Advances, challenges, and prospects for the Unified Health System (SUS) resilience

Abstract This study aims to present and discuss the advancements, challenges, and prospects of Brazilian UHS resilience. An exploratory and qualitative study was conducted to achieve this objective involving 30 interviews with academic experts and practitioners in the health system resilience analysis dimensions. The collected data were analyzed through inductive content analysis. The results present 32 advancements, 40 challenges, and 32 prospects of the UHS resilience divided into the following dimensions and subdimensions: Governance - leadership, politics, and regulatory complex; Financing - generation and allocation; Resources - workforce, infrastructure, medicines, and information technology; Service delivery - primary care and specialized care; and Context - social determinants of health. Therefore, these results show the UHS’s resilience in the last two significant external shocks - the political and COVID-19 pandemic - and point out aspects to be implemented, monitored, and evaluated by public health managers in the future.