Partnership for Health System Sustainability and Resilience

In collaboration with London School of Economics, AstraZeneca, Royal Philips, KPMG, Apollo Hospitals, WHO Foundation and the Center for Asia-Pacific Resilience and Innovation

Research conducted by the PHSSR is grounded in a robust methodology developed by the London School of Economics and shaped by practitioners and policymakers working in PHSSR countries.

A sustainable health system is able to maintain its performance during and after crises. Resilience is therefore a vital component of health system sustainability.

Recognising that the concepts of sustainability and resilience must reflect the diversity and complexity of health systems and that they are context-dependent, the Framework intends to serve as a guide to qualitative analysis, rather than a tool for quantitative measurement or direct comparison.

The Framework consists of five core domains and two additional domains. The five core domains were included in the Framework in the pilot phase and relate to the key components of the health system itself

  • Health System Governance: the wide range of steering and rule-making related functions carried out by governments and decisions makers as they seek to achieve national health policy objectives.
  • Health System Financing: how health systems generate, pool and allocate financial resources and pay for health services.
  • Health System Workforce: how health systems plan for, train, recruit, reward, and deploy their workforce, and shape the conditions in which health professionals work.
  • Medicines and Technology: how health systems make use of medicines and technologies in the delivery of health services.
  • Health Service Delivery: how health services are organised and delivered, including ambulatory and hospital care, and public health.

The two additional domains in phase 2 relate to the health system’s interaction with its context, in terms of population health, which has significant implications for health system sustainability and resilience, and the health system’s environmental impact, which is a key element of sustainability:

  • Population health: how health systems address the social determinants of health and meet the levels of population’s need and demand.
  • Environmental sustainability: how health systems prevent and minimize the carbon footprint and the devastating impacts of climate change.

Work on the development of a quantitative index is now underway.

For more information on the development of the PHSSR framework, please read the Interim Report of the Pilot Phase.

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