Publication: Strategic Investment for Health System Resilience: A Three-Layer Framework
Loading...
Files in English
4,121 downloads
Date
2024-08-26
ISSN
Published
2024-08-26
Author(s)
Abstract
As efforts to build emergency-ready health systems intensify across the globe, Strategic Investment for Health System Resilience: A Three-Layer Framework provides a practical investment framework and a diverse set of country cases to inform decision-making and strategic resource allocations. The framework includes layer 1, risk reduction—promoting emergency-ready primary health care, public health, prevention, and community preparedness; layer 2, detection, containment, and mitigation capabilities; and layer 3, advanced case management and surge response.
This three-layer framework prioritizes interventions that prevent a public health threat from developing in the first place (layer 1), limit its spread should one emerge (layer 2), and manage a widespread crisis that compromises a health system’s ability to deliver care sustainably (layer 3). All three layers play a role in achieving health system resilience, but not all of them have been leveraged equally in the past.
Strategic Investment for Health System Resilience offers a glimpse of the relatively low cost of investments in improving the operation of the weakest parts of the three layers. Layer 1 functions are estimated to cost between US$2 per capita in low-income countries and US$4 per capita in lower-middle-income countries. The framework applies equally to short-term epidemics of communicable diseases and to slow-moving trends in noncommunicable diseases. The pace of the needed response to health threats can vary, but all require a system that is resilient across multiple layers of response. Although there is no universal blueprint for every setting, it behooves all countries to seize the moment and invest in the three layers in ways that fit their needs.
Link to Data Set
Citation
“Zhao, Feng; Kovacevic, Rialda; Bishai, David; Weintraub, Jeff, editors. 2024. Strategic Investment for Health System Resilience: A Three-Layer Framework. Human Development Perspectives. © World Bank. http://hdl.handle.net/10986/42085 License: CC BY 3.0 IGO.”
Associated URLs
Associated content
Other publications in this report series
Journal
Journal Volume
Journal Issue
Collections
Related items
Showing items related by metadata.
Publication Integrating the Response to NCDS and Mental Health in the Context of Building Resilient Health Systems in Africa(Washington, DC: World Bank, 2024-04-03)From June 6 to 8, 2023, the Ministry of Health of Rwanda organized an event entitled “Integrating the Response to Noncommunicable Diseases (NCDs) and Mental Health (MH) in the Context of Building Resilient Health Systems in Africa” followed by a technical workshop, with the participation of representatives from the governments of Eswatini, Ethiopia, Ghana, Kenya, Lesotho, Rwanda, Uganda, and Zimbabwe. The event and the workshop were prepared by the World Bank Group (WBG), with support from the World Health Organization (WHO) and with collaboration from United Nations Children’s Fund (UNICEF), the African Centres for Disease Control and Prevention (Africa CDC), and other multilateral agencies and nonprofit organizations. The workshop was under funding provided by the Access Accelerated (AA) Trust Fund. The full program of the event is included at the end of this summary report.The rate of noncommunicable diseases (NCDs) in the African Region increased by 67 percent between 1990 and 2017. In 2019 NCDs were responsible for 37 percent of African deaths, and by the year 2030, they will be the main cause of the burden of disease in the Region. The incidence of mental health (MH) challenges increased by 13 percent in the Region since 2017. In addition, Africa is experiencing high rates of suicide and alcohol abuse, especially among young people. Yet, the average per capita expenditure on MH provision in African countries is US$0.46, with only 1.6 health professionals per 100,000 population working in this field. Primary health care and community-based services are essential strategies to support health systems and to avoid the consequences of early mortality and the social and economic losses brought on by the increased incidence of NCDs and MH. The challenges imposed by NCDs require a stronger collaboration among African countries to see how policies developed in different countries could be adaptative to other regional needs and contexts. Countries participating in the workshop shared some achievements and discussed the challenges ahead for the integration of the provision of mental health services and NCDs care at the first level of care.Publication Serbia – Toward a More Effective, Efficient, Equitable and Resilient Health System(World Bank, Washington DC, 2023)The health system in Serbia faces significant challenges arising from a long-term demographic trend and the recent shock caused by the COVID-19 pandemic. Serbia’s population is aging at a rapid pace, and the share of