Building health system resilience in and through service delivery

This chapter introduces a framework to analyse the impact of shocks on service delivery and examines the relationship between service delivery and resilience. Shocks, like pandemics or conflicts, can affect service demand and supply differently, leading to surges, shortages, or the need for new infrastructure. Moreover, countries have diverse service delivery systems, affecting their response to shocks, such as pandemics and conflicts or financial crises. Despite these variations, common strategies exist to enhance service delivery resilience and manage fluctuations in demand and supply. Resilient responses in health service delivery require adaptable policies, including enhancing the ability to quickly deploy surge capacity; adapting existing capacities, skill mix, and patient pathways; improving monitoring, planning, and coordination to support demand management; expanding access to virtual care; and investing in or restructure capital, infrastructure, and models of care. However, the risk of potential unintended consequences where one shock triggers another, especially with short-term interventions, emphasises the importance of continuous learning and adopting best practices from other countries to enhance resilience. In the recovery phase, health systems have the opportunity to transform rather than revert to pre-shock conditions, ensuring efficiency and resilience. Given the increasing vulnerability of health systems to various shocks and persistent challenges, ongoing evaluations of resilience in service delivery contribute to the overarching goal of improving health outcomes.