Strengthening Health Systems Toward Dynamic Sustainability

Apart from the devastations in terms of shortage of hospital beds, oxygen supply, and medications, the COVID pandemic halted all non-COVID care, including regular treatments for critical illnesses like cancer, challenging equitable health-care access. This article discusses the need to transition health-care systems toward dynamic sustainability to respond to unprecedented global crises like COVID-19. To explain, we integrate three frameworks: the WHO Health System Framework, the Dynamic Sustainability Framework, and the Transparency, Accountability, Participation, Integrity, and Capacity (TAPIC) model. The structuring of health systems must orient toward dynamic sustainability to be responsive and adaptive to uncertain situations like the COVID-19 pandemic. We discuss the contributions of various Indian initiatives like eSanjeevani, Accredited Social Health Activists (ASHA), Pradhan Mantri Jan Arogya Yojana, Ayushman Bharat Digital Mission, and a governance-centered health system framework proposed.