Does the COVID-19 Pandemic Build Resilient Health Care Systems?

The present COVID-19 pandemic has brought up the conversation of how to build resilient health care systems.  For a health system to be resilient, it has to be able to detect threats before they strike, which means having good epidemiological surveillance.   While a pandemic, like the current COVID-19, represents a significant shock even for the best health care system, resilience also means creating a health care system that will ensure  that the existing care needs do not go unmet, particularly to the most vulnerable segments of the patient population. 


For a health system to be resilient, it has to be able to detect threats before they strike, which means having good epidemiological surveillance.   


For countries with fragile health care systems, a real challenge is ensuring that, during times of crisis, women keep having access to sexual and reproductive health services, as the example of the Ebola crisis resulted in significant increase in maternal mortality due to unmet needs.  We are yet to assess the effect of the COVID-19 pandemic on the ability of health systems to meet the regular needs of its populations.

What Makes a Strong Health Care System?

A resilient or strong health care system also has to be adaptive, which means being able to recover, that is, return to its normal, pre pandemic functioning after the extraordinary event has passed.  In order to do that a health care system requires adequate funding, addressing existing weaknesses in  the  provision of care (both public and individual), and multi sectoral integration that deploys resources far beyond the health care system.

Consistent and planned funding is crucial because we know that weak health systems are a result of boom and bust cycles in funding that come as a consequence of addressing particular and immediate needs when they arise and often diverting resources away from some areas and into those of pressing need, rather than planning strategically for the long run.  Levels of health system resourcing needs to be pinned to the GDP and connected to needs.  Thus, while the level of funding is important, it also has to reflect the health needs of the population.


A health care system requires adequate funding, addressing existing weaknesses in  the  provision of care (both public and individual), and multi sectoral integration that deploys resources far beyond the health care system.


Economic and Social Repercussions of the Current Pandemic

We have seen that the current pandemic has an effect not only on public health,  but has also economic and social repercussions: job loss related stress that leads to an increase in substance abuse, as well as an increase in gender based and domestic violence caused by isolation policies and exacerbated by increased uncertainty and loss of security.  This points to the need to, when planning for and building resilient health care systems, not only look at health system funding and organization, but rather take an approach of multi sectoral partnership to health system strengthening that will address external consequences of the pandemic and respond adequately to prevent a disaster.  It also underlines the interconnectedness of social and economic conditions and their impacts on health.

Finally, the key to long term sustainability of a resilient health care system is in linking practice, policy, and research. The present pandemic is an opportunity to learn from the processes taking place and analyze what it takes to manage it successfully, and where more improvement is needed. The effects of the COVID-19 pandemic are significant in terms of the toll on human lives and it is important to use the evidence from this learning process to create policies which allow for the implementation of practices creating more resilient health care systems and minimize avoidable tragedies.

The analysis was originally published by the International Institute for Health Impact. You can find it here: IIFHI.