Everyday resilience includes having the policies, structures, and capacities in place to respond to the next health emergency and function with quality during non-emergency times. High functioning resilience is required during non-emergency times to minimize the danger and impact of acute public health events when they emerge.
Indicators
The following indicators, drawn from Primary health care measurement framework and indicators: monitoring health systems through a primary health care lens are included in this concept.
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Institutional capacity to meet essential public health functions and operations
There is a public health institution or entity that carries out key public health functions (see technical specification in metadata)
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Management capability And leadership
Percentage of facilities with a manager/management team that has decision-making responsibilities in key areas
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Availability of essential in vitro diagnostics
Percentage of health facilities with availability of appropriate set of essential IVDs and associated laboratory equipment and consumables for their health care facility level on a sustainable basis, based on the WHO’s model list of essential IVDs (EDL 3) and priority medical devices listed in the WHOMEDEVISAn in vitro diagnostic test and its associated laboratory equipment (when applicable) and consumables are available in a community setting or health facility when it is found in this setting/facility by the interviewer on the day of data collection
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Availability of communications
Percentage of facilities that have access to communication systems including key attributes (see technical specifications in metadata)
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Percentage of facilities compliant with infection prevention and control (IPC) measures
Facility meets standards (inadequate, basic, intermediate, advanced) based on the eight core components of the Infection Prevention and Control Assessment Framework (IPCAF)
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Percentage of facilities meeting minimum standards to deliver tracer services
Percentage of facilities offering services that meet minimum standards including availability of Staff and guidelines Equipment Diagnostics Medicines and commodities
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Percentage of facilities offering services according to national defined service package
Percentage of primary care facilities/units offering services according to national defined service package
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Collaboration between facility and community-based service providers
Percentage of primary care facilities and first-referral hospitals that have established formal linkages with community-based service providers (including community health workers)
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Protocols for patient referral, counter-referral and emergency transfer
Explicit protocols and structured communication mechanisms are in place to promote reporting and feedback between primary care practitioners and other levels of care (referral and counter referral) to promote coordination and information continuity that include key data elements (see technical specifications in metadata)
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Existence of effective surveillance system
Country has an effective surveillance system based on the average of two SPAR indicators on early warning function (C6.1) and mechanisms for event management (C6.2) (see technical specifications in metadata)
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Completeness of reporting by facilities
Percentage of facilities that use information systems for capturing and reporting comprehensive patient and facility data and report according to district and/or national requirements within the required deadline.
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Availability of priority medical equipment and other medical devices
Percentage of health facilities with current stock of the below equipment and products that are available and functional
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Availability of essential medicines
Percentage of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis. The indicator is a multidimensional index reported as a proportion (%) of health facilities that have a defined core set of quality-assured medicines that are available and affordable relative to the total number of surveyed health facilities at national level. A medicine is available in a facility when it is found in this facility by the interviewer on the day of data collection.
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Access to emergency transport for interfacility transfer
Percentage of facilities that have access to emergency transport, measured by having key components (see technical specifications in metadata)
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Availability of basic water, sanitation and hygiene (WASH) amenities
Percentage of facilities that have basic WASH amenities (see technical specifications in metadata)
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Purchasing and provider payment methods are in place (including in primary care)
Purchasing and provider payment methods are in place as measured against key criteria
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Health in All Policies with multisectoral coordination
The country has implemented an HiAP approach that includes key elements (see technical specifications in metadata)
Related Concepts
Delivering high-quality primary health care requires many elements of the health system working effectively together. This mapping explores how different concepts with the framework relate to one another.
Upstream elements are those that are required to develop or improve a particular concept. Absence or poor performance of an upstream element is expected to negatively impact the performance of the concept of focus.
Complementary elements are those where improvements or developments in this area will be mutually beneficial to the concept of focus but not required for improvement.
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Funding & Allocation of Resources
Countinuous and protected expenditure on PHC as a core component of the health system helps promote resilience and continuity of services throughout health emergencies.
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Information & Technology
Regular collections and analysis of health and disease data allows for planning and forcasting of future health systems challenges.
Plans are in place for maintained access to medicines and supplies during health emergencies.
