This report examines how health-focused aid interventions strengthen health system resilience and contribute to sociopolitical stability in fragile and conflict-affected states (FCAS) through comparative case studies of Guinea, Ethiopia, Burundi, and Sierra Leone. Using a process-tracing methodology, it draws on 14 semi-structured interviews with humanitarian practitioners, government officials, and health professionals, complemented by organisational reports and secondary data. The findings demonstrate that while health-focused aid can strengthen the absorptive, adaptive, and transformative capacities of health systems, its effectiveness depends on political conditions, sustained financing, and meaningful local ownership. The report argues that resilient health systems contribute to sociopolitical stability not by directly producing peace, but by reinforcing the social contract through equitable, trusted, and locally embedded service delivery. Building on these findings, it offers a set of policy recommendations centred on strengthening political commitment, promoting sustainable financing, fostering local ownership and capacity development, and improving coordination among health actors to enhance the long-term resilience of health systems in FCAS.