Politiques publiques de santé dans les pays en sortie de crise et influence de la communauté internationale: la reconstruction du système de santé primaire dans l’Afghanistan post-conflit

Abstract

Rebuilding health systems in post-conflict countries has the financial and technical support of key actors in international development, such as the World Bank or the World Health Organization. This support helps to influence the process of formulating and implementing public health policies. In Afghanistan, two factors contributed to increase the influence of major stakeholders: first, the institutional legacy of the war years, and second, the positioning of actors on the national and international scene. The absence of modern institutions, the ‘institutional vacuum’, that characterizes the country in 2001, the predominance of the World Bank on the international stage and the lack of any real counterbalance on a national level have contributed to the development of a primary health-care system based on contracting out services.