Experiences and insights on health policy and systems responses to COVID-19

The COVID-19 pandemic demonstrates powerfully the need for stronger health systems for both universal health coverage (UHC) and health security. This global crisis is a sharp reminder that everyone, everywhere should have access to quality and affordable health services. UHC2030, the global movement for stronger health systems for UHC, has emphasised the inter-connectedness of UHC and health emergencies and called on global leaders to remember their UHC commitments as they respond to COVID-19.

Over six months since COVID-19 was declared a pandemic, important evidence and lessons are emerging on how to strengthen health systems to respond effectively to this and future crises, and protect us all. The UHC2030 Related Initiatives are a group of initiatives, networks and platforms that focus on different aspects of strengthening health systems. They have come together to share some of the key messages on health systems and UHC in the context of COVID-19, building on previous work.

Key messages on health systems and COVID-19, and the contributions of UHC2030 Related Initiatives

Health Financing and COVID-19 response

Key messages are emerging on health financing and how specific policies can contribute to a timely and effective response to the pandemic. For example, this includes how to budget for the COVID-19 response, how to purchase health services, and lessons from countries.

P4H has hosted a rich series of more than 30 blogs, uplifting evidence and how measures in health financing policies can contribute to pivot a quick and effective response to the pandemic. These blogs are available in English, French and Spanish and include a range of health financing topics from how to budget for COVID-19 response, how to purchase health services during a pandemic as well as  specific regional and country experiences The P4H web platform hosted five health financing and COVID-19 webinars to share country experiences from China, Korea, Germany, Kazakhstan and Russia along with a series of meetings of ACTA’s Working Group on health financing during COVID-19.

Sharing knowledge and advocating for the health workforce

The COVID-19 crisis is straining health systems and the health workforce worldwide. The Global Health Workforce Network (GHWN) is highlighting the crucial contribution of health workers, the risks they are taking and how much investment and support to the health workforce is required for both COVID-19 responses and essential health services.

GHWN is keeping health professional associations updated on COVID-19 health worker issues and supporting a new series of dialogues between civil society organizations and WHO, plus contributing to the Access to COVID-19 Tools Accelerator initiative.

Important health workforce themes that GHWN and its related hubs are promoting include:

• Gender and building resilience through a gender equitable workforce – including 12 commitments to achieve a gender-transformative COVID-19 response
• Patient safety
• Community health workers, who are taking on increasing roles and responsibilities to respond to COVID-19 and supporting maintaining essential health services in communities
• Youth at the front lines of the COVID-19 response.

Primary health care, a health system’s first line of defence

The COVID-19 pandemic has highlighted the central role of PHC as a foundational element of global health security. Strong ‪PHC is critical to maintaining access to care during emergencies.

PHCPI has developed key messages about how and why countries, global decision-makers and donors should make PHC a key component of the COVID-19 response.  The “Primary Sources” blog series brings together stories of COVID-19 responses from around the world, told through a PHC lens.  Submit your own story to be amplified through the Primary Sources platform, here.

PHCPI has developed new technical resources, available now on COVID-19 landing page, and launched the PHCPI Online Forum, a digital community of practice for improving Primary Health Care measurement and improvement –  you are encouraged to join this growing community!

Accessing and sharing data: vital foundations for HSS and health security

Health data is a strategic asset for the COVID-19 response. The Health Data Collaborative (HDC) has highlighted how this requires strong data governance, disaggregated data, and trust in data.

The pandemic has also increased attention on the need for strong country owned Health Information Systems to collect, store, analyze and use quality data with integrity for decision making. HDC partners supported a WHO process to strengthen data principles and data sharing policy. HDC has also hosted webinars on the new DHIS COVID-19 app and on modeling COVID-19’s effects on health systems. The collaborative plans to share data systems summaries from ten countries (Kenya, Tanzania, Uganda, Malawi, Botswana, Cameroon, Myanmar, Indonesia, Nepal and Bangladesh) and is planning a high-level meeting in November to increase political commitment and promote aligned support for country Health Information Systems.

Learning from countries

Although each country has a unique experience of COVID-19 depending on its health systems context and rates of infection, the importance of learning from other country experiences and responses has never been higher.

