We found international security forces impacted health system governance, information systems and indigenous health delivery organizations.
ISF impacts' on the cases' health systems fall into three 'building block' groups: health sector governance, health information systems and indigenous health services.
Governance, health information systems and health services are the most accessible points of impact and there is opportunity pre-, during, and post- crisis to better engage ISFs all three areas.
Dramatic skewing among the health system building blocks suggests opportunities for more balanced investments with regard to governance, financing, and information system related interventions.
However, progress was clear in improved county health department governance, health management information system functionality, increased health worker salary harmonisation and strengthened financial management.
While key challenges have been identified in each component of the health system, the two main gaps emerged across the literature in the areas of leadership and governance and health information system.
In particular, we focus on the operational aspects of services exchanges governance either within the same information system or between different information systems.
The views of non-experts can act as a reference when reforming privacy governance and designing information systems.
We identified three types of boundaries objects that greatly contributed to the cross-border collaboration: 1) governance structure, 2) information systems and 3) recurring evaluation/feedback opportunities.
In terms of scope, HSR addresses any or several of the health system building blocks: human resources for health, policy and governance, financing, health information systems, service delivery, and medical technology and supplies [ 1].
This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions.
