Fragile States

Recurrent crises, whether they are the result of man-made conflict or natural disasters, perpetuate extreme poverty by degrading government services, dislocating communities and destroying livelihoods. Addressing such challenges in fragile states requires a unique mix of innovation, agility and tenacity in addition to technical expertise—all of which are longtime hallmarks of Abt Associates.

Currently on the ground in a number of fragile states around the world, and with experience in countries as diverse as Pakistan, Haiti, Mali and South Sudan, Abt has proven its ability to design and execute programs and, even more importantly, have impact in the face of rapidly changing circumstances. By creating partnerships, strengthening governance and building capacity and systems, Abt is using its expertise to improve lives in fragile states— creating more equitable access to essential services and providing a way out of extreme poverty.


SOUTH SUDAN: How do you improve the health system when a country is in conflict?

Abt Associates began working in South Sudan in 2012 to strengthen the country’s health system and foster an enabling environment for improved health service delivery. In spite of the current conflict, the project has had a positive impact, making health information more accessible and actionable. The project has supported county health departments to develop Health Information System (HIS) Monthly Bulletins which capture and present routine health data. Recently, Bulletins revealed faulty reporting on HIV/AIDS indicators, which demonstrated the need to improve data quality and provide more capacity building on HIV data collection tools, coupled with supervision and timely performance feedback. The HIS Bulletins have greatly enhanced health authorities’ ability to effectively prioritize and direct scarce health resources—even during a period of conflict.
CLIENT: USAID / PROJECT: South Sudan Health Systems Strengthening (HSSP)


NIGERIA: How can innovative thinking lower maternal death rates in conflict zones?


Half of all Nigerians live in rural areas, with limited access to health care. Thousands of deaths from obstetric complications each year are blamed on lack of transportation, which is further complicated by ongoing conflict. The Emergency Transport Scheme (ETS), led by Abt Associates, is working to improve emergency obstetric care in many of the highest conflict zones by training taxi drivers to provide volunteer emergency transportation. Since its launch in 2012, Abt has recruited and schooled nearly 900 taxi drivers on basic emergency procedures, and more than 4,600 women have utilized the ETS. Based on the success of the program in saving women’s lives, the governors of Kaduna and Kano hope to roll it out throughout their states.
CLIENT: DIFD / PROJECT: Partnership for Transforming Health Systems II (PATHS2) Emergency Transport Scheme (ETS)


MOZAMBIQUE: How does a country struggling to become economically viable address an epidemic of disease?

Although Mozambique’s civil war ended in 1992, the country has been waging an even greater battle to become economically viable. Those efforts have been hampered by an epidemic of HIV/AIDS—fueled in part by returning refugees and disproportionately claiming young women as its victims. In an effort to reach more people with prevention, treatment, and medical services, USAID in Mozambique turned to Abt Associates. Focusing on the provinces of Sofala, Manica and Tete, Abt worked to build capacity of health personnel and reduce HIV transmission. More than 3,000 health personnel have been trained in HIV service provision, over 212,000 adults and 19,000 children are receiving antiretroviral therapy (ART) and 75 percent of HIV+ pregnant women are receiving ART to prevent mother-to-child transmission.
CLIENT: USAID / PROJECT: Clinical HIV/AIDS Services Strengthening in Sofala, Manica and Tete (CHASS-SMT)