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1.
European Journal of Public Health ; 31:1, 2021.
Article in English | Web of Science | ID: covidwho-1610408
2.
European Journal of Public Health ; 31, 2021.
Article in English | ProQuest Central | ID: covidwho-1514639

ABSTRACT

The COVID-19 pandemic has demonstrated that effective leadership and strong governance are essential for resilience in the face of a shock to the health system. Even though adequate financing of health systems, and ensuring that they have an adequate workforce, physical infrastructure and material supplies can bolster health system resilience, resilience is not merely a function of hard resources but also of soft factors, including capacities of leaders, strengths of institutions, and societal values and culture. Indeed, countries that topped the Global Health Security Index (GHSI), an index that focuses on measuring technical preparedness for epidemics and pandemics, in 2019 were among those that performed the worst during the COVID-19 crisis, as measured in deaths or damage to the economy. A country's initial governance capacity, at the onset of the pandemic, shaped its ability to respond. For example, countries with effective leaders, strong institutions and higher levels of societal trust were often better positioned to respond adequately. But government capacity and trust could change over the course of the response. For example, deliberative decision making that is inclusive, transparent, and accountable, coupled with effective public engagement, can build legitimacy and support for difficult decisions. In the longer term, it can contribute to building trust and improving policy making. This presentation will provide an overview of the strategies that countries-mainly in Europe but also with examples from other regions-have implemented to achieve effective leadership and decision making, coordination, generation and use of information in COVID-19 response decisions. A brief overview of key metrics to assess resilience in the area of governance will also be provided.

3.
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2021.
Article in English | MEDLINE | ID: covidwho-1196319

ABSTRACT

COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as "Long COVID". Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk. Long COVID has a serious impact on people's ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society. Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include: The need for multidisciplinary, multispecialty approaches to assessment and management;Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;The creation of appropriate services, including rehabilitation and online support tools;Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates;and Implementing well-functioning patient registers and other surveillance systems;creating cohorts of patients;and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.

4.
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2020.
Article in English | MEDLINE | ID: covidwho-1181976

ABSTRACT

Preoccupation with the value created by health systems has been longstanding, and will likely only intensify given the ongoing health systems strains and shocks such as the COVID-19 pandemic. But the focus so far has usually been limited to value as seen from the perspectives of certain actors in the health system and/or to certain dimensions of value. In this policy brief we call for a shared understanding of value that embraces the health system in its entirety, including preventive services and other public health functions. We then define value to be the contribution of the health system to societal wellbeing. Any meaningful formulation of the concept of wellbeing includes health, and by extension health systems, as an important contributor to our wellbeing. Health improvement, responsiveness, financial protection, efficiency and equity are widely accepted as health systems' core contributions to wellbeing. Health systems can also contribute to wellbeing indirectly through the spillover effects that its actions have on other sectors. Health systems are shaped by a wide array of actors, including national policy-makers, purchasers, providers, practitioners, citizens and patients. These different actors make important but discrete contributions to value, so in order to maximize it, their actions should be aligned. The aim should be to create a value-based health system. A range of policy levers can be used to enhance value, ranging from cross-sectoral policies to involving patients in decision-making. While such levers normally focus on one or two dimensions of value, it is important to ensure that they do not undermine other dimensions or the efforts of other actors. Effective governance of the whole health system is needed to ensure that stakeholder perspectives and policy levers are aligned to promote a common concept of health system value and, ultimately, of societal wellbeing. There are governance tools, such as the Transparency, Accountability, Participation, Integrity and Capacity (TAPIC) framework, that can help achieve this. Moving towards a value-based health system will often be a gradual process, focusing first of all on the areas where it might make the biggest difference.

5.
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.

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