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Asia-Pacific Journal of Public Health
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Public Health and Health Services Development in Postconflict Communities: A Case Study of a Safe Motherhood Project in East Timor

Penny Marlowe, BPhty, MPH

Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, Australia

Mohammad Afzal Mahmood, MPH, PhD

Discipline of Public Health, School of Population Health & Clinical Practice, University of Adelaide, Adelaide, Australia, afzal.mahmood{at}adelaide.edu.au

Armed conflict causes suffering in many countries; it contributes to poor health and hinders health services development. The effects of conflict are evidenced by weakened community structures and can make reconstruction efforts challenging. East Timor has a history of prolonged conflict and saw a resurgence of internal violence in 2006. This participant observation study discusses considerations for implementing public health and health systems development projects in postconflict settings using a case study of a maternal and child health project. It illustrates the importance of appreciating the historical context and community dynamics when implementing development projects. The sequelae of conflict are often characterized by reduced human resource development capacity, distrust of hierarchy, and limited capacity for resource mobilization. Working in such postconflict communities requires flexibility in program design, stronger efforts for community capacity building, and rebuilding trust between various stakeholders.

Key Words: community development • safe motherhood

Asia-Pacific Journal of Public Health, Vol. 21, No. 4, 469-476 (2009)
DOI: 10.1177/1010539509345520
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