Health system resilience is not an inevitable byproduct of any investment in health but must be intentionally programmed and developed with necessary input, investment and contextualization. This technical product aims to guide national, subnational and global health actors to operationalize the concept of health system resilience for advancement of universal health coverage, health security and ultimately better health for all. It supports the translation of relevant conceptual guidance and high-level recommendations into practical actions. The specific objectives are to: present a concise overview of the concept of health system resilience; provide a roadmap outlining practical and foundational steps for building health system resilience to be adapted to different contexts; share examples of actions and tools, including stakeholder roles, to support country application of the roadmap. The target audience for this work is the various stakeholders involved in strengthening health systems and public health including management of emergencies (from prevention and preparedness to response and recovery) and other public health challenges in countries. This ranges from the donors, policymakers and decision-makers at global, national and subnational levels to the implementing institutions and line managers of health system functions and services across the health system building blocks.

The COVID-19 pandemic has caused unprecedented disruption worldwide highlighting once again the interdependency of health and socioeconomic development, and the global lack of health systems resilience. Two years into the pandemic, most countries report sustained disruptions across service delivery platforms and health areas with a profound impact on health outcomes. The impact of these disruptions is magnified within marginalized communities and in countries experiencing protracted conflict. There is an urgent need to focus on recovery through investment in the essential public health functions (EPHFs) and the foundations of health systems with a focus on primary health care, and whole-of-government and -society engagement. The aim of this Research Topic is to gather, transfer and promote operationalization of key experiences from COVID-19 to inform global and country level recovery that better promote health; guide policy direction towards building health systems resilience; and thereby ensure economic and social prosperity. Experience with COVID-19 has demonstrated that traditional approaches to health system strengthening have failed to achieve the complementary goals of Universal Health Coverage (UHC) and health security with the divide between the most vulnerable and well-off only widening. Much of what had been learned from previous experiences such as Ebola in West Africa has not been widely applied. This has left health and economic systems vulnerable to 21 st century public health challenges, ranging from conflict and natural disasters to aging demographics and rising rates of non-communicable and communicable diseases and antimicrobial resistance. These challenges require intentional focus and investment as well as whole-of-government and -society engagement with health to build health system resilience. Greater action is needed to prevent the devastating effects of war and conflict on the health of the most vulnerable. This Research Topic will convene the knowledge and practices of leaders in public health, health systems, and humanitarian and development sectors. This is to ensure lessons from COVID-19 inform the recovery agenda and promote sustainable health and socioeconomic recovery for all. Lest we forget and find ourselves again unprepared and vulnerable in the face of an even greater threat.

In this Handbook, Steve Thomas and Padraic Fleming compile invaluable and original insights on the resilience of health systems in the face of shocks and crises, from economic and climate emergencies, to conflicts and pandemics. They examine how health system resilience has been conceptualised by scholars and applied in specific contexts, assessing different theoretical models for measuring and evaluating resilience, as well as highlighting the growing challenges facing health systems now and in the future.

The package of health system resilience indicators serves as a dedicated resource to measure and monitor health system resilience in routine operations as well as in the context of disruptive shocks and stressors. This work addresses an identified gap in measurement and monitoring of health system resilience. It complements the Health Systems Resilience Toolkit and supports implementation of the recommendations in WHO’s position paper on building health system resilience for UHC and health security. The package aims to support countries to progressively build their capacities to measure, monitor and build health system resilience from national to subnational levels covering health facilities and other service delivery platforms. It emphasizes an integrated approach to health system strengthening underpinned by essential public health functions, encompassing health emergency preparedness. It includes: - guidance on how to utilize and adapt the health system resilience indicators, including a step-by-step guide - a suite of recommended health system resilience indicators with technical specifications - supplementary indicators of relevance to health system resilience The primary target audience for this package is national and subnational health authorities (including planners and managers) and service providers, as well as local, regional, and global technical organizations and partners working on health system strengthening, including WHO, United Nations country teams, donors, nongovernment organizations, development and humanitarian agencies, and other health-related technical agencies.

This report represents a focused review of the essential public health functions (EPHFs) in Ireland with respect to policy and planning, infrastructure, service delivery and coordination and integration. This work was developed through a collaboration between the WHO and the Department of Health in Ireland. The report offers perspectives to strengthen public health through improved stewardship, coordination and integration and operationalization of the EPHFs.

Experience with public health emergencies such as the COVID-19 pandemic clearly demonstrates that weak public health capacities leave populations and health, economic, and social systems vulnerable. Health system challenges are increasing in number and complexity, while health system resourcing, often seen as a cost rather than an investment, remains inadequate. The limited resources available are skewed towards clinical services and emergency response, leaving persistent weaknesses in preventive, promotive and protective capacities. World Health Assembly resolution WHA69.1 of 2016 provided the World Health Organization (WHO) with a mandate to support Member States to strengthen the essential public health functions (EPHFs) while recognizing their critical role in achieving universal health coverage. This has been reaffirmed in the Declaration of Astana on Primary Health Care, 2018, and by global partners since, creating an impetus towards and need for guidance in strengthening public health stewardship and capacities informed by the EPHFs. This technical package provides a range of technical resources and flexible tools in relation to EPHFs, to support comprehensive operationalization of public health in countries. The unified list of essential public health functions (EPHFs) consists of 12 activities that can be used to operationalize public health in a country. This comprehensive approach to public health orients health systems to population need and health system risks, and governments and societies towards health and well-being. This maximizes health gains within available resources and builds resilience, while reducing population vulnerability and the overall burden on the health system. The EPHFs can be used to plan public health systems, strengthen stewardship and coordination for public health delivery at national and subnational levels, and integrate public health capacities within health and allied sectors. The EPHFs anchor protective, promotive and preventive capacities within health systems while leveraging multisectoral efforts for health. In this way, strengthening health systems with the EPHFs is central to the primary health care approach and supports the achievement of universal health coverage, health security and healthier populations in tandem.

This book presents the health emergency and disaster risk management (H-EDRM) research landscape, with examples from Asia. In recent years, the intersection of health and disaster risk reduction (DRR) has emerged as an important interdisciplinary field. In several landmark UN agreements adopted in 2015–2016, including the Sendai Framework for Disaster Risk Reduction 2015–2030, the 2030 Sustainable Development Goals (SDGs), the Paris climate agreement, and the New Urban Agenda (Habitat III), health is acknowledged as an inevitable outcome and a natural goal of disaster risk reduction, and the cross-over of the two fields is essential for the successful implementation of the Sendai Framework. H-EDRM has emerged as an umbrella field that encompasses emergency and disaster medicine, DRR, humanitarian response, community health resilience, and health system resilience. However, this fragmented, nascent field has yet to be developed into a coherent discipline. Key challenges include redundant research, lack of a strategic research agenda, limited development of multisectoral and interdisciplinary approaches, deficiencies in the science–policy–practice nexus, absence of standardized terminology, and insufficient coordination among stakeholders. This book provides a timely and invaluable resource for undergraduate and postgraduate students, researchers, scholars, and frontline practitioners as well as policymakers from across the component domains of H-EDRM.