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1.
Eurohealth ; 27(1):10-15, 2021.
Article in English | GIM | ID: covidwho-2125858

ABSTRACT

Governance is the most important enabler of health system functioning. It provides a foundation and lever for resource generation, financing, and service delivery and ensures they operate well and in coordination with the rest of the system. It also extends beyond the health system through interactions between levels and actors. While there is no unanimously accepted framework for assessing governance, country examples can be used to illustrate how governance has contributed to health systems resilience during the crisis. Good governance prior to the pandemic, underpinned by strong state capacity, political leadership and community engagement, is key to responding resiliently during a novel infectious disease outbreak, such as COVID-19.

2.
European Journal of Public Health ; 31:1, 2021.
Article in English | Web of Science | ID: covidwho-1610408
3.
European Journal of Public Health ; 31:2, 2021.
Article in English | Web of Science | ID: covidwho-1609891
4.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514643

ABSTRACT

Dual delivery of COVID-19 and non-COVID-19 services proved to be the core challenge of the service delivery response. Health systems responded by implementing strategies to manage a surge in demand for both health and social services, while continuing to provide other necessary health care services. These involved adapting or transforming patient care approaches, including the coordination of care across levels (e.g., acute vs. outpatient) and settings (e.g., PHC vs. long-term care), and coordinating response measures with social services provided outside of health system. The initial capacities and available reserves of physical infrastructure, such as hospital and intensive care unit (ICU) beds, the organization and coordination of service delivery and previous experience of responding to epidemics such as SARS or MERS or other health system shocks, influences a country's ability to anticipate and cope with surges in demand for health and social services. This presentation will provide an overview of strategies on ensuring the ability to cope with surge in demand for and managing provision of services for COVID and non-COVID patients, including social services. It will also cover strategies on increasing capacity to cope with surges of need for physical resources, such as infrastructure, equipment and medical supplies. A brief overview of key metrics to assess resilience in delivery of health and social services will also be provided.

5.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514642

ABSTRACT

Public health has faced unprecedented pressures from the dual demands of responding to the COVID-19 pandemic while maintaining delivery of essential public health services such as screening and vaccinations. At the beginning of the pandemic, public health efforts turned towards implementing appropriate preventative health measures to control or mitigate transmission, while the rollout of COVID-19 vaccines has started since late 2020. Preventative public health measures to control or mitigate transmission include observing hygiene guidelines;using personal protective equipment (such as masks);limiting contact through physical distancing measures, curfews, bans on non-essential persons' movement and closing schools, businesses, as well as regional and national borders. All these measures have been supported, with Find, Test, Trace, Isolate, and Support (FTTIS) services, but many countries have struggled to implement these successfully, even months into the pandemic. While organisations such as the ECDC have issued guidance on implementing such interventions depending on the epidemiological situation, national strategies have ultimately depended on the countries' priorities, political realities and weighing the benefits against the potential adverse effects (such as mental health, economic and social impacts) and there has been little coordination among the countries. International coordination in the area of vaccines has also not always worked effectively. This presentation will provide an overview of strategies on implementing effective public health measures, including FTTIS systems and COVID-19 vaccinations. A brief overview of key metrics to assess resilience in the area of public health delivery will also be provided.

6.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514641

ABSTRACT

The COVID-19 pandemic has confronted health systems with extraordinary changes in demand for health services, which magnified underlying disparities in the health workforce. Initial health workforce capacities were critical, as health systems only have two options to increase workforce level: increasing capacity among the existing workforce or mobilising/recruiting additional personnel. Workforce capacity became a limiting factor in an effective pandemic response, particularly in countries with acute workforce shortages. Countries in Europe have pursued various strategies to rapidly surge the numbers of health workers and using their existing human resources differently, including by introducing or expanding on alternative and flexible approaches such as task shifting and other skill-mix changes. The pressure to provide services across the continuum of care, from prevention and vaccination to specialist and inpatient care, led several countries to re-evaluate the distribution of tasks among the health workforce. In the best cases, multidisciplinary team-based staffing models combined the skills of multiple health professionals, enabling provision of the right care at the right time. This presentation will provide an overview of strategies to increase capacity for surges in human resources requirements, as well as supporting measures that help recognise the key role of health workers in the pandemic response. A brief overview of key metrics to assess resilience in the area of human resources will also be provided.

