DataSheet1_From Public Health Policy to Impact for COVID-19: A Multi-Country Case Study in Switzerland, Spain, Iran and Pakistan.DOCX

Objectives: With the application of a systems thinking lens, we aimed to assess the national COVID-19 response across health systems components in Switzerland, Spain, Iran, and Pakistan.
Methods: We conducted four case studies on the policy response of national health systems to the early phase of the COVID-19 pandemic. Selected countries include different health system typologies. We collected data prospectively for the period of January–July 2020 on 17 measures of the COVID-19 response recommended by the WHO that encompassed all health systems domains (governance, financing, health workforce, information, medicine and technology and service delivery). We further monitored contextual factors influencing their adoption or deployment.
Results: The policies enacted coincided with a decrease in the COVID-19 transmission. However, there was inadequate communication and a perception that the measures were adverse to the economy, weakening political support for their continuation and leading to a rapid resurgence in transmission.
Conclusion: Social pressure, religious beliefs, governance structure and level of administrative decentralization or global economic sanctions played a major role in how countries’ health systems could respond to the pandemic.

研究目标：本研究采用系统思维视角，旨在评估瑞士、西班牙、伊朗及巴基斯坦四国卫生系统各构成维度的国家级新冠疫情（COVID-19）应对举措。
研究方法：本研究针对四国国家卫生系统在新冠疫情早期阶段的政策应对开展四项案例研究。所选国家涵盖不同类别的卫生系统。我们于2020年1月至7月期间前瞻性收集数据，覆盖世界卫生组织（WHO）推荐的17项新冠疫情应对举措，这些举措囊括卫生系统全部核心领域：治理、筹资、卫生人力、信息系统、药品与技术，以及服务提供。此外，我们同步监测了影响上述举措采纳或落地的各类背景因素。
研究结果：各国出台的防疫政策与新冠疫情传播速率下降呈现相关性。然而，沟通不到位以及社会普遍认为防疫举措有损经济的认知，削弱了政策持续推行的政治支持，最终导致病毒传播快速反弹。
研究结论：社会压力、宗教信仰、治理结构、行政分权程度以及全球经济制裁，是影响各国卫生系统应对疫情能力的关键影响因素。