Assessing the institutional capacities for the resilience of the SUS based on the World Health Organization’s Building Blocks

Abstract This study proposes a new version of the Coefficient of Resilience in Public Health (CoReS) to assess the potential of the Brazilian Unified Health Systems (SUS) for resilient performance. We conducted an ecological study using data on the SUS from 2010 to 2022. The indicators analyzed derived from the World Health Organization (WHO)’s Building Blocks framework, whose dimensions are leadership and governance, workforce, information systems, medical products and technologies, service delivery, and financing. Data normalization and the application of a mean coefficient allowed a comparative assessment between the Brazilian capitals. The results show a significant heterogeneity in the capital cities’ resilience capacities. São Paulo scored the highest CoReS (0.78), while Macapá scored the lowest (0.25). The Governance and Information Systems dimensions showed robust performance, while Essential Medical Products and Technologies and Workforce had the worst scores, below 0.25, highlighting the need for intervention in these areas. The CoReS is a promising tool for assessing and improving the resilience of health systems. Data suggest that targeted interventions are urgently needed.