# Continuum of community engagement to ensure access to health care in conflict-affected areas in South Sudan and Central African Republic (CAR): Lessons from the Red Cross

## TL;DR

Community engagement is vital for maintaining healthcare access in conflict zones like South Sudan and CAR, as shown through Red Cross programs.

## Contribution

The study provides insights into how community engagement supports health systems across all disaster risk management phases in conflict settings.

## Key findings

- Community engagement builds trust and inclusivity in health service delivery during conflicts.
- Local ownership and resource mobilization improve the sustainability of health interventions.
- Health programs should integrate community engagement throughout disaster risk management phases.

## Abstract

In conflict-affected settings such as South Sudan and the Central African Republic (CAR), fragile health systems face immense challenges in maintaining service delivery including essential health service access. Community engagement is a critical enabler across the Disaster Risk Management (DRM) cycle—preparedness, response, recovery, and resilience—by fostering trust, inclusivity, and local ownership. This qualitative study draws on data from the Advanced Partnership in Health (APiH) program (2019–2023), implemented by the Red Cross in CAR and South Sudan. Data were collected through 15 key informant interviews and 16 focus group discussions with community members, health workers, and program implementers. Framework analysis was used to explore the role of community engagement across each DRM phase. Community engagement was integral across all DRM phases—preparedness, response, recovery, and resilience. It enabled trust-building, inclusive participation, support for community health services, and local resource mobilization, contributing to more effective and sustainable health interventions in conflict settings. Community engagement is essential for sustaining healthcare delivery in conflict settings. Humanitarian health programs should institutionalize community engagement throughout the DRM cycle. Policies must prioritize inclusive planning, support for community health workers, and investment in local infrastructure to build resilient, community-driven health systems.