Publication: Change Cannot Wait: Building Resilient Health Systems in the Shadow of COVID-19
Loading...
Files in English
4,794 downloads
526 downloads
Published
2022
ISSN
Date
2022-10-31
Author(s)
Editor(s)
Abstract
As the world approaches the third anniversary of the SARS-CoV-2 outbreak, the devastating health, economic, and societal impacts of the COVID-19 pandemic remain on every continent. COVID-19 underscored how unprepared we are for a public-health emergency of staggering proportions. And yet potentially graver health threats loom. The increasing number of acute infectious diseases combines with trends such as population aging, chronic-disease burdens, and climate change to raise the risk of syndemics—events in which two or more diseases adversely interact with each other and with political and economic conditions of inequality and poverty. The only way to prevent, prepare for, and manage these threats is by building resilient health systems to withstand shocks and improve health outcomes between crises. This report, which is filled with country examples of resilience, shows how strengthening resilience is within every country’s reach, even those with low incomes. It describes the key features of resilient systems as integrated systems that are aware of threats; agile in response to evolving needs; absorptive of shocks; adaptive to minimize disruptions; and able to transform after crises, based on lessons learned. The report makes recommendations for countries to operationalize resilience based on a framework that prioritizes investments according to their impact. The most important investments center on risk reduction, including prevention and community preparedness. The second most important investments focus on disease detection, containment, and mitigation to contain outbreaks before they spread widely. The final set focuses on advanced case management and surge response during an epidemic or pandemic, making this the most expensive and least cost-effective tier. The final message of the report is urgency. Investments are needed to save lives and economies - before it is too late.
Link to Data Set
Citation
“World Bank. 2022. Change Cannot Wait: Building Resilient Health Systems in the Shadow of COVID-19. © World Bank. http://hdl.handle.net/10986/38233 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 History and Evolution of Social Assistance in Indonesia(Washington, DC, 2012-02)Over the past 13 years, the Government of Indonesia (GOI) has moved from a set of temporary, crisis-driven social assistance initiatives towards a more permanent system of social assistance programs. This background paper aims to provide a brief history of the major developments in the GOI's household-targeted social assistance policy and programs with more limited discussion of supply-side and community social assistance initiatives. The note is organized chronologically with developments in social assistance presented together with information about the economic, political and social contexts in which these developments occurred. Indonesia's economic growth was also associated with substantial declines in the poverty, especially among rural households. The poverty headcount fell from 54.2 million to 34.5 million Indonesians and poverty incidence fell from 41.1 to 17.7 percent. While poverty reduction was not a policy objective in GOI documents until the early 1990s, the GOI's agricultural and rural development strategies and commitment to human capital investment through financing and provision of education and health services also contributed to poverty reduction. Furthermore, the GOI intervened in staple foods markets for the purpose of reducing domestic price volatility and increasing food security. During this era, when individuals or families employed in the informal sector required in-kind or financial assistance, they sought it from extended families, communities, or informal credit markets.Publication Rapid Assessment of the Effect of the Economic Crisis on Health Spending in Mongolia(World Bank, Washington, DC, 2010-12)This rapid assessment examines the effect of Mongolia's economic crisis on government health budgets and health expenditure, household out-of-pocket spending and donor health commitments. This study was part of a larger assessment conducted in four countries on the effects of the economic crisis on health spending. A standardized approach was developed for all country case studies and consisted of a desk review of internationally-available literature and databases, extensive in-country review of data and documents available in government and donor offices, and semi-structured interviews with government staff, health providers and development partners. This assessment in Mongolia reveals a substantial reduction in the government health budget: the 2009 national health budget was significantly lower than the previous year's, and then was further reduced by 10 percent in a subsequent budget amendment. At national level, budget cuts were concentrated in investment line items. Among recurrent line items, the pharmaceutical budget was hardhit, but salaries were largely preserved, and there were no retrenchments. Similar patterns were observed