GRF · Policy Nexus
Health and social policy
Health and social protection systems decide whether a shock becomes a crisis for households. An epidemic, a disaster or a recession tests the capacity to detect, treat, pay and support at the same time. Health and social policy covers the institutions, legal obligations and financing that sustain wellbeing and resilience. This page sets out how policy risk propagates through these systems, how their capacity is measured, and which institutions hold the decisions.
Health and social policy in seven parts.
- 01The questionHealth and social policy: how the risk develops
- 02IndicatorsWhat is measured, and how well
- 03SourcesWhere the evidence comes from
- 04DecisionsWho decides, and what the evidence serves
- 05Core questionsWhat experts ask
- 06Mechanisms and driversShocks reveal existing gaps
- 07Methods and dataHow the evidence is built, and where it stops
Health and social policy: how the risk develops.
Resilience and wellbeing. The dossier below sets out how the risk develops, what is measured, where the data come from, how it is modelled and who decides.
Capacity gaps surface under stress
Surveillance, laboratory, workforce and supply capacities that look adequate in normal times are exposed when demand surges. Gaps in core public health functions become visible in the event, when they are hardest to close.
Financing shocks reach households
Where health care depends on out-of-pocket payment, illness pushes households into hardship, and a shock that raises costs or cuts incomes deepens it. Social protection decides whether the burden is shared or borne alone.
Coordination across sectors
Pandemic response engages health, finance, education, labour, transport and border authorities together. Unclear legal powers and coordination arrangements delay decisions and erode public confidence in them.
Trust and compliance
Public measures work only if people follow them, and compliance depends on trust in institutions and on whether measures are explained and seen as fair. Trust lost in one emergency carries over into the next.
Environmental exposure in Africa.
Population density, daytime surface heat and haze over Africa, from NASA GIBS. Each layer carries its own date.
The interactive map needs JavaScript; the layer list and sources are below.
Layers 3
Environmental exposure, for this page
Keyboard, with the map focused
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Latest available
NASA GIBS / EOSDIS · ASTER GDEM (METI, NASA) · Blue Marble (NASA) · © OpenStreetMap contributors (ODbL) · Natural Earth
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Environmental exposure, framed on Africa.Satellite and model products as NASA publishes them, each with its own date. They are indicators, not assessments of any place.
Data: NASA GIBS · ASTER GDEM · Blue Marble · © OpenStreetMap contributors · Natural Earth · NASA EONET · U.S. Geological Survey · NOAA GOES-East ABI GeoColorSources and licences
- We acknowledge the use of imagery provided by services from NASA's Global Imagery Browse Services (GIBS), part of NASA's Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- We acknowledge the use of imagery provided by services from NASA's Global Imagery Browse Services (GIBS), part of NASA's Earth Science Data and Information System (ESDIS). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- Center for International Earth Science Information Network (CIESIN), Columbia University. 2018. Gridded Population of the World, Version 4 (GPWv4): Population Density, Revision 11. NASA Socioeconomic Data and Applications Center (SEDAC). Licensed under CC BY 4.0. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). doi:10.7927/H49C6VHW. CC BY 4.0
- VIIRS near-real-time products (flood, land surface temperature, snow cover, corrected reflectance), NASA LANCE; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- MODIS and VIIRS atmosphere products, NASA LANCE and LAADS DAAC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- VIIRS Black Marble night-time lights, NASA Goddard Space Flight Center; distributed by the NASA Level-1 and Atmosphere Archive and Distribution System (LAADS DAAC); imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- OMI nitrogen dioxide (Aura) and OMPS aerosol index (Suomi NPP), NASA; distributed by the NASA GES DISC; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- ASTER GDEM is a product of METI and NASA (ASTER Global Digital Elevation Model V003, NASA LP DAAC); imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). Cite as: NASA/METI/AIST/Japan Spacesystems and U.S./Japan ASTER Science Team (2019). ASTER Global Digital Elevation Model V003. doi:10.5067/ASTER/ASTGTM.003. NASA open data
- Made with Natural Earth. Free vector and raster map data @ naturalearthdata.com. Public domain
- © OpenStreetMap contributors (ODbL), via NASA GIBS (coastlines, boundaries, roads and place names). Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). ODbL
- Blue Marble, NASA Earth Observatory; imagery via NASA GIBS. Colours redrawn from the published colour map; values averaged into hexagonal cells where shown (modified). NASA open data
- Context on the globe and flat map: coastlines, boundaries, roads and place names from NASA GIBS reference layers (OpenStreetMap data, ODbL, © OpenStreetMap contributors); Blue Marble imagery as an optional base; 3D terrain and the elevation read-out from the ASTER GDEM elevation colour index (5 m to 200 m classes, exaggerated for legibility). Boundaries are drawn as published and imply no position on any territory.
