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Table 5 The broader context of fragility in the two case studies

From: Addressing fragility through community-based health programmes: insights from two qualitative case study evaluations in South Sudan and Haiti

Identified key drivers Literature Context Haiti Context South Sudan
Inability or unwillingness of the state to provide basic services Failure of a state to establish itself as a service provider (e.g. health services, physical security and economic development) drives fragility by poor overall governance and administration and are characterised by a lack of state representation at local levels and weak state-society relations [7, 57] Study participants felt that the government has only weak roots at the local level and that much-needed services are mainly provided, if at all, by international actors. State–society relations are considered extremely weak. The government lacks legitimacy among a large part of the population and there is no real sense of citizenship Study participants perceived a lack of the government legitimacy by civil society. The failure of state institutions to provide services in South Sudan is well documented, mainly attributed to the nascence of the state institutions, the inadequacy of fiscal transfers to lower tiers of government, and the lack of capacity among South Sudan’s public servants, institutions and organisations [58]
Lack of effective mechanisms to ensure inclusive citizen participation States that lack effective mechanisms to ensure inclusive participation in the social, economic and political processes may be unable to meet social expectations of equitable distribution of and access to services and to manage social disruption, unrest or violence that may arise as a consequence [41] The various stakeholders met in Haiti underlined the gap between the population and the political elite. Many feel excluded from any decision-making process. Moreover, the country is plagued by corruption at all levels. Control mechanisms are lacking to prevent personal enrichment by the elite (“10% have everything and 90% have nothing”). Rampant discontent is evidenced by recurring and sometimes violent manifestations and strikes The stakeholders interviewed felt that public satisfaction and citizen participation were enhanced at county level through the implementation of needs-based and locally accepted and adapted programme strategies. However, in South Sudan, since its independence in 2011, institutional mechanisms have been insufficiently in place to foster trust and civil society inclusion [59]. Perceptions are widespread of government’s malfeasance, self-interest and disregard for citizen priorities [59]. Violent tribal clashes in the project area occurred frequently
Erosion of social cohesion and community spirit Social cohesion refers to the capacity of a society to ensure the welfare of its members, minimising disparities and avoiding polarisation. Social cohesion is often considered as a protective factor that confers some resilience upon communities [60, 61]. The absence of social cohesion in society contributes to overall insecurity, lack of trust between groups and may prevent states from establishing a robust governing system, contributing, in turn, to the fragility of state institutions [62] According to the study participants met in Haiti, it has become difficult to encounter community spirit among the population. Traditional systems of mutual help and support, such as rural community work (Konbit), have been displaced by cash-for-work projects implemented by international aid agencies since long before a major earthquake in 2010. A World Bank report from 2006, moreover, stated that population shifts from rural to urban areas place a high burden on state institutions to provide basic services in the face of a loss of social cohesion [63]. After the 2010 earthquake, interpersonal trust decreased even further due to the vulnerabilities of the displaced [64] Since before its independence, the southern part of Sudan has been war-torn for several decades, with a number of war-disabled persons, broken-up families, eroded cultural patterns and social cohesion and losses of assets [65]. Study participants in South Sudan felt that, even though the project had no explicit strategy to tackle the loss of social cohesion through decades of violent conflict, it contributed to building trust among various local stakeholders through its activities
High external aid dependency and weak coordination Long-term humanitarian relief assistance and development aid fail to promote efficient government institutions and sustainable economic development, especially when other forms of international engagement with crisis are absent that would address root causes or when the capacity of states to absorb and equitably manage large resource flows is reduced [66,67,68] The various participants felt that Haiti’s chronic dependence of external aid is largely a result of long-term humanitarian relief assistance as well as the absence of economic reforms and international economic agreements. Furthermore, externally imposed standard structural adjustment programmes have harmed Haiti’s economy in the long run, according to many scholars [63]. Aid is, moreover, not systematically integrated into national budgets and structures, partly due to a lack of absorption capacities, and thus implemented through parallel structures, posing a real threat to sustainability [69] According to study participants, a high aid dependency is largely due to the long-term international humanitarian engagement during the many years of civil war, often exacerbated by natural disasters. The aid system is fragmented, marked by weak coordination among partner organisations.
During the Comprehensive Peace Agreement period and after independence in 2011, billions of dollars of aid and technical assistance to ‘build capacity’ in the nascent Government of South Sudan were provided by foreign development agencies [70]. Aid dependency, especially in the areas of food aid and health service delivery, is often considered as harming self-reliance and long-term development prospects [70, 71]