Handbook for Addressing the Risks of Violence against Health Care in Insecure and Conflict-affected Settings
Insecurity Insight has developed a comprehensive handbook on security risk management tailored specifically for the health sector. Health care provision has unique characteristics that shape its specific exposure to security risks in conflict zones. The Security Risk Management for Health Care (SR4H) Handbook – available in Arabic, English and French – provides guidance on how to implement a range of actions intended to promote respectful and violence-free environments and prepare individuals or organisations to face and respond appropriately to violent incidents, also dealing with the aftermath of such events.
While this handbook is primarily aimed at health programme managers providing frontline services, it is also highly relevant for non-governmental organisations (NGOs) working with partners who implement healthcare services. The handbook helps to identify practical activities that local health partners can implement and that NGO partners can include in partnership agreements and budget for.
The SR4H Handbook brings together some of the best practices on security risk management and proposes a framework adapted for health care providers working with limited resources. The objective is to promote an approach that considers the safety and security of health professionals while ensuring patients’ access to care.
Why do we need specialized approach to protect the health sector?
This handbook draws on best practices from international healthcare providers operating in conflict zones, offering a clear framework for security risk management tailored specifically to healthcare. This handbook was developed because healthcare faces unique risks during conflict requiring a focused and adaptable approach.
Direct frontline engagement – remote management is often not an option
Healthcare workers must provide in-person care. They need to physically see and treat patients, which means they cannot operate remotely.
Healthcare facilities must remain accessible – “bunkerization” is impractical
Healthcare services cannot operate as a detention center or carry out airport-level security protocols. Facilities must remain open and accessible to patients, as overly restrictive security measures can cost lives, draw people away, and give the wrong impression.
Healthcare is vital during conflict – it may also be a target of violence
In times of instability, healthcare needs increase significantly. Conflicts often lead to more injuries, weakened health systems, higher rates of communicable diseases due to reduced vaccinations, poorer nutrition, and escalating mental health needs.
As combatants might be operating without precautions, hindering and threatening the offer of healthcare, healthcare professionals may suffer direct consequences of hostilities, and be coerced or attacked. Medical supplies may become valuable assets in a war economy.
Additionally, healthcare providers are sometimes perceived as supporting one side in a conflict because they treat the injured. Health care providers are also often those through the sheer nature of their work hold evidence for conflict related crimes. This perception can lead to the arrest of healthcare workers or the targeting of health facilities by armed actors using remote weapons.
Thus, healthcare plays an indispensable role to support the survival of civilians during conflicts, while facing distinct security challenges. Its frontline nature, the necessity to remain open and accessible, and its vulnerability to becoming a target all make security risk management for the health sector especially complex. Addressing these challenges is crucial for ensuring the safety of those who provide essential frontline care.
The SR4H Handbook
The main part of the handbook is structured around four factors comprising the security risk management for health care cycle that need to be in place to ensure appropriate management of risks threatening health care:
- Awareness: Generating awareness of possible threats facing health and communicating ways of managing these threats.
- Preparedness: Assessing the risks and putting systems and procedures in place to better prevent and cope with violence before it occurs.
- Response: How to respond if a violent incident occurs.
- Sustainability: Dealing with the aftermath of violent incidents and working towards sustainable health care provision and access.
Each chapter includes boxes with tips, reminders and other important elements, and each chapter contains resources for further reading on a particular chapter’s topic.
The SR4H Handbook is available in Arabic, English and French. Visit our website for more information.
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