O Centro Brasileiro de Estudos de Saúde (Cebes) publica, em parceria com o Centro de Estudos Estratégicos Antonio Ivo de Carvalho (CEE Fiocruz), livro sobre Resilência na Saúde Pública, de Alessandro Jatobá e Paulo Victor Rodrigues de Carvalho. Os autores querem ajudar a suprir o que entendem ser uma lacuna na bibliografia de sanitaristas sobre o assunto, que ganhou impulso com a pandemia de Covid-19.
World Health Organization. Regional Office for South-East Asia. (2017). Framework for action in building health systems resilience to climate change in South-East Asia Region, 2017-2022. World Health Organization. Regional Office for South-East Asia.
The COVID-19 pandemic and its devastating health, economic, and societal impacts demonstrate how unprepared the world is for such immense public health emergencies. The increasing frequency of acute infectious disease outbreaks and trends such as population aging, rising chronic-disease burdens, and climate change raise the risk of syndemics - events in which two or more diseases adversely interact with each other and with political and economic conditions of inequality and poverty. COVID-19 is a bitter lesson in how these dynamics interact to cause profound suffering. The only way to prevent, prepare for, and manage these threats is by building resilient health systems to withstand shocks and improve health outcomes between crises. Enablers are crosscutting factors that influence all aspects of health systems: governance, partnerships, financing, human resources, and innovation. Core capacities essential for resilience include health intelligence; health service delivery, especially primary health care (PHC); community engagement and risk communication; and the health supply chain. The report details recommendations for countries to operationalize health system resilience and sets out a three-tier framework to help them prioritize investments based on their resilience impact: Tier 1: risk reduction - prevention and community preparedness. Tier 2: detection, containment, and mitigation capabilities. Tier 3: advanced case management and surge response.
This document is a consolidated, fit-for-purpose technical reference package to support countries in strengthening health systems resilience at national and subnational level from policy and planning, through operational and services delivery, to monitoring and evaluation. The Toolkit may be adapted to varying contexts and will also contribute to the dual agenda of universal health coverage (UHC) and global health security. The Toolkit serves as a compendium of technical resources to support countries in strengthening the resilience of their health systems and provides technical grounding and clarity on the conceptualization and operationalization of health systems resilience
Countries worldwide are facing complex and diverse health challenges in 21st century, and usually there is one national health system for individual and population health outcomes. The COVID-19 pandemic and other emerging health challenges have exposed gaps and fragmentation in health systems with limited public health capacities and governance. In this context, “essential public health functions” (EPHFs) have been revitalized to support an integrated approach to sustainable health systems strengthening, complementary to primary health care, various programme-specific and health security approaches. Resolution WHA69.1 identified “public health functions as the most cost-effective, comprehensive and sustainable way to enhance the health of populations and individuals and to reduce the burden of disease”; operational framework for primary health care highlighted EPHFs as a key consideration to provide public health services; and WHO’s position paper on building health systems resilience towards universal health coverage (UHC) and health security recommended investing in EPHFs as a key mean for countries’ health systems recovery and transformation during COVID-19 and beyond.
Este documento apresenta um marco conceitual renovado das funções essenciais de saúde pública (FESP) para a Região das Américas, com o qual se pretende dar maior clareza conceitual e operacionalidade ao novo campo de atuação da saúde pública e preencher uma lacuna nas propostas conceituais sobre o fortalecimento dos sistemas de saúde. O marco proposto apresenta um novo paradigma para a saúde pública, baseado em quatro pilares orientados para a ação: a necessidade de incorporar a abordagem dos direitos humanos às políticas públicas de saúde; a necessidade de a saúde pública ampliar seu enfoque para ter uma abordagem mais ampla dos determinantes sociais da saúde; o papel da saúde pública para garantir de forma integral e integrada o acesso a intervenções de base populacional e atenção individual de qualidade; e a necessidade de as autoridades de saúde atuarem em colaboração com outros setores e com a sociedade civil no desempenho das funções de saúde pública. São propostas e descritas 11 FESP apropriadas para a Região das Américas, contextualizadas como um conjunto de capacidades que fazem parte de um ciclo integrado de políticas em quatro etapas: avaliação, formulação de políticas, alocação de recursos e acesso. Esse modelo orienta o desenvolvimento de políticas integradas de saúde públicas por meio da colaboração intersetorial nas quatro etapas do ciclo. A proposta culmina em uma série de recomendações para a aplicação da abordagem integrada das FESP. Essas recomendações destacam a necessidade de vincular as FESP a exercícios nacionais de avaliação e melhoria contínua de capacidades.
The COVID-19 pandemic represents a health system shock of unprecedented scale. Health systems resilience – defined as the ability to absorb, adapt, and transform to cope with shocks – is needed to ensure sustained performance of the health system functions (governance, financing, resource generation, and service delivery) so that the ultimate health system goals, especially that of improving health of the population, can be achieved. As we have witnessed, few countries could achieve this goal and even fewer could do so in a sustained way – leaving all countries with important lessons to learn. The lessons derived in this study can inform both the ongoing efforts, while countries are still grappling with the pandemic, as well as help ensure these efforts also incorporate a longer-term perspective, thus improving preparedness to any future health system shocks.
Leitura que faz parte da curadoria do laboratório para as "Leituras Essenciais". O livro está hospedado no portal da Organização Pan-Americana da Saúde (OPAS), 2017. É possível realizar o acesso através…
Increased attention to the strengthening of health systems would not be sustainable in the absence of a sound monitoring strategy that enables decision-makers to accurately track health progress and performance, evaluate impact, and ensure accountability at country and global levels. This handbook describes a set of indicators and related measurement strategies, structured around the WHO framework that describes health systems in terms of six “building blocks”: service delivery, health workforce, information, medicines, financing and governance.
resilisus@fiocruz.br
ResiliSUS - CEE/Fiocruz
@resilisus
