ReviewLancet (London, England)2021
Fragmented health systems in COVID-19: rectifying the misalignment between global health security and universal health coverage.
Review in Lancet (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 235 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
235 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Pooled it
- Equitable access to COVID-19 vaccines in Botswana: a scoping review.Frontiers in health services · 2025Pooled it
- The influence of the COVID-19 pandemic on measles vaccination coverage.Cadernos de saude publica · 2025Pooled it
- The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Pooled it
- The worldwide impact of COVID-19 on cancer care: A meta-analysis of surveys published after the first wave of the pandemic.Frontiers in oncology · 2022Pooled it
- Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis.The British journal of surgery · 2023Trial
- Managing health systems under armed conflict: a scoping review of international evidence and a document review of Iranian experiences.Global health action · 2026Article
- Antiviral efficacy of honey bee antimicrobial peptides against SARS-CoV-2.Molecular diversity · 2026Article
- Structural gradients in excess mortality during and after the COVID-19 pandemic: economic development, preparedness, and cross-national differences, 2020-2024.Journal of global health · 2026Article
- Security governance and health inequity in contemporary crises: a critical discourse analysis of securitization, exception-making, and responsibility displacement.Globalization and health · 2026Article
- Barriers to Long COVID Care in the U.S.: An Application of Levesque et al.'s Access Framework.Health care analysis : HCA : journal of health philosophy and policy · 2026Article
- Global Health Reform through a Regional Lens: The Middle East and Central Asia Perspective.Journal of epidemiology and global health · 2026Article
- Inclusion of antimicrobial resistance in a pandemic agreement: why it matters and what comes next?Health affairs scholar · 2026Review
- The association between COVID-19 and incident gestational diabetes (GDM): A population-based case-control study of the National Health Insurance Research Database in Taiwan.Journal of diabetes investigation · 2026Article
- Health policy, collaboration and investment in the post-COVID era: a review from UHC and health security integration perspective.Globalization and health · 2026Review
- Towards a coherent global health architecture: perspectives on integrating global health security and universal health coverage through diplomacy and governance reforms.Health policy and planning · 2026Article
- Healthcare system disruption across WHO-declared PHEICs: a 4S comparative case analysis.Frontiers in public health · 2026Article
- Fragmentation in health system financing: a major challenge for improving effectiveness, efficiency, equity and choice within health systems.BMJ public health · 2026Review
- Social vulnerability and spatial patterns of COVID-19 mortality: Global implications for respiratory health equity.PloS one · 2026Article
- Temporal trends in African healthcare system capacities in prevention, detection, response, and sustainability between 2010 and 2023.PLOS global public health · 2026Article
175 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The COVID-19 pandemic has placed enormous strain on countries around the world, exposing long-standing gaps in public health and exacerbating chronic inequities. Although research and analyses have attempted to draw important lessons on how to strengthen pandemic preparedness and response, few have examined the effect that fragmented governance for health has had on effectively mitigating the crisis. By assessing the ability of health systems to manage COVID-19 from the perspective of two key approaches to global health policy-global health security and universal health coverage-important lessons can be drawn for how to align varied priorities and objectives in strengthening health systems. This Health Policy paper compares three types of health systems (ie, with stronger investments in global health security, stronger investments in universal health coverage, and integrated investments in global health security and universal health coverage) in their response to the ongoing COVID-19 pandemic and synthesises four essential recommendations (ie, integration, financing, resilience, and equity) to reimagine governance, policies, and investments for better health towards a more sustainable future.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.