The COVID-19 pandemic has made vivid the need for resilient, high-quality health systems and presents an opportunity to reconsider how to build such systems. Although even well resourced, well performing health systems have struggled at various points to cope with surges of COVID-19, experience suggests that establishing health system foundations based on clear aims, adequate resources, and effective constraints and incentives is crucial for consistent provision of high-quality care, and that these cannot be replaced by piecemeal quality improvement interventions. We identify four mutually reinforcing structural investments that could transform health system performance in resource-constrained countries: revamping health provider education, redesigning platforms for care delivery, instituting strategic purchasing and management strategies, and developing patient-level data systems. Countries should seize the political and moral energy provided by the COVID-19 pandemic to build health systems fit for the future.

COVID-19 大流行凸显了对有弹性、高质量的卫生系统的需求，并为重新考虑如何建立此类系统提供了机会。尽管即使资源充足、表现良好的卫生系统在不同方面都在努力应对 COVID-19 的激增，但经验表明，建立基于明确目标、充足资源以及有效约束和激励措施的卫生系统基础对于持续提供高水平的医疗服务至关重要。 - 质量护理，并且这些不能被零碎的质量改进干预措施所取代。我们确定了四项相辅相成的结构性投资，可以改变资源受限国家的卫生系统绩效：改进卫生提供者教育、重新设计医疗服务平台、制定战略采购和管理战略、并开发患者级别的数据系统。各国应抓住 COVID-19 大流行提供的政治和道德能量，建立适合未来的卫生系统。