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Multi-Sectoral Approach
Multi-sectoral action and accountability to the population is necessary for PHC system resilience and continued functioning during health emergencies.
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Physical Infrastructure
Facilities are designed to be future-proof. Protocols are in place for potential emergency scenarios.
Establishment of PHC policies ensures that plans are made for situations that may challenge a health systems resileince (e.g. emergencies, conflict).
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Purchasing & Payment Systems
Protected purchasing and payment systems for PHC resources are critical to maintaining health services and ensuring resilience in times of health emergencies.
Adjustment to Population Health Needs
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Documenting lessons learned and researching potential prevention interventions helps promote health system resilience.
Workforce deployment, distribution and retention to ensure constant access to adequate health human resources is complimentary to resilience.
Coordination between health facilities during health emergencies. Joint protocols for preparedness and response.
Management plans and protocols for maintaining and delivering high quality care during health emergencies.
Population Health Management
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Involvement of the community in planning for emergency preparedness and response. Understanding the critical role of communities in these events can help promote resilience.
Resilient Facilities and Services
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Active and ongoing assessments of resilience in health facilities and in the delivery of PHC services prepares for continued delivery of essential health services during public health emergencies.
Safety protocols are incorporated in preparedness and response measures.
Service Availability & Readiness
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Safety protocols are incorporated in preparedness and response measures.
Improvement Strategies
Explore the Improvement Strategies for approaches to addressing Capacity and Performance concepts that influence Impact.
Potential Funding opportunities
Interested in understanding how this topic intersects with investment opportunities from major funding streams? The Global Frameworks Mapping provides a starting point to help identify and make connections between key PHC topics, relevant funding initiatives, and investment cases.
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Walking the Talk: Reimagining Primary Health Care After COVID-19
- Priority Reform 1: Fit-for-purpose multidisciplinary team-based organization
- Priority Reform 2: The fit-for-purpose multi-professional health workforce
- Priority Reform 3: Fit-for-purpose financing for public-health-enabled primary care
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Universal Health Coverage for Sustainable Development (Issue Brief)
- Building resilient and sustainable systems for health
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Universal Health Coverage
- "Priority Area 1: ramp up investments in affordable, quality primary healthcare"
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UNICEF Health Strategy 2016-2030
- Action 3: Strengthen service delivery
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UNDP Strategic Plan 2022-2025
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UHC in Africa: A Framework for Action
- 4. Prepardness: Strengthening Health Security
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The UNICEF Health Systems Strengthening Approach
- 5. Comprehensive supply system strengthening
- Goal 1B: Support countries to introduce and scale up coverage of vaccines for prevention of endemic and epidemic diseases
- Goal 1C: Enhance outbreak response through availability and strategic allocation of vaccine stockpiles
- "Goal 2C: Work with countries and communities to build resilient demand, and to identify and address gender-related barriers to immunisation"
- Cross-cutting: climate change and environmental sustainability
- Area of Focus 5: Developing an HIV Vaccine
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High-Performance Health-Financing for Universal Health Coverage: Driving Sustainable, Inclusive Growth in the 21st Century
- 6. Strengthening Health Security
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Health Sector Framework Document
- Line of Action 2: Address Fiscal and Financial Sustainability
- "Line of Action 3: Improve the organization and quality of healthcare service delivery particularly for diverse, marginal, and disadvantaged groups"
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Global Delivery Programs
- Area of Focus 3: Health systems - identify new approaches to improving the efficiency and effectiveness of health systems and primary care delivery.
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Global AIDS Strategy 2021-2026
- "Result Area 10: ""Fully prepared and resilient HIV responses that protects people living with, at risk of, and affected by HIV in humanitarian settings and from the adverse impacts of current and future pandemics and other shocks"""
- Area of Focus 2: Strengthening the capacity of emergency responders
- Area of Focus 3: Learning and Innovation
- Resilient and sustainable systems for health: Data science in community health
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2020-2022 Strategic Initiatives
- "Cross-Cutting: service delivery innovations - south-south learning, national laboratory systems and health security"
- Strategic Objective 2: Buliding Resilient and Sustainable Systems for Health