In June 2020, the Joint Learning Network launched the COVID-19 Network for Open Dialogue (NODE) expanding the network’s technical agenda to better respond to countries’ most pressing needs in responding to the COVID-19 pandemic while maintaining essential health services. With the NODE, the JLN has been able to start 18 new technical teams and engage 57 countries in joint learning this year. As these virtual learning exchanges get started, countries will come together and share their experiences on a variety of health topics, including:

• private sector integration and governance
• human resources for health
• infection prevention and control
• medicines pricing strategies
• primary health care systems
• data needs through the pandemic.

Join the JLN’s mailing list to stay up-to-date with the latest news and opportunities to get involved with the JLN.

Supporting coordinated action in countries

Among many things, COVID-19 demonstrates the importance of collaboration and coordination in countries. Now more than ever, all partners need to work in solidarity and coordinate their efforts to support governments to provide emergency response and essential health services.

The UHC Partnership has been working closely with regional and country offices to support the COVID-19 response with a longer-term view of achieving UHC. This has been made possible through the Partnership’s flexible funding and technical assistance that are enabling countries to take advantage of opportunities to emerge stronger from the pandemic by investing in stronger health systems coupled with solid health security interventions. These updates are documented in the special series of stories from the field on COVID-19.

While supporting COVID-19 response activities, the UHC Partnership pursues efforts on the expansion of activities in the UHC Partnership’s fourth phase of operation (2019-2022), including a special focus on noncommunicable diseases (NCDs) and health security, while maintaining efforts in favour of health systems strengthening for UHC.

Thinking ahead: recovery and reset of global health governance architecture

COVID-19 has laid bare the challenges to our health and social systems and the inequities of our economic world order. Key messages from those working on governance point to the urgent need for everyone to align to reset global governance for health systems and to collaborate to access and share data in emergency and non-emergency settings.

COVID-19 has highlighted the need for collective action in both the response and how countries and the international community ‘build back better’. This is a key message from the Health Systems Governance Collaborative's “Building the Reset” initiative, and a common thread in discussions it has led on launching the reset, planetary health, common goods for health, equity and agency, and adaptivity of health systems.

These sessions have highlighted that Common goods for health are a foundational step for UHC and must be firmly embedded, organized and financed in our health systems. You can read summaries here, watch the Governance Collaborative YouTube channel and subscribe to the newsletter for upcoming events.

Sharing research insights on health policy and systems responses to COVID-19

Supporting and sharing emergent research and learning about building stronger health systems are crucial activities during COVID-19.

The Alliance for Health Policy and Systems Research has convened an international Network on Health System Responses to COVID-19 (NHSC-19), a group of international research collaborators with a common interest in understanding how health systems have shaped country responses to COVID-19. It has also detailed how it is responding to the crisis and has also given an overview of the resources it has previously produced for conducting rapid reviews in the context of the COVID-19 response. Their work includes supporting and conducting health systems research to inform the COVID-19 response in countries including India, Georgia, Malaysia and Zimbabwe.

Health Systems Global members are contributing to knowledge interchange across the research and the policy communities. Emerging evidence and approaches from countries and the global response to the COVID-19 pandemic and building back better and stronger health systems, are being reflected in a vast collection of blogs, webinars and virtual meetings. HSG is sharing learning experiences from the private sector, through a series led by HSG’s Private Sector in Health thematic working group. This aims to generate mutual knowledge that supports both governments and the private sector response to the COVID-19 challenge and further engage beyond this emergency in strengthening future health systems for UHC.

The Sixth Global Symposium on Health Systems Research (HSR2020) takes place virtually over three phases from 8th November 2020 to 31st March 2021. HSR2020 comes at a potentially defining moment for health systems across the world and the need, perhaps more than ever, to learn from and collaborate with one another against a shared global threat to health, wellbeing and social justice. The themes and outcomes of HSR2020 will be critical to our success in addressing COVID-19; seeking to break down old silos and re-orient health systems to address public health.  

Building on all these themes, the UHC2030 Related Initiatives will host a joint session at the global symposium, “All together – stronger health systems for UHC and health security”. This will be a further opportunity to share lessons learned during the COVID-19 response, and identify and enhance common approaches for strengthening health systems towards both UHC and health security goals.

Find out more about the UHC2030 Related Initiatives in this information pack.