Insights for health systems strengthening in the COVID-19 response

The COVID-19 crisis demonstrates powerfully the need for stronger health systems for both universal health coverage (UHC) and health security. The UHC2030 Related Initiatives, which are working on strengthening health systems in different ways, have come together to share their important insights, guidance and learning during the pandemic response.

This includes activities like data management in emergency settings, sharing useful resources on COVID-19 and health systems, acting now to reset the health governance architecture, health financing during the pandemic, the importance of primary health care (PHC) and the application of research and evidence.

Related Initiatives and Health Systems Strengthening

COVID-19 poses an enormous threat to the attainment of UHC and all the Sustainable Development Goals. Infectious disease outbreaks can challenge even those countries considered to have advanced health care systems. The COVID-19 crisis highlights the vital importance of strengthening health systems both for UHC and to protect people and countries from emerging threats to global health security.

UHC2030 is the global movement for stronger health systems for UHC and part of our work brings together a diverse group of international partnerships, alliances and networks – known collectively as “UHC2030 Related Initiatives”- which focus on strengthening different aspects of health systems. This document presents a short profile of each UHC2030 Related Initiative with information about opportunities to work together.

UHC2030 and the Related Initiatives play an important role in promoting coherent approaches to strengthening health systems and to inform both the immediate and longer-term response to the COVID-19 pandemic. UHC2030’s co-chairs recently made this statement calling on political leaders to remember their UHC commitments as they respond to COVID-19. This article now brings together some of the insights, guidance and learning already being promoted by Related Initiatives.

Related Initiatives and their work on COVID-19

Latest experiences and insights on health policy and systems responses to COVID-19

Many of Health Systems Global (HSG)’s 1,700-plus members around the world are contributing to the response to COVID-19. The news and commentary section of the HSG website includes a list of curated blogs and articles written by HSG members, which share experiences and insights from the COVID-19 response in different national contexts, as well as thinking about the recovery from the pandemic and the structural implications of it.

HSG have also created a Wakelet collection with resources on COVID-19 and the implications for health policy and systems. HSG members are contributing to this collection and UHC2030 partners and related initiatives are also encouraged to add relevant resources (links to documents, video, blogs, social media content, etc).

Sharing knowledge and advocating for the health workforce

The Global Health Workforce Network (GHWN) is demonstrating how health care workers are on the frontline fighting Covid19; at the same time, the crisis and its impact on the health workforce shows how vulnerable they are. GHWN and its Hubs are championing the needs and contributions of health workers. Its Youth Hub has launched an advocacy campaign highlighting youth and young health professionals on the COVID-19 frontline. GHWN is focusing especially on gender and the health workforce in emergencies and hosted a special session (24 March) including key messages from this Lancet article.

Some videos, webinars and news have focused on nurses, midwives and the gender dimension of the COVID-19 response.
Video (2 mins): Nurses and midwives from around the world tell us what it’s like to fight COVID-19
Webinar: ‘Global Health Security: Delivered by Women During COVID-19 and beyond’ co-hosted by Women in Global Health and Women Deliver.
Webcast: The First-Ever State of the World's Nursing Report: Unlocking the Gender Dimensions
News: Nurses and midwives and the COVID 19 response, published on World Health Day 2020

Health Financing and COVID-19 response

P4H is hosting a series of blogs on the implications of COVID-19 for health financing. The first two (available in English, French and Russian) cover:

Priorities for the Health Financing Response to COVID-19. Key messages are to ensure sufficient funding for common goods for health (i.e. public health functions such as surveillance, data/information systems, and communication campaigns); and remove financial barriers to health services to enable the timely diagnosis and treatment of COVID-19 for all who need them.

How to budget for COVID-19 response Key messages are to ensure sufficient funds plus an appropriate balance between flexibility and accountability. Funds need to be made available rapidly to the frontlines, while setting effective expenditure tracking mechanisms to guarantee the effective use of resources and accountability.

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

PHCPI is contributing through existing tools and editorials to support the policies in the COVID-19 response and at the same time reinforce focus on PHC as the foundation of strong health care systems. Read this commentary on why it’s time to diagnose and treat our broken primary health care systems.

Accessing and sharing data in emergency and non-emergency contexts

The Health Data Collaborative (HDC), WHO and partners of HDC will review and strengthen policy and guidance for stakeholders on data sharing and data principles with an emphasis on the need for strong underlying health information systems in the UHC context. The COVID-19 situation highlights the need for stakeholders at all levels to have clear norms, standards and guidance on what data can be shared, with legal, ethical, programme and digital aspects considered. It is expected a group of experts will support this process in May 2020.

Bringing together evidence to inform COVID-19 responses in low- and middle-income countries

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.

The Alliance is also supporting and conducting health systems research to inform the COVID-19 response in multiple countries. For example, ‘Embedding RApid reviews in health system decision-making’ (ERA) projects in India, Georgia, Malaysia and Zimbabwe are actively responding to requests from ministries of health: the Frontline health workers in COVID-19 prevention and control review in India informed state government guidelines and has been translated for use in Nepal, and in Georgia the rapid review of COVID-19 epidemic Projections and Policy Options synthesized national response best practices for the office of the Prime Minister. Systematic review centres previously supported by the Alliance are also active. In Lebanon, the Knowledge to Policy Center was among the first to publish a rapid response to the situation in Lebanon, Informing Lebanon's response to the COVID-19 Pandemic.

The Alliance has 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.

Thinking ahead: Recovery and reset of global health governance architecture

The Health Systems Governance Collaborative together with a number of sister global health systems governance and policy networks such as UHC2030, The Collectivity, Health Systems Global and COVID19 Ethics have launched the "Global Health Governance Corona Appeal: Building the Reset". This appeal aims to connect and amplify current health governance work, which is gaining prominence and urgency in the face of COVID-19 and its consequences. The Appeal hopes to facilitate connections across seven ’streams’ of vital work:

1. Moving to adaptive health systems
2. Health as Common Good
3. Upgrading the health and equity agendas, and cultural dimensions of health
4. Building new agency in governance, shifting powers in health and health systems
5. Climate change and health: the next frontier
6. New multilateralism in health
7. Pathways of change and preventing the ‘crisis grab’.

Click here for more detail on this Global Appeal and how to engage.

Note: This article will be updated as work progresses.