Resilient health systems for attaining universal health coverage

The Millennium Development Goals (MDGs) galvanised global-level, regional-level and country-level efforts to scale up health interventions and improve health outcomes for health-related MDGs. However, despite improvements in coverage and in the health status of the African people, there persist challenges, to which countries need to pay attention. The 2013–2016 Ebola virus disease (EVD) outbreak in West Africa revealed many weaknesses in the health system detection, preparedness and response systems of the three most affected countries (Liberia, Guinea and Sierra Leone). These pointed to major gaps in the implementation of Integrated Disease Surveillance and Response and the International Health Regulation (IHR) 2005, as well as the weakness of health systems overall.1 2 More importantly, it brought to the fore the importance of building resilient health systems that can withstand shocks and sustain provision of regular health services. Kieny and Dovlo underscored this point and asserted that ‘…we need to build systems that are grounded in primary healthcare principles and capable of responding to routine as well as unexpected challenges that might arise in the future….’3 In pursuant of this agenda, the WHO Regional Office for Africa developed a framework for ‘Strengthening health systems for Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) in Africa’ which consolidates systems and services around a logical results chain with the …