 Was this situation an aberration, or can health status continue to improve event during armed conflict within a country?  Devkota and Teijlingen think that the lessons learned by analyzing Nepal's approach towards health systems during civil war can indeed be applied elsewhere, and for good reason.  At the end of the day, the primary takeaway message is that of coordination, a common theme even in the most stable of countries when discussing health systems.  Coordination among the Ministry of Health and community offices, passing off duties when appropriate.  Coordination between the Ministry of Health and international agents, such as the UN or NGOs.  However, the conflict in Nepal had its own set of rules that likely don't exist in other areas.
	In Taliban-controlled Afghanistan, NGO workers are regularly held hostage or killed due to their perceived western ties.  In many conflicts aid organizations are often viewed as a target.   In Nepal, the NGOs tended to keep a low profile which might have helped in this case.  Of course, the bigger issue is involvement by both sides of the conflict.  The idea that both sides will choose not to interfere with healthcare provision is simply unrealistic in many areas of the world.  While utilizing the existing healthcare infrastructure as Nepal was able to do would be ideal, in genocides, such as in Rwanda or the Sudan, expecting both sides of the conflict to make efforts not to impede healthcare access is unrealistic.  
	In addition, Nepal's situation was unlike many countries dealing with internal conflict and IDPs.    The effect of the continued growth of the national GDP cannot be understated, as the relationship between increased GDP and increased health indicators (such as the MDGs Nepal is on track to meet) is quite close.  While internal conflict  would certainly mitigate some of the expected improvements due to GDP, those increases, as well as the infrastructure investments, likely played an important role in helping health status continue to improve through the ten year war.
	There are some takeaways from Nepal and the other literature reviewed that can be applied to  all conflict situations, however.  Firstly, increasing preventative care is of clear importance, as was also seen in the discussion of using MHUs in IDP situations.  Vaccinations and screenings can do much to stop the spread of infectious diseases before a full-fledged outbreak of malaria occurs.  In addition to preparation and disease monitoring, flexibility in these sorts of volatile, unpredictable situations is a clear priority.  
	The sorts of special considerations in Afghanistan and the Sudan should not be viewed as insurmountable obstacles.  In an ideal world (more Nepal than some of the other cases) conflict would not affect citizens' access to healthcare and qualified health workers.  However, as seen, there are real consequences that can be expected when internal conflict erupts (geographic and financial barriers and the brain drain).  The international community has certainly worked hard at establishing frameworks for working in these sorts of situations, but there is still work to be done in developing plans to mitigate the long-term effects of some of these issues. 