Repair as a circular strategy for increasing resource availability and health system resilience during a crisis

Abstract

Background -- Healthcare is a complex socio-technical system where nations regularly struggle with the misalignment between public needs and available resources. The advent of COVID-19 further exacerbated shortcomings, as evidenced by the global panic to find ventilators and beyond. However, the pandemic catalysed a successful Brazilian public-private voluntary partnership that united key industry players, industrial training centres and several volunteers, who, in the absence of a supportive government, could repair ventilators in record time, giving the health system means to succeed. Objectives -- Characterise how a voluntary public-private partnership came into existence and codify recommendations on how it effectively used repair as a circular strategy to increase ventilator availability and bolster health system resilience. Methods -- Case study using multiple data sources collected over 10 months, including national data, semi-structured interviews, daily reports, and internal communications. Sampling, research instruments, and subsequent qualitative data analysis and theory development grounded in repair strategy, resilience, and supply chain literature. Results -- A successful public-private voluntary partnership delivered 2,514 repaired ventilators, approximately 3% of the total ventilators in use in Brazil and impacting around 24,700 lives. Furthermore, effectively functioned as a first-responder bringing to hospitals approximately 500 repaired units as early as April 2020, surpassing the government's procurement and doing so just-in-time for Brazil's COVID 1st wave. More than 70 institutions and 700 professionals helped hospitals in 25 out of 27 Brazilian states. This case documents how the initiative persevered through adversity, including inadequate policies representing a widespread difficulty in enforcing the “right to repair”.

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DOI

https://doi.org/10.1016/j.hlpt.2023.100778

Repository URI

https://strathprints.strath.ac.uk/86089/