- Live events: NASA Earth Observatory Natural Event Tracker (EONET); events are indicative and keep their original source links.
- Live: NASA EONET Events are indicative, not authority warnings.
- Live: U.S. Geological Survey Events are indicative, not authority warnings.
- Live: NOAA GOES-East ABI GeoColor (CIRA). We acknowledge the use of imagery provided by services from NASA's Global Imagery Browse Services (GIBS), part of NASA's Earth Science Data and Information System (ESDIS).
- NASA GIBS: We acknowledge the use of imagery provided by services from NASA's Global Imagery Browse Services (GIBS), part of NASA's Earth Science Data and Information System (ESDIS).
- Air quality forecast, 5 days, PM2.5 (CAMS via Open-Meteo): Contains modified Copernicus Atmosphere Monitoring Service information 2026.
- Past year, daily temperature (ERA5 via Open-Meteo): Contains modified Copernicus Climate Change Service information 2026.
- Weather data by Open-Meteo.com (https://open-meteo.com/), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/).
- Optional layers (14 sources in the layer list: live, forecast, observed and context) print their provider credit on the map and here when switched on; forecasts are model output and derived indices are estimates.
Layers and dates
- Population density, 2020: Population: CIESIN, Columbia University, Gridded Population of the World v4.11 (2018), NASA SEDAC, CC BY 4.0 · static
- Land surface temperature, day, 8-day composite: VIIRS NOAA-20 Level 3, 8-day, NASA LANCE · 14 Sep 2026
- Aerosol optical depth, daily: VIIRS NOAA-20 Deep Blue AOD, NASA LANCE · 13 Oct 2026
- Flood water, 3-day composite: VIIRS Global Flood Product, NASA LANCE · 14 Oct 2026
- Night-time lights, daily: VIIRS Black Marble (VNP46A2), NASA LAADS DAAC · 12 Oct 2026
- Nitrogen dioxide, lower atmosphere column: OMI Aura, NASA GES DISC · 10 Oct 2026
What is measured, and how well.
Each indicator carries its unit, its cadence, the kind of source behind it and the evidence label a value would carry. No values are shown: a programme supplies them under its own authority.
| Indicator | Unit | Cadence | Source type | Label |
|---|---|---|---|---|
| IHR core capacity attainment | percent of attributes met, by capacity | annual | WHO States Parties Self-Assessment Annual Reporting | DECLARED |
| Joint External Evaluation capacity scores | score by technical area | per evaluation | WHO Joint External Evaluation reports | REPORTED |
| Out-of-pocket health spending | share of current health expenditure | annual | WHO Global Health Expenditure Database | Published statistics |
| Population covered by at least one social protection benefit | percent of population (SDG indicator 1.3.1) | periodic | ILO World Social Protection Database | Published statistics |
| Social protection programmes able to scale up in a shock | categorical, by programme | periodic review | World Bank ASPIRE and programme documents | REPORTED |
| Trust in national government | percent of respondents | biennial | OECD Trust Survey | ESTIMATED |
| Wellbeing by dimension | index by dimension | periodic | OECD Better Life Index | ESTIMATED |
Policy tracker.
The screen a team would use to follow this subject: its measures, states and decisions. Names are examples and values are illustrative.
Policy tracker
Health and social policy · Member state A · Session 3
Policy cycle
Options appraisal, planning law
| A · guidance only | 24 | Low | Mixed | High |
| B · duty with standards | 56 | Medium | Positive | Medium |
| C · duty, standards, funding | 80 | High | Positive | Low |
Decision record
- Owner
- Policy owner
- Decision by
- Legislative committee
- Evidence
- synthesis SY-21
- GRF role
- convenes, does not decide
Where the evidence comes from.
