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 大流行凸显了对有复原力的高质量卫生系统的需求，并提供了重新考虑如何建立此类系统的机会。尽管即使是资源充足、表现良好的卫生系统在应对 COVID-19 激增方面也遇到了一些困难，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卫生服务至关重要。 - 高质量的护理，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，可以改变资源有限国家的卫生系统绩效：改进卫生服务提供者教育、重新设计护理服务平台、制定战略采购和管理策略以及开发患者级数据系统。各国应抓住 COVID-19 大流行提供的政治和道德能量，建设适合未来的卫生系统。