the population aged 65 and above almost doubled —from 9.6 percent to 18.7 percent—between 1990 and 2019. This, coupled with high prevalence of unhealthy lifestyle factors, such as smoking, heavy drinking, and high consumption of fatty and sugary diet, has contributed to a rapidly rising burden of noncommunicable diseases (NCDs). Addressing NCDs exerts significant financial pressure on the health system that has been further squeezed after more than two years of dealing with COVID-19. This is all happening in a context where the economic contraction that began in 2020 after the advent of COVID-19 pandemic and compounded with the war in Ukraine has adversely affected the country’s capacity to pay for health. The health system also has a challenge to meet population expectations, which have become more demanding after decades of strong economic growth.Publication Why is the Safety of Medicines Important for Resilient Health Systems? A Synthesis Report(Washington, DC: World Bank, 2023-08-22)This report discusses the importance of pharmacovigilance (PV) in contributing to building up resilient health systems. It is based on and summarizes the findings of a review of available literature on the topic and relevant case studies focusing on a set of country and regional experiences. Although indispensable in improving health outcomes, the administration and use of medicines may produce adverse reactions, requiring continuous monitoring to ensure that the benefits outweigh the risks. PV, which involves the systematic detection, reporting, assessment, understanding, and prevention of adverse drug reactions (ADRs), is an essential public health function, but it is often overlooked. The review suggests that successful PV programs are built on three essential pillars: statutory provisions that establish standards for PV centers and programs, well-trained health professionals and associated stakeholders, and engaged PV reporters using effective reporting systems. These pillars allow PV programs to be effective in three core activities: reporting adverse drug events (ADEs) and identifying signals, determining threats through a benefit-risk balance analysis, and taking appropriate actions. This is in addition to supporting various functions of a health system, such as national drug policy and regulation, the delivery of medical care, specific disease control programs, increasing the trust of the general public in the system, and promoting eco-PV. Aided by emerging opportunities for development through automation and machine learning, PV programs show immense potential to enhance the monitoring of patient safety and improve the use of medicines. The report offers policy considerations for countries and international partners in building PV capacity as an essential public function of a health system.Publication The Value of Pharmacovigilance in Building Resilient Health Systems Post-COVID(World Bank, Washington, DC, 2023-08-15)Although indispensable for improving health outcomes, medicines and vaccines or their administration and use can produce adverse effects, requiring continuous vigilance to ensure that the benefits outweigh the risks. Monitoring the safety of the use of marketed medicines and vaccines, also known as pharmacovigilance, should therefore become much more explicit in efforts to strengthen health systems and prepare for public health crises and normal times because the world is determined to build back better after the COVID-19 pandemic. The objective of this report is to examine the importance of pharmacovigilance in a health system both during a health crisis and in normal times, describe the function, structure, and processes of a functional pharmacovigilance system, and explain the value of drug safety monitoring in building resilience in health systems post-COVID-19 pandemic.Publication A Way Forward for Building Resilient Health Systems(Washington, DC: World Bank, 2023-08-01)This report looks at resilience through national health system lenses and provides lessons to strengthen health systems for future shocks. The findings are based on case studies from five countries in Eastern Europe and the South Caucasus (Armenia, Azerbaijan, Georgia, Moldova and Ukraine), as well as focus group discussions with the population and health care workers in Georgia, Armenia, and Moldova. The following section provides the definition and examples of health system resilience. This is followed by descriptions of the baseline characteristics of the five Eastern European and South Caucasus countries’ health systems pre-pandemic performance, which determined most of their capacity and decisions to deal with the shock. The rest of this report reviews key baseline characteristics of the health systems in the countries, which are followed by lessons from the countries’ responses to the pandemic (a summary of each country case study is provided in Annex A). The report concludes with recommendations for building the strong and resilient health systems needed to protect human capital through shocks and crises.
