course ID: 2021_cFHS

Making sense of troubled healthcare arenas


This course intends to introduce participants to healthcare provision in crisis, with examples and lessons drawn from violent and impoverished settings, misruled states, migrant populations, divided societies, and degraded environments.


  • Plenary* (Wed 25): Making sense of troubled healthcare arenas: first steps in a tricky field (one hour). Overview of the disturbances affecting healthcare provision: shocks, stresses and their interplay. Studying processes in motion, and from multiple points of view. Questioning ‘fragility’, as a construct of dubious explanatory power. Looking outside the healthcare field, to better understand its features.
  • Thematic session 1 (Thu 26): Taming deep uncertainty, by accepting it (two hours). Wearing a complexity lens allows decision-makers to make sense of flawed, uncertain, sparse and changing information. Such sense-making should inspire strategic decisions, and in turn facilitate the coordination of and communication with participants.
  • Thematic session 2 (Fri 27): Two important issues chosen with participants (one hour each). Participants  will receive a menu of options to chooose from in early August 2021.
  • Thematic session 3 (Sat 28): Engaging in a health recovery process (closing session of the whole course, two hours).  Lessons learnt in documented recovery processes. Ways to encourage an informed debate with assorted stakeholders. Negotiating realistic goals and strategies, firmly linked to contextual patterns. Seizing opportunities, containing harmful drives, supporting positive innovations and changing course when necessary. Design, management and evaluation of recovery-oriented interventions.

    * This plenary, from 17:00-18:00 (CEST) on Wednesday August 25, is mandatory for the enrolled participants.


    To raise awareness about:

    a) the main issues shaping the health field, highlighting differences alongside commonalities,

    b) the analytical tools to be used to obtain valuable insights,

    c) the engagement approaches to be adopted in troubled healthcare arenas, and

    d) the relevant literature to be studied after the course.


    Willingness to critically appraise mainstream interpretations and tools, in light of the characteristics of the contexts under scrutiny.

    Pedagogical method:

    Mix of written and oral exchanges with participants, including presentations, handouts and exercises (to be done between sessions).

    Assessment procedure:

    An evaluation questionnaire distributed to participants after the closing of the course.

    Enrico Pavignani

    Freelance public-health practitioner, affiliated to the University of Queensland Brisbane, and to the Scuola Superiore Sant’Anna, Pisa

    Barbara Profeta

    Regional health Advisor for Eastern Europe and Central Asia and Focal point of the Global Programme Health at the Swiss Agency for Development and Cooperation, Research Associate at the School of Global Studies of the University of Sussex and at the Institute of Development Studies (Sussex).