The Scorecard Approach: Identifying and Prioritizing Strategies for Strengthening Public Health System Resilience

Introduction: Shifting environmental, social, and political climates demonstrate the need to systematically identify, prioritize, and scale local strategies for strengthening public health system resilience. The UNDRR Scorecard approach can address this challenge. Specifically, the Public Health Scorecard (Scorecard), launched in April 2020, has been used in diverse settings and translated into 15 languages. This has expanded to food security, education, and rehabilitation services. When coupled with the Delphi process, this approach achieves consensus on implementable grassroots strategies. Methods: The Scorecard has been applied by co-authors in 20 locations across nine countries. This included pre-disaster, post-disaster, and a conflict setting covering five thematic areas, public health (n = 15), food security (n = 4), education (n = 4), and rehabilitation services (n = 1). This method requires workshop participants to discuss and then individually complete the Scorecard questions, organized around the Ten Essentials for Making Cities Resilient. Upon consensus, participants develop and prioritize actions. The Delphi process was used for 13 workshops conducted as part of a project funded by the WHO Kobe Center. This method allowed further synthesis of recommendations based on impact and feasibility. Results: The WHO Kobe Centre funded project promulgated further application of the Scorecard method to help guide the recovery of public health systems after the Türkiye earthquakes of 2023. This also led to the expansion of this approach into other sectors such as education and food security. Also, almost two years after the application of the Scorecard in Waco, Texas, United States, the local health district was awarded the best in Texas. The Scorecard approach can also be modified towards assessing emerging issues, which was demonstrated by application in Lviv, Ukraine, to identify and prioritize strategies for strengthening rehabilitation services. Conclusion: The Scorecard approach is now a feasible methodology for identifying and prioritizing strategies for strengthening public health system resilience in conflict, disaster, and other crisis settings.