Users also downloaded
Showing related downloaded files
Publication Timor-Leste Economic Report(Washington, DC: World Bank, 2025-02-12)Timor-Leste faces a defining moment in its economic journey. As the country seeks to transition from petroleum dependency to a more diverse and resilient economy, the stakes cannot be higher. The Petroleum Fund, a lifeline that has sustained much of the national budget, risks depletion by 2035, based on recent Ministry of Finance estimates, unless there are urgent reforms. Ambitious national goals - such as upcoming ASEAN membership - reflect the country’s aspirations to integrate globally and broaden its growth horizons. Yet, these opportunities are weighed down by significant fiscal challenges. More specifically, an expanding national budget that raises concerns about fiscal sustainability and the efficiency of public spending. The question is clear: how can Timor-Leste spend better to fuel sustainable growth while preserving fiscal stabilityPublication Pathways to Prosperity for Adolescent Girls in Africa(Washington, DC: World Bank, 2024-10-10)Africa stands at a crossroads, with its future prosperity hinging on the policy and investment decisions it makes today. The continent has an opportunity to shape the trajectories of generations to come by investing in the success of a pivotal population: its adolescent girls. With over 145 million adolescent girls calling Africa home, the potential for transformative change is immense. Yet challenges persist: from high rates of child marriage to limited educational opportunities. Over half of African girls ages 15 to 19 are out of school or married or have children. How can African countries overcome these challenges to ensure that adolescent girls enter adulthood empowered to thrive? Pathways to Prosperity for Adolescent Girls in Africa offers a groundbreaking road map for change. This landmark report: Outlines concrete, actionable policy recommendations; Provides a comprehensive review of evidence-based interventions; Presents a data-driven categorization of African countries to guide investments in adolescent girls; and Introduces an innovative framework for understanding and measuring adolescent girls’ empowerment. Drawing on extensive research and consultations with adolescent girls, policy makers, and practitioners, this report reveals that investing in adolescent girls can yield a tenfold return in economic impact. It outlines six key areas for targeted action: building human capital, enhancing economic success, focusing on the most vulnerable girls, adopting a holistic approach, addressing data and evidence gaps, and mobilizing diverse stakeholders. Whether you are a policy maker, researcher, development practitioner, or advocate, this report will equip you with the knowledge and tools to drive meaningful change. Discover how empowering adolescent girls can transform individual lives and African economies. Join the movement to secure a brighter future for Africa’s adolescent girls and nations alike. The time for action is now.Publication Business Ready 2024(Washington, DC: World Bank, 2024-10-03)Business Ready (B-READY) is a new World Bank Group corporate flagship report that evaluates the business and investment climate worldwide. It replaces and improves upon the Doing Business project. B-READY provides a comprehensive data set and description of the factors that strengthen the private sector, not only by advancing the interests of individual firms but also by elevating the interests of workers, consumers, potential new enterprises, and the natural environment. This 2024 report introduces a new analytical framework that benchmarks economies based on three pillars: Regulatory Framework, Public Services, and Operational Efficiency. The analysis centers on 10 topics essential for private sector development that correspond to various stages of the life cycle of a firm. The report also offers insights into three cross-cutting themes that are relevant for modern economies: digital adoption, environmental sustainability, and gender. B-READY draws on a robust data collection process that includes specially tailored expert questionnaires and firm-level surveys. The 2024 report, which covers 50 economies, serves as the first in a series that will expand in geographical coverage and refine its methodology over time, supporting reform advocacy, policy guidance, and further analysis and research.Publication An Investment Framework for Nutrition(Washington, DC: World Bank, 2017-04-12)The report estimates the costs, impacts and financing scenarios to achieve the World Health Assembly global nutrition targets for stunting, anemia in women, exclusive breastfeeding and the scaling up of the treatment of severe wasting among young children. To reach these four targets, the world needs $70 billion over 10 years to invest in high-impact nutrition-specific interventions. This investment would have enormous benefits: 65 million cases of stunting and 265 million cases of anemia in women would be prevented in 2025 as compared with the 2015 baseline. In addition, at least 91 million more children would be treated for severe wasting and 105 million additional babies would be exclusively breastfed during the first six months of life over 10 years. Altogether, achieving these targets would avert at least 3.7 million child deaths. Every dollar invested in this package of interventions would yield between $4 and $35 in economic returns, making investing in early nutrition one of the best value-for-money development actions. Although some of the targets—especially those for reducing stunting in children and anemia in women—are ambitious and will require concerted efforts in financing, scale-up, and sustained commitment, recent experience from several countries suggests that meeting these targets is feasible. These investments in the critical 1000 day window of early childhood are inalienable and portable and will pay lifelong dividends – not only for children directly affected but also for us all in the form of more robust societies – that will drive future economies.Publication Using the Results of a National Assessment of Educational Achievement(World Bank, 2009)This book, the fifth and final volume of the National Assessments of Educational Achievement series, draws on the experiences of over forty countries that have implemented a national assessment. It considers the role of contextual factors which impinge on the use of assessment findings. The attachment of sanctions to performance on a national assessment and use of assessment results for accountability are discussed. Key components of a national assessment report are specified . Other instruments to communicate findings are described. Uses of national assessment findings for policy, management, teaching, and raising public awareness are described. A number of ways in which the use and value of national assessments could be optimized are proposed. This volume is intended primarily for teams who are responsible for conducting national assessments and policy makers responsible for the dissemination and use of national assessment results.