This is an interesting viewpoint about 'rethinking health systems'. [ https://doi.org/10.1016/S2214-109X(21)00356-9 ]
I find it easier to agree with, 'countries should seize the political and moral energy provided by the COVID-19 pandemic to build health systems fit for the future.' because in our experience political will is key in LMICs where prioritisation of health has been lacking. Also it is important to 'revamping health provider education, redesigning platforms for care delivery, instituting strategic purchasing and management strategies, and developing patient-level data systems.'
We found that to strengthen the Whole Health sector of which the system is a part, the LMICs must establish Health Act to give legal underpinning to the whole idea, establish a mandatory health insurance scheme to cover all the population including the most vulnerable such as unemployed, students, disabled sections of the population, provide appropriate physical infrastructure, basic and advanced appropriate equipment, 24/7 utilities such as water and electricity, and ensure adequate sanitation and hygiene of the facilities. Without these foundational necessities, every other intervention cannot succeed in delivering quality and safe health care. To crown them all, the welfare and motivation of personnel must come tops too, which is why in 2004 we defined the 12-Pillar Clinical Governance programme as, 'protecting patients and supporting practitioners in tandem'. Motivated and enabled health workers deliver consistent quality and patient centred care.
HIFA profile: Joseph Ana is the Lead Consultant and Trainer at the Africa Centre for Clinical Governance Research and Patient Safety in Calabar, Nigeria. In 2015 he won the NMA Award of Excellence for establishing 12-Pillar Clinical Governance, Quality and Safety initiative in Nigeria. He has been the pioneer Chairman of the Nigerian Medical Association (NMA) National Committee on Clinical Governance and Research since 2012. He is also Chairman of the Quality & Performance subcommittee of the Technical Working Group for the implementation of the Nigeria Health Act. He is a pioneer Trustee-Director of the NMF (Nigerian Medical Forum) which took the BMJ to West Africa in 1995. He is particularly interested in strengthening health systems for quality and safety in LMICs. He has written Five books on the 12-Pillar Clinical Governance for LMICs, including a TOOLS for Implementation. He established the Department of Clinical Governance, Servicom & e-health in the Cross River State Ministry of Health, Nigeria in 2007. Website: www.hriwestafrica.com Joseph is a member of the HIFA Steering Group and the HIFA working group on Community Health Workers.
Email: jneana AT yahoo.co.uk