Named public datasets and institutional records, each with its licence class. Sources by agreement are used only under their terms and never republished.
| Source | What it gives | Licence class |
|---|---|---|
| WHO SPAR and IHR monitoring | Annual State Party self-assessment of core public health capacities | Free, CC BY-NC-SA 3.0 IGO |
| WHO Joint External Evaluation reports | Voluntary external evaluations of health security capacities | Free, CC BY-NC-SA 3.0 IGO |
| WHO Global Health Expenditure Database | Health spending by source and function | Free, CC BY-NC-SA 3.0 IGO |
| ILO World Social Protection Database | Coverage, expenditure and legal frameworks for social protection | Open, CC BY 4.0 |
| World Bank ASPIRE | Social protection programme coverage and adequacy from household surveys | Open, CC BY 4.0 |
| OECD Better Life Index and How's Life? data | Wellbeing indicators across income, health, social connections and governance | Open, CC BY 4.0 |
| OECD Trust Survey | Trust in public institutions and the drivers of trust | Open, CC BY 4.0 |
Compare instruments: rules, incentives and information.
Three families of instruments side by side against the baseline, each with its own lag and adoption speed, under the coverage and compliance you set; effect sizes are teaching values to replace with evidence. Scenario: named assumptions about the future, not a forecast. The map on this page shows Africa; the model itself is not tied to a place.
Controls
- Baseline trend of the outcome
- 2.0% a year
- Coverage of the instrument
- 70%
- Compliance
- 75%
- Effect size, against the teaching value
- 100%
- Years ahead
- 20 years
Readouts
- Largest reduction at the horizon
- Regulation
- Its reduction against the baseline
- 21%
Numbers, methods and sources
| Year | Baseline | Regulation | Economic incentive | Information and capacity |
|---|---|---|---|---|
| 0 | 100.0 | 99.5 | 98.8 | 99.1 |
| 1 | 102.0 | 101.2 | 100.1 | 99.8 |
| 2 | 104.0 | 102.5 | 101.1 | 99.9 |
| 3 | 106.1 | 103.5 | 101.6 | 100.0 |
| 4 | 108.2 | 103.7 | 101.8 | 100.7 |
| 5 | 110.4 | 103.2 | 101.7 | 102.1 |
| 6 | 112.6 | 102.0 | 101.6 | 103.9 |
| 7 | 114.9 | 100.4 | 101.6 | 105.9 |
| 8 | 117.2 | 99.2 | 102.1 | 108.0 |
| 9 | 119.5 | 98.6 | 102.9 | 110.1 |
| 10 | 121.9 | 98.9 | 104.2 | 112.3 |
| 11 | 124.3 | 99.7 | 105.7 | 114.5 |
| 12 | 126.8 | 101.1 | 107.4 | 116.8 |
| 13 | 129.4 | 102.7 | 109.4 | 119.2 |
| 14 | 131.9 | 104.5 | 111.4 | 121.6 |
| 15 | 134.6 | 106.5 | 113.5 | 124.0 |
| 16 | 137.3 | 108.5 | 115.7 | 126.5 |
| 17 | 140.0 | 110.7 | 118.0 | 129.0 |
| 18 | 142.8 | 112.9 | 120.4 | 131.6 |
| 19 | 145.7 | 115.1 | 122.8 | 134.2 |
| 20 | 148.6 | 117.4 | 125.2 | 136.9 |
Methods
- Tools of government Hood (1983), The Tools of Government, Macmillan
- Carrots, sticks and sermons Bemelmans-Videc, Rist and Vedung (1998), Transaction
- Diffusion of innovations Rogers (2003), Diffusion of Innovations, Free Press
- Uncertainty fan (parameter Monte Carlo) Spiegelhalter, Pearson and Short (2011), Visualising uncertainty about the future, Science 333
- One-at-a-time sensitivity (tornado) Saltelli and others (2008), Global Sensitivity Analysis: The Primer, Wiley
Data
The model runs on the teaching values set by the controls. To calibrate it for a place, read it against these admitted layers and series, which this page's map can draw:
- Borders Natural Earth
- Cities Natural Earth
Across the six pillars, led by Nexus Consortium
- Experiments Labs
- Built in Policy Nexus in Foundry
- Tested at Policy Nexus in Universe
- Codified in Foundations and Governance in Standards
- Published in Policy Nexus in Reports
- Taught in Faculty of Governance, Policy and International Affairs in Academy
Who decides, and what the evidence serves.
