Health governance in lower-income countries and conflict-affected populations

Purpose This paper aims to investigate the governance challenges faced by healthcare providers in Kalar, Iraq, particularly regarding the delivery of healthcare services to internally displaced persons (IDPs). By analyzing structured questionnaire responses from healthcare employers, the study identifies key barriers to effective health governance, including resource limitations, legal framework inefficiencies, and the need for enhanced collaboration among stakeholders. The insights gained will inform policymakers and healthcare providers on improving health service delivery in conflict-affected regions, ultimately contributing to better health outcomes for vulnerable populations, including both IDPs and the local community. Design/methodology/approach This study employed a mixed-methods approach, utilizing structured questionnaires to gather data from healthcare employers in Kalar, Iraq. The questionnaires focused on identifying governance challenges related to healthcare delivery for internally displaced persons (IDPs). Quantitative data were analyzed using descriptive statistics to highlight key barriers, while qualitative feedback provided deeper insights into the complexities of health governance. The combination of quantitative and qualitative methods allowed for a comprehensive understanding of the factors influencing healthcare provision in conflict-affected regions, facilitating the development of targeted recommendations for policymakers and healthcare providers. Findings The study revealed significant governance challenges in healthcare delivery for internally displaced persons (IDPs) in Kalar, Iraq. Key findings included that 78.4% of respondents identified a lack of medical equipment as a major barrier, and 67.6% cited financial constraints as critical obstacles to implementing governance principles. Although 70.3% felt that national legal frameworks offered moderate support, gaps in practical application were evident. The involvement of IDPs in health governance through committees was notable, yet only 13.5% recognized community leaders’ influence. Targeted health policies were found effective, while mental health support emerged as a crucial area needing attention. Research limitations/implications This study’s limitations include a reliance on self-reported data from healthcare employers, which may introduce bias and affect the accuracy of responses. The sample size may not fully represent the diverse perspectives of all stakeholders involved in healthcare delivery for internally displaced persons (IDPs) in Kalar. Additionally, the study’s focus on quantitative measures may overlook nuanced qualitative insights. Future research should incorporate broader stakeholder engagement, including IDPs and community leaders, and consider longitudinal studies to assess the evolving governance challenges. These insights can inform more comprehensive strategies to enhance healthcare service delivery in conflict-affected regions. Practical implications The findings of this study have several practical implications for improving healthcare governance in Kalar, Iraq. Policymakers and healthcare providers should prioritize addressing resource limitations, particularly the lack of medical equipment and financial constraints. Strengthening legal frameworks to ensure effective implementation of health rights for internally displaced persons (IDPs) is crucial. Additionally, fostering greater community engagement by involving IDPs and local leaders in decision-making processes can enhance health governance. Targeted health policies, particularly in mental health support, should be developed and implemented to address the unique needs of displaced populations and improve overall healthcare delivery in conflict-affected areas. Social implications The study highlights significant social implications for healthcare governance in Kalar, Iraq, particularly concerning internally displaced persons (IDPs). Enhancing healthcare delivery for IDPs can improve their overall well-being, promote social inclusion, and foster community cohesion. By involving IDPs in health governance and decision-making processes, their voices and needs can be acknowledged, leading to more tailored and effective healthcare services. Improved health outcomes can also reduce social stigma associated with displacement and contribute to rebuilding trust within the community. Ultimately, addressing the health needs of IDPs not only benefits them but also strengthens the resilience of the entire population in Kalar. Originality/value This study offers original insights into the governance challenges faced by healthcare providers in Kalar, Iraq, specifically regarding internally displaced persons (IDPs). By utilizing a mixed-methods approach, it reveals critical barriers to effective healthcare delivery, such as resource limitations and financial constraints, while highlighting the need for stronger legal frameworks and community engagement. The research adds value by providing actionable recommendations for policymakers and healthcare stakeholders aimed at improving health service delivery in conflict-affected regions. Additionally, it emphasizes the importance of addressing mental health needs, contributing to a more comprehensive understanding of health governance in humanitarian contexts.