COVID-19 – An Opportunity to Redesign Health Policy Thinking

Abstract

Coronavirus disease 2019 (COVID-19) dramatically unveiled the fragile state of the world’s health and social systems – the lack of emergency health crisis preparedness (under-resourced, weak leadership, strategic plans without clear lines of authority), siloed policy frameworks (focus on individual diseases and the lack of integration of health into the whole of societal activity and its impact on individual as well as community well-being and prosperity), and unclear communication (misguided rationale of policies, inconsistent interpretation of data). The net result is fear – about the disease, about risks and survival, and about economic security. We discuss the interdependencies among these domains and their emergent dynamics and emphasise the need for a robust distributed health system and for transparent communication as the basis for trust in the system. We conclude that systems thinking and complexity sciences should inform the redesign of strong health systems urgently to respond to the current health crisis and over time to build healthy, resilient, and productive communities.

Addressing Gaps for Health Systems Strengthening: A Public Perspective on Health Systems’ Response towards COVID-19

“…The need for good governance with strategic visions at all level was therefore pivotal to ensure success. This concern was in line with many studies done identifying crucial roles of leaders in determining the outcomes during a disaster or programme implementations [41,[44][45][46].…”

“…Various leadership approaches have demonstrated different outcomes in dealing with COVID-19. Each approach had its own strengths and weaknesses [46]. Regardless of the approach, it was argued that in an outbreak of such magnitude, governance should be approached with flexible and accommodative manner, including transforming the leadership and systems design during the crisis for a better adaptation [2].…”

The SARS-CoV-2 pandemic: A syndemic perspective

“…The focus on finding a response to the COVID-19 pandemics, which should have been thought of previously (since for a long time, it was a given fact that a new epidemic would strike) led to a blurred approach to all other prevalent health issues and problems reflecting the “curse of piecemeal perspectives” and “siloed frameworks” [ 129 , 130 ].…”

Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage

“…Because national systems “lack interconnectivity”, decision makers and health experts struggle to work across the resulting “self-protecting silos” of health specialties, which are sometimes purposefully kept distinct to prioritise one area of the health system over another. 55 Subsequently, poor communication and collaboration across institutions and national health systems means that unifying GHS and UHC policies at all levels of governance is a monumental challenge. However, analyses offer important insights on where synergies might be possible.…”