Policy Nexus prepares evidence. The decisions below are taken by the authorities named, under their own rules, and never by the platform.
| Who decides | The question | Evidence this page serves |
|---|---|---|
| Ministries of health and national public health institutes | How to close core capacity gaps and organise emergency powers and coordination | Self-assessed and external capacity scores side by side, each with its label |
| Ministries of social protection and labour | How to design programmes that can expand quickly in a shock | Comparative designs of shock-responsive programmes and their evaluations |
| National legislatures | What emergency powers to grant, with which limits, oversight and sunset | Comparative review of public health emergency law and parliamentary oversight |
| Ministries of finance | How to finance surge capacity and contingent social spending | Contingent financing instruments compared; evidence on fiscal space |
Outputs this topic produces
- Policy primer on legal powers and coordination for public health emergencies
- Comparative brief on shock-responsive social protection arrangements
- Review of evaluations of health and social programmes, with their identification strategies
- Dialogue records from exchanges between health, finance and social protection institutions
From mandate to evaluation, by pillar.
The steps an instrument takes from mandate to evaluation, each with the pillar that runs it, and the decisions that stay with the authority. Teaching model with stated illustrative values, not a prediction. The map on this page shows Africa; the model itself is not tied to a place.
- Mandate and problem framing Competent authority (outside the programme)
A competent authority frames the problem and the mandate under its own rules. Howlett, Ramesh and Perl (2009) - Evidence and system model Foundry
The system is modelled with its feedbacks, data and stated limits. OECD (2014), principle 2 - Options appraised with scenarios Foundry
Instruments are compared under scenarios, with uncertainty shown. Hood (1983) - Exercise with stakeholders Universe
The options are tested in an exercise with those who would implement and bear them. OECD (2014), principle 3 - Standard or guidance drafted Nexus Standards
What works is codified as a standard or guidance, open to comment. Nexus Standards process - Decision by the authority Competent authority (outside the programme)
The authority decides, outside the programme, with the evidence on record. Howlett, Ramesh and Perl (2009) - Capacity and training Risk Academy
Those who implement are trained on the decided instrument and its data. Sendai Framework (2015), priority 2 - Monitoring and public report Reports
Indicators are published with sources, limits and corrections. OECD (2014), principle 5 - Evaluation and revision Nexus Standards
Results return to the standard and the model: the cycle closes. Howlett, Ramesh and Perl (2009)
Methods
- Policy cycle Howlett, Ramesh and Perl (2009), Studying Public Policy, Oxford University Press
- Governance of critical risks OECD (2014), Recommendation of the Council on the Governance of Critical Risks
- Layered drawing of directed graphs Sugiyama, Tagawa and Toda (1981), IEEE SMC 11
Across the six pillars, led by Nexus Consortium
- Experiments Labs
- Built in Policy Nexus in Foundry
- Tested at Policy Nexus in Universe
- Codified in Foundations and Governance in Standards
- Published in Policy Nexus in Reports
- Taught in Faculty of Governance, Policy and International Affairs in Academy
What experts ask.
Health and social policy experts ask how systems protect people when shocks arrive.
- How do health systems maintain essential services during surges and disruptions?
- How quickly can social protection reach people affected by a shock, and who is missed?
- How do health, social and economic policies interact during a crisis?
- How do pre-existing inequalities shape the impact of shocks and the effectiveness of responses?
- How is public trust built and maintained for health and social measures?
Exercise a cascade in health and social policy with the people who decide.
Assembled from the Nexus Standards area profile Political and governance risk standards: the hazards it names, the systems and communities that carry the loss, the controls and institutions that dampen it and the data that observe it. Pick an initiating event and step through the cascade to see where mandates meet and which decisions fall to whom. The Map view places the run on an example geography with open data. Every weight is a stated assumption. An exercise for dialogue, not a forecast, an assessment or a position. To model a place of your own choosing, open the full System Builder.
