Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries
Open accessAbstract
Health systems resilience is key to learning lessons from country responses to crises such as coronavirus disease 2019 (COVID-19). In this perspective, we review COVID-19 responses in 28 countries using a new health systems resilience framework. Through a combination of literature review, national government submissions and interviews with experts, we conducted a comparative analysis of national responses. We report on domains addressing governance and financing, health workforce, medical products and technologies, public health functions, health service delivery and community engagement to prevent and mitigate the spread of COVID-19. We then synthesize four salient elements that underlie highly effective national responses and offer recommendations toward strengthening health systems resilience globally.
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- Authors
- Haldane, V., De Foo, C., Abdalla, S. M., Jung, A.-S., Tan, M., Wu, S., Chua, A., Verma, M., Shrestha, P., Singh, S., Perez, T., Tan, S. M., Bartos, M., Mabuchi, S., Bonk, M., McNab, C., Werner, G. K., Panjabi, R., Nordström, A., & Legido-Quigley, H.
- Affiliations
- University of Toronto (CA)
- Boston University (US)
- London School of Hygiene & Tropical Medicine (GB)
- University of Auckland (NZ)
- ORCID
- Venue
- Nature Medicine
- Published
- 2021-05-17
- Volume
- 27
- Issue
- 6
- Pages
- 964-980
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- OpenAlex
- W3161021559
- Cited by
- 1,264
- References
- 52
- Citations by year
- 2026: 184 · 2025: 217 · 2024: 305 · 2023: 273 · 2022: 237 · 2021: 47 · 2020: 1
- FWCI
- 44.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Practices
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Legal, Health, Environmental and COVID-19 Challenges
- Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
- Keywords
- health system resilience, COVID-19 pandemic, health governance, health care financing, healthcare workers, public health functions, health care delivery, community participation, cross-national comparison
- MeSH terms
- COVID-19, SARS-CoV-2, Delivery of Health Care, Government, Government Programs, Humans, Public Health, Global Health, Pandemics
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