Macro-health system governance and the UHC agenda : key learnings from the COVID-19 pandemic

Open Access

Abstract

This STG Resilience Paper is part of the Commission Research Report and Interim Progress Report (June 2021) published by Reform for Resilience. ; • Prior to the Covid-pandemic, the 'Political Declaration of the High-Level Meeting on Universal Health Coverage' signalled a high point for an approach to global health focussed on health systems. • The Covid pandemic has served to highlight the critical importance of the fundamental goals of Universal Health Coverage ie broad and equitable access to services and essential technologies; multi-stakeholder participation in decision making; increased funding; and, protecting citizens against debilitating health care costs. • The Covid pandemic has also demonstrated the need to delve deeper into the organisation and administration of health systems as the key factor in achieving universal health coverage and effective pandemic control. • Four elements of health system governance have been exposed as key to maintaining resilient, adaptable, strong and equitable health systems and are manifest in how the relationships within health systems are organised, legitimised and maintained. First, relationships between levels and types of health services; second, relationships between levels of government and health administration; third, relationships between technical experts and decision makers; and fourth, relationships between public and private actors in health. • Global health policy, the Universal Health Coverage paradigm and the drive to improve health will be strengthened by increasing attention to these factors and the empirical evidence base for improved health governance and administration