Systems and implementation science should be part of the COVID-19 response in low resource settings

Abstract

The huge strategic response to COVID-19 is, put simply, the globe's single largest and most concentrated health service redesign effort. To counter the effects of the pandemic in Low Resource Settings (LRS) the World Bank has promised to invest $160 billion into Africa over the next 15 months with bilateral donors also pledging large sums to support COVID-19 responses (e.g. USAID $775 million, UK-AID £200 million). Over 60 LRS governments had applied for World Bank funding by 19th June 2020 with plans to spend huge sums on health system strengthening at unprecedented speed [1]. UN agencies and a multitude of technical assistance organisations are reorienting their work to support countries in areas spanning guideline dissemination, training, improving information systems and equipment and consumable production, procurement and supply chain management amongst others. Some LRS governments are planning emergency recruitment to address critical workforce deficits. It is imperative, therefore, that we use the COVID-19 moment to optimise learning about how to transform health service delivery to benefit population health.