Governments are primarily held responsible for building resilient health and social systems to face accelerating threats from climate change, geopolitical tensions, economic crises, and pandemics. While government agencies are strengthened and redesigned to prevent, prepare for, and respond to these threats, building resilience amongst people and communities is equally important.
Health Literacy
General literacy is a key social determinant of health. Health literacy is being increasingly recognized as an important determinant of health status and health security and resilience. Health literacy aids in health promotion, disease prevention, and care of self, family, and others. It reduces prevalent information asymmetry between patients and providers and enables people to make informed health decisions. It also empowers them to participate in local governance and seek their moral and/ or legal right to health.
Equity
It is an accepted fact that no one is safe until everyone is safe. Ensuring equitable access to essential healthcare and health security is in everyone’s interest. Inequity arises on account of differentiation based on economic status, age, gender, race, religion, caste, literacy, occupation, place of living, etc. While social development will reduce inequity to some extent, there is a need for enabling policies and laws to bridge the divides. Monitoring of equity should be embedded in monitoring and evaluation systems of good governance.
Participatory Governance
People, the public sector, and the private sector form equal limbs of the triangle of governance. Each one has defined roles and responsibilities in governance. In addition, people have certain fundamental rights enshrined in constitutions. Each one has to participate in governance for the shared objective of sustainable development. Transparency in information sharing and communications, institutional mechanisms for harmonious relations between the actors, and trust in each other are vital for effective governance. Effective governance was found to be the key differentiator in outcomes of the Covid pandemic with weightage higher than strength and security measures of health systems.
Self Help Groups
Self-help groups were most effective in protecting each other during the pandemic. Women’s Self-help groups in particular were most active in rural areas to provide help. Online self-help groups were equally effective in sharing useful information in preventing infections. However, there was also the flip side of misinformation being shared on social media. Even the medical fraternity resorted to helping each other through these groups.
Community Health Volunteers
Community health volunteers have become an important link between people and the health systems in low- and middle-income countries. They bridge the information asymmetry that exists between people and health systems. They also bridge the growing digital divide as every country is going through the inevitable digital transformation in every walk of life. These volunteers offer their services for the recognition and prestige they gain in the societies in which they live and for the satisfaction they derive by helping others. Both the government and society should recognize their services and reciprocate in helping them.
Culture of Saving
Culture of saving evolved in populations that were constantly exposed to challenges in daily living. Biologically these populations evolved to store limited calories in visceral fat. Socially there is a culture of storing limited cash in gold and jewelry and other saving instruments. A popular form of saving and lending is through chit funds which are highly prevalent in India in both urban and rural communities. That’s also reflected in greater use of debit cards than credit cards.
Connectivity
Last-mile connectivity has emerged as an essential determinant of health and vulnerability. Connectivity to the road, rail, air, clean drinking water, clean cooking gas, electricity, television, internet, telephone, and mobile address various social determinants of health and also bring equitable access to healthcare services and goods that is essential for resilience during public health emergencies. Though these appear basic, many low- and even middle-income countries lack these amenities, especially in rural areas. Mobile and drone delivery systems along with telemedicine came to the rescue of millions during the pandemic-imposed lockdowns and restricted mobility. Hence, building community resilience is as important as building strong health systems in preparing people for future health, economic, and environmental shocks. Governments should invest in building community resilience; it has not only great economic value but also secures people’s lives.
Photo Credits: https://www.piramalswasthya.org/community-involvement-key-addressing-public-health-challenges-india/