The Health and Peace Approach to programming

The GHPI is operationalized using the Health and Peace Approach to programming. While the GHPI builds on past WHO health programs which delivered health projects in conflict settings, such as the WHO Health as a Bridge for Peace projects in the 1980s and 1990s, what is new and innovative about the Health and Peace Approach is that it suggests that in some settings, and only when and where appropriate, health programming can be designed in a way that addresses underlying causes of conflict, tension, or mistrust. The focus is on local level peace outcomes, such as social cohesion, dialogue, or resilience to violence, rather than on high-level political solutions. 

The Health and Peace approach is made up of three components:

1. Defining the context and developing a risk analysis that includes peace and conflict analysis. “Peace and conflict analysis” is necessary to generate understanding of the dynamics (social structures, practices and behaviors) that contribute to peace and conflict respectively; and the way that health programming – and the health sector in general – interacts with them. It should be conducted in conjunction with the use of public health assessment tools such as Rapid Risk assessments and/or Public Health Situational Analyses for instance, which inform decision making vis a vis acute public health events.
2. Ensuring that health programs are “conflict sensitive”. This means they are designed and implemented in a way that proactively seeks to mitigate the risks of inadvertently exacerbating social tensions, contributing to conflict, or undermining factors of social cohesion in a given society or community. It is closely related to the widely known ‘do no harm’ principle.
3. Where the context, capacities and risks allow, designing and implementing health programs that are “peace responsive” – meaning, that seek to contribute to improving the prospects for peace such as trust, dialogue, equity, inclusivity, social cohesion or community resilience to violence through health-related activities. 

The second component of this approach, conflict sensitivity, is the core requirement of the Global Health and Peace Initiative and applies in almost all settings to all programming. Health programs must always be sensitive to conflict and peace dynamics in order to avoid unintentionally exacerbating or generating new grievances, contributing to social tension, sustaining non-inclusive practices, or otherwise causing harm to the structures or behaviors that support peace at the community level.

The third component of this approach, peace responsiveness of health programs, is very much dependent on the context. It is to be decided at country level and can be addressed – if at all - in different ways, depending on the situation:

• By making health care more accessible and equitable and thereby reducing inequalities and empowering communities.
• By improving social cohesion at the local level through community dialogue linked to health care, inclusive health promotion initiatives, or programming that helps to address local grievances (such as community-based Mental Health and Psychosocial Support (MHPSS) programming).
• By building collaboration through joint training or disease surveillance across the conflict lines. Etc.

Context specificity is key in deciding the type of peace outcomes and activities to be implemented. This is one of the principles of the Health and Peace Approach or more specifically, of peace-responsive programming. Those principles are:

• National leadership
• Medical ethics and humanitarian principles
• Context specificity
• Participation
• Equity and inclusiveness

These principles are relevant to both the success of health programs and the pursuit of peace outcomes.

Conflict-sensitivity or peace-responsiveness should not affect health objectives or priorities; they merely require adapting the approach, and in some cases adding peace outcomes to health objectives. This may require additional capacity.

For this reason, a vital component of programming linking health and peace is partnerships and collaborations (as reflected in the GHPI Roadmap). While the Initiative draws on WHO’s comparative advantage, it also requires and benefits from collaboration with both peace and health actors. Through operational partnerships and collaborations with traditional health partners, other UN entities and peacebuilding actors such as Interpeace, the International Organization for Migration (IOM), UNICEF, the UN Population Fund (UNFPA), the UN Department of Peace Operations and others, and with support from the Peacebuilding Fund (PBF), WHO is playing an increasing role in fragile and conflict-affected settings around the world to better understand the contexts in these areas and further improve the way health programs interact with them, for the benefit of all communities.