at sub-national level for hospital budgets, which depend on the central allocations, but not for primary care facilities, which are funded on a capitation basis. Compared to other sectors, the health sector was relatively protected during the economic crisis and the share of health in the total government budget was higher after the budget amendment than before. To protect households from the effects of the economic crisis on health spending, the government undertook specific policy measures to expand health insurance coverage to vulnerable groups. Donor commitments to the health sector during the crisis largely tracked previously planned commitments.Publication Strengthening Governance of Social Safety Nets in ASEAN(World Bank, Washington, DC, 2013)Several Association of Southeast Asian Nation (ASEAN) member states, in the aftermath of the global financial crisis, are expanding their social safety net programs. In many cases, existing delivery mechanisms for social assistance in the region tend to be basic, in line with the small size of programs. This paper is an analytical framework to systematically consider and include governance aspects in the design and analysis of modern social assistance programs. The underlying conceptual model is simple. Programs face a set of supply-side challenges that have to do with their institutional structure and the ways in which accountability and incentive relationships are shaped. However, both in the region and elsewhere in the world there are a number of experiences with diverse governance tools that countries can draw upon as they think how best to design and implement more sophisticated and comprehensive social safety net programs. Finally, administrative capacity is likely to represent a constraint as governments seek to deliver increasingly complex programs to a growing number of beneficiaries over a wide geographically dispersed area. While large investments in administrative capacity are unlikely, it is possible to think about context appropriate solutions that can contribute to reduce governance risk. This report is the first attempt to systematically apply a governance lens to Social Safety Net (SSN) programs in the region. An analytical framework and diagnostic resource to review governance dimensions of SSN programs in ASEAN, the report intends to document existing efforts and challenges and provide guidance to World Bank staff, donors and policy makers interested in strengthening program administration and mitigating potential governance risks within social assistance programs in the region.Publication Malaysia Public Expenditures : Managing the Crisis; Challenging the Future(Washington, DC, 2000-05-22)Malaysia achieved unprecedented economic growth and dramatic poverty reduction in the two decades prior to 1997. As a result, pressure on public expenditures was alleviated and when the regional financial crisis hit in 1997, the budget was in surplus and public debt had fallen to around 30 percent in GDP. But the crisis brought to the fore issues in public expenditure management that might have remained of less significance in a fast-growing economy: large and increasing off-budget liabilities that could undermine fiscal prudence, accountability, and efficiency in the use of public resources. The government is rethinking its role in tertiary education, tertiary health care, social protection against income risk, and infrastructure. In these areas, there is a potential role for the private sector in provision and financing, and the government's role is gradually shifting from being a provider of these services to a financial supporter and a regulator. In this evolving public-private partnership, the goal of the government is to reduce the fiscal burden while ensuring equity in delivering public services and efficiency in allocating and using public resources. This public expenditure analysis aims to analyze fiscal issues arising from the crisis, gauge the government's public expenditure management system, and assess performance and future challenges in education, health, poverty reduction, and infrastructure.Publication Social Protection in Latin America : Achievements and Limitations(2010-05-01)Social protection systems in Latin America have been transformed in the past two decades. Until the 1980s, those who were not covered by the social security arrangements available primarily in the urban formal sector received little public assistance beyond universal subsidies for some food or fuel purchases. Since the 1990s, the introduction of non-contributory social insurance programs (including "social pensions") and conditional cash transfers has substantially extended the coverage and improved the incidence of social assistance. However, the organic growth of subsidized social assistance in parallel to the older social insurance system, financed largely out of taxes on formal sector employment, has led to a dual system that is neither properly equitable nor efficient. The twin challenges that now face social protection in Latin America are to better integrate those two halves of the system, and to develop programs that promote sustainable self-reliance, by moving from "safety nets" to "opportunity ropes."
