Song Jialu, Zhu Ziqi, Li Qi, Chen Ying, Wang Zhebin, Zhou Shuduo, Xu Ming, Zheng Zhi-Jie
Peking University First Hospital, No.8 Xishiku Road, Xicheng District, Beijing, 10034, China.
Peking University School of Public Health, 38 Xue Yuan Road, Haidian District, Beijing, 100191, China.
Glob Health Res Policy. 2025 Feb 21;10(1):6. doi: 10.1186/s41256-024-00400-y.
The COVID-19 pandemic exposed significant limitations in health systems worldwide and emphasized the need for updated National Health Policies, Strategies, and Plans (NHPSPs). This study aimed to evaluate the NHPSPs of Organization for Economic Cooperation and Development (OECD) and BRICS (Brazil, Russia, India, China, and South Africa) countries before and after the COVID-19 pandemic. Specifically, it explored each country's commitment to strengthening health systems to address health threats and analyzed the specific changes made.
NHPSP documents from the WHO document repository and official governmental websites were systematically searched. Data were extracted using a standardized template. A coding framework was inductively developed to sort qualitative texts into categories, with frequencies calculated and weighting evaluated, followed by organizing underlying content into subthemes.
Out of 154 documents initially identified, 36 met the screening criteria, covering 14 OECD and 3 BRICS countries. The most predominant theme was prevention (88.9% pre-pandemic, 99.4% post-pandemic), which was addressed as a primary theme in 26 included NHPSPs. After the COVID-19 pandemic, 6 out of 14 analyzed themes saw higher occurrences, among which infection prevention and control (22.2-50.0%) and resilience to health crisis (22.2-44.4%) increased most significantly. Themes mainstreamed in post-pandemic NHPSPs included prevention (94.4%), health research and technology (61.1%), and One Health (66.7%). Primary healthcare emerged as the most concerned subtheme under prevention. Notably, OECD countries displayed more increased occurrences of themes (13 out of 14) or increased emphasis on themes with similar occurrences before and after COVID-19, while BRICS countries only differed in infection control. Additionally, OECD and BRICS countries varied in their subthemes and specific actions under similar primary themes.
COVID-19 exposed vulnerabilities in many countries' health systems, highlighting the need to build resilient health infrastructures through the optimization of NHPSPs. However, only about half of the OECD and BRICS countries have implemented new NHPSPs since the pandemic. Our findings highlight the critical need for global health system reforms and offer actionable recommendations for other countries in formulating their NHPSPs.
新冠疫情暴露出全球卫生系统存在的重大局限性，并凸显了更新国家卫生政策、战略和计划（NHPSPs）的必要性。本研究旨在评估经济合作与发展组织（OECD）国家以及金砖国家（巴西、俄罗斯、印度、中国和南非）在新冠疫情前后的NHPSPs。具体而言，本研究探讨了各国在加强卫生系统以应对卫生威胁方面的承诺，并分析了所做出的具体变化。
系统检索了世界卫生组织文件库和官方政府网站中的NHPSP文件。使用标准化模板提取数据。归纳制定了一个编码框架，将定性文本分类，计算频率并评估权重，然后将基础内容组织成子主题。
在最初识别的154份文件中，36份符合筛选标准，涵盖14个经合组织国家和3个金砖国家。最主要的主题是预防（疫情前为88.9%，疫情后为99.4%），在纳入的26份NHPSP文件中被视为主要主题。新冠疫情后，在分析的14个主题中，有6个主题出现频率更高，其中感染预防与控制（从22.2%增至50.0%）和卫生危机应对能力（从22.2%增至44.4%）增幅最为显著。疫情后NHPSP文件中主流化的主题包括预防（94.4%）、卫生研究与技术（61.1%）以及“同一健康”理念（66.7%）。初级卫生保健成为预防主题下最受关注的子主题。值得注意的是，经合组织国家在新冠疫情前后，更多主题出现频率增加（14个主题中有13个）或对出现频率相似的主题的重视程度增加，而金砖国家仅在感染控制方面有所不同。此外，经合组织国家和金砖国家在相似的主要主题下的子主题和具体行动也存在差异。
新冠疫情暴露了许多国家卫生系统的脆弱性，凸显了通过优化NHPSP来构建有韧性的卫生基础设施的必要性。然而，自疫情以来，经合组织国家和金砖国家中只有约一半实施了新的NHPSP。我们的研究结果凸显了全球卫生系统改革的迫切需求，并为其他国家制定NHPSP提供了可操作的建议。
