Effective governance and partnerships key to building health system resilience
WASHINGTON, Nov. 3, 2022 – As the experience from COVID-19 has shown, countries need to take transformative action to build stronger, more resilient health systems, says a new World Bank report. Boosting health system resilience now reaps large dividends when emergencies occur. To do so, governments need to improve their health sector governance, cross-sectoral partnerships based on a One Health approach that prioritizes health service delivery, and pandemic prevention, preparedness, and response (PPR).
According to the new report, Change Cannot Wait: Building Resilient Health Systems in The Shadow of COVID-19, resilient health systems are integrated systems that are aware of threats and risk drivers; agile to respond to evolving needs; absorptive to contain shocks; adaptive to minimize disruptions; and able to leverage lessons learned to transform after a crisis. These systems also integrate essential public health functions to help prevent, manage, and mitigate impacts of other challenges, such as climate change, ageing populations, and fragility and conflict.
“Investing in resilient health systems requires long-term commitment and action by governments,” said Mamta Murthi, Vice President for Human Development, World Bank. “With shrinking health budgets following the COVID-19 crisis response, countries need to set priorities for their health spending, including on areas such as public health, disease prevention, and primary health care to protect human capital and ensure health services for all, especially the poorest and most vulnerable.”
The report identifies several actions governments can take to make their health system more resilient:
- Investing in robust public health institutions and agile, evidence-based decision making for health crises
- Improving awareness and early warning functions
- Expanding community health workforce and building multi-disciplinary competencies for PPR
- Prioritizing and tracking investments in PPR
- Strengthening risk communication and community engagement
- Investing in primary health care with integrated public health functions
- Enhancing quality legal and regulatory frameworks
“Pandemic prevention, preparedness, and response is integral to strong health systems. A country that is not prepared cannot be resilient,” said Juan Pablo Uribe, World Bank Global Director for Health, Nutrition & Population and the Global Financing Facility. “Investments in health system resilience need to go hand-in-hand with the broader health agenda, including advancing toward Universal Health Coverage (UHC), to enable equity.”
This report proposes a three-tiered framework to help countries prioritize spending options based on their impact on resilience. The framework proposes risk reduction, prevention and community preparedness as most important tier one activities, followed by tier two with a focus on detection, containment and mitigation activities. Tier three which is the most expensive part includes advanced case management and surge response.
The World Bank has long been committed to helping low- and middle-income countries build stronger, more resilient health systems and provide quality, affordable health services to everyone. Our $34 billion global health portfolio includes over 240 projects that help countries take a comprehensive approach to improving health outcomes, especially for poor and vulnerable people, by strengthening primary care and key public health functions.