The COVID-19 pandemic represents a health system shock of unprecedented magnitude. The resilience of health systems – defined as the capacity to absorb, adapt and transform to cope with shocks – is necessary to ensure sustained performance of health system functions (governance, financing, generation of resources and service delivery) so that the ultimate goals of the health system, particularly that of improving the health of the population, can be achieved. As we have seen, few countries could achieve this goal and even fewer could do so sustainably – leaving important lessons for all countries to learn. Lessons learned from this study can inform both on-going efforts, as countries still grapple with the pandemic, as well as help ensure that these efforts also incorporate a longer-term perspective, thereby improving preparedness for the pandemic. any future shock to the health system.
While there is no ‘one size fits all’ answer that all countries could replicate, the study identifies 20 key strategies, grouped according to health systems functions, that have been shown to improve the resilience of health systems. in the face of COVID-19. They are closely linked and do not operate in isolation, and this book also examines how the health system operates within the context of other systems and broader political and governance structures.
The strategies describe how to secure and (re) allocate funding without leaving anyone behind. They emphasize the need for more employable and well-supported health workers. They demonstrate the importance of strong public health systems and safety nets. They show how providers have increased their capacity and adapted care pathways for COVID-19 and non-COVID-19 patients. While the relative importance of the different strategies and their configurations will depend on the specific contexts of the countries, governance appears to be the foundation and the lever for the functioning and resilience of health systems. It plays a crucial role in allowing all other functions to work in unison to ensure health service delivery that is adequately funded and otherwise resourced to promote better health.
This study is aimed at political decision-makers and has two objectives. First, it provides national policymakers with evidence from other countries to assess their own responses to COVID-19 and incorporate adjustments appropriate to their national contexts. To this end, the study provides examples of assessment areas for each of the strategies identified that can be used as a first step in national health system resilience assessments. Second, the findings and lessons in the study allow us to learn from the experience of the COVID-19 pandemic to begin to “build back better” to improve the response to future shocks to health systems and hopefully. it, even to anticipate them. This supports the transition from managing the crisis to building more resilient health systems and societies.