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0395/2025 - Assessment of institutional capacities for SUS resilience based on the Building Blocks defined by the World Health Organization
Avaliação das capacidades institucionais para resiliência do SUS a partir dos Blocos de Construção definidos pela Organização Mundial de Saúde

Author:

• Alessandro Jatobá - Jatobá, A - <alessandro.jatoba@fiocruz.br>
ORCID: https://orcid.org/0000-0002-7059-6546

Co-author(s):

• Paula de Castro Nunes - Nunes, PC - <paula.nunes@fiocruz.br>
ORCID: https://orcid.org/0000-0002-9117-9805
• Paloma Palmieri - Palmieri, P - <paloma.palmieri@fiocruz.br>
ORCID: https://orcid.org/0000-0003-3376-2215
• Omara Machado - Machado, O - <omara.machado@fiocruz.br>
ORCID: https://orcid.org/0000-0002-8264-0196
• Patricia Simões - Simões, P - <patricia.simoes@fiocruz.br>
ORCID: https://orcid.org/0000-0002-8206-5398
• Paulo Victor Rodrigues de Carvalho - Carvalho, PVR - <paulo.rodrigues@fiocruz.br >
ORCID: https://orcid.org/0000-0002-9276-8193


Abstract:

This study proposes a new version of the Coefficient of Resilience in Health (CoReS) to assess the resilience potential of public health systems in Brazil. An ecological study was conducted using data from the Unified Health System (SUS) between 2010 and 2022. The indicators analyzed were from the WHO Building Blocks, whose dimensions are leadership and governance, workforce, information systems, medical products and technologies, service delivery, and financing. The normalization of the data and the application of an average coefficient allowed a comparative assessment between the Brazilian capitals. The results show a significant heterogeneity in the resilience capacities of the capitals. São Paulo had the highest CoReS (0.78), while Macapá had the lowest (0.25). The governance and information systems dimensions showed robust performance, while medicines and human resources had the worst indices, below 0.25, highlighting the need for intervention in these areas. CoReS is a promising tool for assessing and improving the resilience of health systems. The data suggests that targeted interventions are urgently needed, especially in the weakest dimensions, and that innovative approaches can contribute to more effective and equitable public health decisions that make the SUS more resilient.

Keywords:

Health System Resilience; Health Evaluation; Indicators (Statistics); Public Health Systems

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Jatobá, A, Nunes, PC, Palmieri, P, Machado, O, Simões, P, Carvalho, PVR. Assessment of institutional capacities for SUS resilience based on the Building Blocks defined by the World Health Organization. Cien Saude Colet [periódico na internet] (2025/Nov). [Citado em 13/03/2026]. Está disponível em: http://cienciaesaudecoletiva.com.br/en/articles/assessment-of-institutional-capacities-for-sus-resilience-based-on-the-building-blocks-defined-by-the-world-health-organization/19871



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