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Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building

Overview of attention for article published in Conflict and Health, October 2015
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  • Good Attention Score compared to outputs of the same age (74th percentile)

Mentioned by

1 policy source
3 tweeters


46 Dimensions

Readers on

225 Mendeley
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Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building
Published in
Conflict and Health, October 2015
DOI 10.1186/s13031-015-0056-3
Pubmed ID

Alastair K. Ager, Martina Lembani, Abdulaziz Mohammed, Garba Mohammed Ashir, Ahmad Abdulwahab, Helen de Pinho, Peter Delobelle, Christina Zarowsky


Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. A systems dynamics analysis was conducted to identify key pathways of threat to provision and emerging pathways of response and adaptation. Structured interviews were conducted with 39 stakeholders from three local government areas selected to represent the diversity of conflict experience across the state: Damaturu, Fune and Nguru, and with four officers of the PRRINN-MNCH program providing technical assistance for primary care development in the state. A group model building session was convened with 11 senior stakeholders, which used participatory scripts to review thematic analysis of interviews and develop a preliminary systems model linking identified variables. Population migration and transport restrictions have substantially impacted access to health provision. The human resource for health capability of the state has been severely diminished through the outward migration of (especially non-indigenous) health workers and the suspension of programmes providing external technical assistance. The political will of the Yobe State government to strengthen health provision - through lifting a moratorium on recruitment and providing incentives for retention and support of staff - has supported a recovery of health systems functioning. Policies of free-drug provision and decentralized drug supply appear to have been protective of the operation of the health system. Community resources and cohesion have been significant assets in combatting the impacts of the insurgency on service utilization and quality. Staff commitment and motivation - particularly amongst staff indigenous to the state - has protected health care quality and enabled flexibility of human resource deployment. A systems analysis using participatory group model building provided a mechanism to identify key pathways of threat and adaptation with regard to health service functioning. Generalizable systems characteristics supportive of resilience are suggested, and linked to wider discussion of the role of factors such as diversity, self-regulation and integration.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 225 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 2 <1%
Kenya 1 <1%
Unknown 222 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 49 22%
Student > Ph. D. Student 34 15%
Researcher 28 12%
Other 12 5%
Lecturer 12 5%
Other 53 24%
Unknown 37 16%
Readers by discipline Count As %
Medicine and Dentistry 36 16%
Social Sciences 36 16%
Nursing and Health Professions 26 12%
Business, Management and Accounting 14 6%
Engineering 11 5%
Other 47 21%
Unknown 55 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 January 2020.
All research outputs
of 16,522,185 outputs
Outputs from Conflict and Health
of 416 outputs
Outputs of similar age
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Outputs of similar age from Conflict and Health
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Altmetric has tracked 16,522,185 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 416 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.8. This one is in the 28th percentile – i.e., 28% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 255,402 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 74% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them