno Serra (Centre for Health Economics, University of York, UK) and Dr Oscar Bernal (Escuela de Gobierno, Universidad de los Andes, Colombia)

Other academic partners: Professor Nina Caspersen, Department of Politics and International Relations (University of York), Department of Health Services Research and Policy (London School of Hygiene & Tropical Medicine)

Funders: MRC/ESRC/DFID/Wellcome Trust (Joint Health Systems Research Initiative)

Grant amount: £0.8 million

Duration: 2.5 years (30 months)

The overarching goal of this project is to investigate the consequences of long-term internal conflict for population health, the health system and post-conflict health policymaking through an in-depth study of the experience of conflict and peace agreement in Colombia. Since 1958 an estimated 220,000 people have died in Colombia due to the civil conflict and more than six million (13% of the population) have been forcibly displaced. A peace accord between the largest rebel group and the Colombian government was agreed in December 2016 and has ended hostilities, creating a unique window of opportunity to conduct research of immediate policy relevance.
Our project will provide much needed evidence on issues such as the consequences of conflict for health service organisation and delivery, and the impact on often overlooked populations including internally displaced families and the poorest groups – including their post-conflict health needs.

These questions will be answered through several methods. The quantitative work will rely on survey data collected by the team and data already available, analysed using state-of-the-art techniques. Qualitative and historic analyses will employ focus groups with residents of selected municipalities, interviews with national and local government officials and civil society representatives, and examination of publicly available official documents and historic administrative datasets, generating a uniquely rich portrait of the consequences of civil conflicts for the health system.

The conclusions drawn from all these analyses will provide the basis for evidence-based health policy recommendations for Colombia and other conflict-affected countries. Potential beneficiaries of our research include populations affected by conflict violence, health policymakers and the broad academic community.
Through comprehensive stakeholder engagement and communication strategies, the project will build links among researchers in the UK and Colombia, Colombian policymakers and other stakeholders (care providers, major non-governmental actors, practitioners, health service users), as well as regional and international policymakers.

Dr Moreno Serra said: “Armed conflicts can have devastating consequences for population health and national development. The War and Peace project will bring about novel contributions to a number of under-researched questions related to conflict and health, which will be valuable to guide post-conflict health policy not only in Colombia, but also in many developing countries where sustained conflicts with resulting population displacements are currently ongoing or have recently concluded.
“We are very excited to have the opportunity to work in close collaboration with experienced academic partners and stakeholders in Colombia and the UK during the War and Peace project. This will help ensure that our research is useful to inform policies aimed at improving the health and general welfare of those populations affected directly or indirectly by conflict violence.”

Dr Bernal said: “Colombia has a historic opportunity to build peace and we at Universidad de los Andes are committed to participate in a joint effort with our UK colleagues to generate evidence and propose policies to improve the quality of life of all Colombians, who have endured more than 40 years of conflict.”