How can we build the sustainability of our health systems?

Healthcare is an important determinant of promoting the general physical, mental and social well-being of people around the world. An efficient and effective health care system is the key to the good health of citizens and has a significant contribution to the economy and overall development of the country. Poor health systems are holding back progress in improving health in countries at all income levels, according to a joint report by the OECD, the World Health Organization (WHO) and the World Bank. Achieving universal health coverage, the overarching goal that should facilitate the achievement of the health and non-health goals of the Sustainable Development Goals, is directly related to the work of the health system.

Globally, health systems have undergone intense changes and reforms over the past 30 years, leading to improved health care. During the recent COVID-19 pandemic, we saw that countries with stable health systems were less affected than those with fragile health systems. Overall, however, COVID-19 also revealed weaknesses in our health systems that need to be addressed. The crisis has highlighted the importance of equipping health systems with good governance, the use of efficient human resources, the maintenance of continuous supply chain systems, the equitable distribution of financial resources, effective information and monitoring mechanisms, together with stable provision of community services. .

Sustainability is defined as the ability to recover quickly from difficulties; or physical, mental or emotional endurance. Thomas Edison once said, “I did not fail. I’ve just discovered 10,000 ways that won’t work. ” Such is the ability of any health care organization that is either not deterred from difficult circumstances or returns to normal as soon as those circumstances pass. The health systems of all countries, especially low- and middle-income countries, need to be resilient enough to see difficulties as a challenge and an opportunity for growth, to visualize the effects as temporary rather than permanent, and to prevent failures from affecting unrelated areas. These health organizations must invest their time and energy in strategic and operational planning; monitoring and evaluating their key performance areas; time management, stress and self; management of materials, money and human resources; stable health information systems; undertaking innovation and developing good cross-sectoral partnerships and networking. Sustainable organizations must also focus on good communication, quality assurance, patient satisfaction, health sector reforms and building leadership and management skills among health care providers.

There is an urgent need to educate low- and middle-income public health managers on how to build a sustainable health system that is not only effective and efficient in routine health care, but can also adapt to crisis situations. Such training should be provided through live examples and case studies that health professionals can visualize and apply in healthcare with limited resources. The experience and expertise of people working in health systems, academia and NGOs at different levels should be used in such training to document good and reproducible practices related to the various building blocks of the health system.

There are several forums in developing countries that aim to build the capacity of public health managers and students by developing the basic skills needed to strengthen health systems. Apart from these, there are no case-based books on healthcare systems that are practical and comprehensive. The current books are highly theoretical and are mostly from developed countries, the training of which may not be fully applicable in our conditions in low- and middle-income countries. The book Health systems management bridges the gap by providing a comprehensive source of reference based on the curriculum for teachers and students of health management and administration who pursue higher degrees in public medicine, public health, hospital and health management, and those who practice healthcare and hospital management management in public and private hospitals.

So what are the main conclusions? First, and most importantly, the health care system must be resilient enough to take on adversity in advance without losing weight. Second, we need to cultivate the necessary skills among healthcare providers so that they maintain momentum even in stressful situations. Third, we need to dispel the myth that building sustainability within an organization cannot be learned. Fourth, health organizations must devote time and energy to building certain management and leadership skills among health care providers in order to build a sustainable health system.

In summary, as an industry, we need to look critically at how resilient our health systems are. How can we build additional resilience? What are our limitations and challenges that can be turned into opportunities and challenges? Finally, do we have a strong health care system that can overcome any crisis, including COVID-19 and similar pandemics?

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