Users also downloaded
Showing related downloaded files
Publication Two Dragon Heads : Contrasting Development Paths for Beijing and Shanghai(World Bank, 2010)In broad terms, the sources of economic growth are well understood, but relatively few countries have succeeded in effectively harnessing this knowledge for policy purposes so as to sustain high rates of growth over an extended period of time. Among the ones that have done so, China stands out. Its gross domestic product (GDP) growth rate, which averaged almost 10 percent between 1978 and 2008, is unmatched. Even more remarkable is the performance of China's three leading industrial regions: the Bohai region, the Pearl River Delta, and the Yangtze River (Changjiang) delta area. These regions have averaged growth rates well above 11 percent since 1985. Shanghai is the urban axis of the Yangtze River Delta's thriving economy; Beijing is the hinge of the Bohai region. Their performance and that of a handful of other urban regions will determine China's economic fortunes and innovativeness in the coming decades. The balance of this volume is divided into five chapters. Chapter two encapsulates the sources of China's growth and the current and future role of urban regions in China. The case for the continuing substantial presence of manufacturing industry for growth and innovation in the two urban centers is made in chapter three. Chapter four briefly examines the economic transformation of four global cities and distills stylized trends that can inform future development in Beijing and Shanghai. Chapter five describes the industrial structure of the two cities, identifies promising industrial areas, and analyzes the resource base that would underpin growth fueled by innovation. Finally, chapter six suggests how strategy could be reoriented on the basis of the lessons delineated in chapter four and the economic capabilities presented in chapter five.Publication Global Value Chains in a Postcrisis World : A Development Perspective(World Bank, 2010)The world is in the midst of a sporadic and painful recovery from the most severe economic crisis since the 1930s Great Depression. The unprecedented scale of the crisis and the speed of its transmission have revealed the interdependence of the global economy and the increasing reliance by businesses on global value chains (GVCs). These chains represent the process of ever-finer specialization and geographic fragmentation of production, with the more labor-intensive portions transferred to developing countries. As the recovery unfolds, it is time to take stock of the aftereffects and to draw lessons for the future. Have we experienced the first global crisis of the 21st century or a more structural crisis of globalization? Will global trade, demand, and production look the same as before, or have fundamental changes occurred? How have lead firms responded to the crisis? Have they changed their supply chain strategies? Who are the winners and losers of the crisis? Where are the engines of recovery? After reviewing the mechanisms underpinning the transmission of economic shocks in a world economy where trade and GVCs play increasing roles, the book assesses the impact of the crisis on global trade, production, and demand in a variety of sectors, including apparel, automobiles, electronics, commodities, and off-shore services. The book offers insights on the challenges and opportunities for developing countries, with a particular focus on entry and upgrading possibilities in GVCs postcrisis. Business strategies and related changes in GVCs are also examined, and the book offers concrete policy recommendations and suggests a number of interventions that would allow developing countries to better harness the benefits of the recovery.Publication Corporate Governance of State-Owned Enterprises : A Toolkit(Washington, DC, 2014-10-04)This Toolkit provides an overall framework with practical tools and information to help policymakers design and implement corporate governance reforms for state-owned enterprises. It covers the key elements of corporate governance, including legal and regulatory framework, state ownership arrangements, performance management systems, financial and fiscal discipline, boards of directors, transparency and disclosure, and protection of shareholders in mixed ownership companies. Experience shows that no one approach is universally applicable and the choice of measures depends on country and enterprise circumstances. The Toolkit thus provides a range of frameworks, concepts, case examples, checklists, and model documents that together aim to help government officials make the appropriate choices for their circumstances. The Toolkit concludes with guidance on managing the reform process, in particular how to prioritize and sequence reforms, build capacity, and engage with stakeholders.Publication China 2030 : Building a Modern, Harmonious, and Creative High-Income Society [pre-publication version](Washington, DC: World Bank, 2012-02-27)China should complete its transition to a market economy--through enterprise, land, labor, and financial sector reforms--strengthen its private sector, open its markets to greater competition and innovation, and ensure equality of opportunity to help achieve its goal of a new structure for economic growth. These are some of the key findings of a joint research report by a team from the World Bank and the Development Research Center of China’s State Council, which lays out the case for a new development strategy for China to rebalance the role of government and market, private sector and society, to reach the goal of a high income country by 2030. This report recommends steps to deal with the risks facing China over the next 20 years, including the risk of a hard landing in the short term, as well as challenges posed by an ageing and shrinking workforce, rising inequality, environmental stresses, and external imbalances. The report lays out six strategic directions for China’s future: * Completing the transition to a market economy; * Accelerating the pace of open innovation; * Going “green” to transform environmental stresses into green growth as a driver for development; * Expanding opportunities and services such as health, education and access to jobs for all people; * Modernizing and strengthening its domestic fiscal system; * Seeking mutually beneficial relations with the world by connecting China’s structural reforms to the changing international economy.Publication Empowerment in Practice : From Analysis to Implementation(Washington, DC: World Bank, 2006)This book represents an effort to present an easily accessible framework to readers, especially those for whom empowerment remains a puzzling development concern, conceptually and in application. The book is divided into two parts. Part 1 explains how the empowerment framework can be used for understanding, measuring, monitoring, and operationalizing empowerment policy and practice. Part 2 presents summaries of each of the five country studies, using them to discuss how the empowerment framework can be applied in very different country and sector contexts and what lessons can be learned from these test cases. While this book can offer only a limited empirical basis for the positive association between empowerment and development outcomes, it does add to the body of work supporting the existence of such a relationship. Perhaps more importantly, it also provides a framework for future research to test the association and to prioritize practical interventions seeking to empower individuals and groups.