7.
European Journal of Public Health ; 30, 2020.
Article in English | ProQuest Central | ID: covidwho-1015306

ABSTRACT

The analytical framework used in the 2019 EU Country Health Profiles defines resilience as “health systems' capacity to absorb disturbance created by changing environments, sudden shocks or crises, and to adapt and respond effectively with the provision of needed services”. These challenges can be driven by changes or shocks in supply (economic shocks, growing shortages in available resources, technological innovations) or demand (demographic changes, public health threats like the Covid-19 pandemic). The Profiles analyse relevant policy measures to assess whether countries are well prepared to face health system shocks and strains. Methods The framework distinguishes three dimensions of resilience: Ensuring long-term stability of resources: the capacity to protect or generate adequate financial, physical and human resources, as well as information necessary to address a variety of major challenges.Responding efficiently: the ability to manage the health system with limited resources, through achieving efficiencies, while not sacrificing key priorities, benefits, access or entitlements.Strengthening governance: the capacity to steer the system in order to adapt it quickly to new objectives and priorities and to respond to major challenges through key governance tools. The profiles use a harmonised approach to analyse the degree of resilience in each country across these three dimensions through a range of quantitative and qualitative indicators. Results A matrix clusters the findings from the 30 Country Profiles in 2019 (pre Covid-19 outbreak) and identifies common resilience-related challenges and risks facing EU Member States. The matrix also captures examples of countries that are successfully deploying resilience-building policy strategies. Conclusions The evidence shows that resilience is a necessary condition for health systems to mitigate the impact of adversities, as well as respond effectively to both foreseen and unforeseen challenges. Panelists Josep Figueras, Moderator, European Observatory on Health Systems and Policies Federico Pratellesi, DG SANTE, European Commission Guillaume Dedet, Health Division, OECD, Paris, France Anna Maresso, European Observatory on Health Systems and Policies, University of Technology Berlin, Germany

8.
Eurohealth ; 26(2):83-87, 2020.
Article in English | GIM | ID: covidwho-942063

ABSTRACT

COVID-19 has affected the incomes of some health professionals by reducing demand for care and increasing expenditures for treatment preparedness. In a survey of 14 European countries, we found that most countries have incentivised substitutive e-health services to avoid loss of income. Health professionals have also received financial compensation for loss of income either through initiatives specifically designed for the health sector or general self-employment schemes, and have either been reimbursed for extra COVID-19-related expenditures such as personal protective equipment (PPE) or had these provided in kind. Compensation is generally funded from health budgets, complemented by emergency funding from government revenue.

9.
Eurohealth ; 26(2):20-24, 2020.
Article in English | CAB Abstracts | ID: covidwho-942022

ABSTRACT

From the early days of the pandemic policy analysts have been trying to understand what constitutes a resilient health systems response. This article takes stock of the national responses over the past ten months and distils strategies and general lessons for enhancing health systems resilience. Among health systems functions, effective governance, while not easy to pinpoint or secure, has been key to a resilient response, constituting a mortar binding everything else together. The pandemic has also highlighted the importance of solidarity, both within and between countries - bringing us to a realisation that we cannot be truly safe until everybody is safe. Over the course of the pandemic, the focus in studying resilience has broadened towards a more holistic recovery that extends beyond the health system.

10.
Eurohealth ; 26(2):45-50, 2020.
Article in English | GIM | ID: covidwho-941935

ABSTRACT

Surveillance and monitoring systems are central to governments' responses to the COVID-19 pandemic. This article focuses on assessing differences in mortality recording across countries and over time, to inform country comparisons. We show that variations in definitions, testing policies and changes over time affect international and intra-country comparability. Estimating excess deaths is therefore increasingly used to monitor the impact of COVID-19, with early evidence showing a major increase in excess mortality in countries most affected. Enhanced monitoring of the impact of COVID-19 on mortality using multiple data sources, with data published in a timely and accessible manner, is thus important.

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