Systems and couplings
Controls
NS-0Constitution and principlesNS-9Contextual UNIs (deployments, instances, programme instances)NS-10Policies and clauses (machine-readable obligations: definition, binding, evaluation and enforcement)NS-11Verification and monitoring (evidence, attestations, zero-trust conformance observation)NRS-H112Hazard family: Governance and institutional failure (NHS-1 soc.governance)NRS-U9Universe platform profile: Financial Regulation NexusNRS-H59Hazard family: Economic shocks and governance failure (NHS-1 soc.economic)NRS-H118Hazard family: Organised crime and illicit economies (NHS-1 soc.crime)NRS-A5Built-in licensing and rightsNRS-U24Universe platform profile: Policy Nexus
Observation
- Worldwide Governance Indicators (listed for reference)
- V-Dem dataset (listed for reference)
- Global SDG Indicators Database (listed for reference)
- Proportion of population satisfied with their last experience of public services
- Proportion of population who believe decision-making is inclusive and responsive
- Number of countries that adopt and implement national DRR strategies in line with the Sendai Framework
Shocks reveal existing gaps.
Crises tend to expose and widen existing weaknesses. Health systems with limited surge capacity, fragile supply chains or workforce shortages struggle to maintain routine care during emergencies, leading to indirect harm that can rival the direct effects. Social protection systems with low coverage, outdated registries or no means to scale up leave many people without support when incomes collapse.
Systems that respond well tend to have broad coverage before the crisis, data and delivery mechanisms that can expand quickly, and pre-agreed rules for scaling up. Public trust, built through transparency and fairness, affects whether people follow health guidance and take up support.
Why now: social protection systems are being asked to respond to climate and economic shocks as well as long-term needs, and adaptive social protection has moved from pilots to policy. Policy Nexus compares designs and convenes the ministries involved on triggers and roles.
Who a decision on health and social policy reaches.
The sectors a policy on health and social policy has to coordinate: a choice in one ministry lands in the others.
Signature
Health and its partners
Health gives workforce for operations to infrastructure (0.3), farm labour to food (0.3) and utility workforce to water (0.2).
W · E · I · F · H · B
- Sectors
- 4 of 6
- Relations
- 6 of 15
- Coupling
- 0.42 share of total
Strongest relations in play
- Water → Food · irrigation0.8
- Food → Health · nutrition0.7
- Infrastructure → Water · pipes, dams and treatment works0.6
- Water → Health · drinking water and sanitation0.7
How the evidence is built, and where it stops.
- 01
Health system resilience analysis
Assessing capacity, continuity and adaptability. Resilience is easier to observe after a shock than before.
- 02
Social protection review
Comparing coverage, adequacy and scalability of programmes. Informal workers are often invisible in data.
- 03
Impact evaluation
Estimating effects of crisis measures with causal inference. Many measures were introduced simultaneously, complicating attribution.
- 04
Comparative policy analysis
Learning from different national responses with policy and institutional science. Context shapes what transfers.
How health and social policy is governed: instruments, mandates and commitments.
The instruments, mandates, actors and accountability arrangements a policymaker, diplomat or development agency works with, citing the agreements that set them. Structures follow the frameworks named. Any state or progress drawn is illustrative, not a record.
Policy instrument matrix
The kinds of instrument available on health and social policy, by level of government and cooperation.
| Instrument type | Local | National | Regional | Global |
|---|---|---|---|---|
| Regulatory | Zoning, building codes | Laws, standards, licensing | Harmonised rules | Conventions and treaties |
| Economic | Local levies, grants | Budget lines, taxes, insurance schemes | Risk pools, regional funds | Financing mechanisms |
| Information | Local warnings | Disclosure, early warning, statistics | Data sharing arrangements | Global monitoring and reporting |
| Institutional | Local committees | Lead agencies, coordination councils | Regional bodies and secretariats | Multilateral mandates |
| Cooperative | Community agreements | Partnership compacts | Memoranda and joint programmes | Agreements and joint commitments |
How it is studied, and what the methods cannot say.
- 01Causal inference and impact evaluationStaggered adoption of a reform · Eligibility thresholds in programmesApplied here
- 02Policy, institutional and decision scienceMandate mapping for a cross-sector risk · Review of regulatory impact assessmentsApplied here
- 03Decision analysis under uncertaintyOption appraisal for a policy instrument · Adaptive pathways for public planningApplied here
- 04Game theory and mechanism designStability of a transboundary agreement · Design of a regional risk poolApplied here
Questions and answers.
Why do capacity scores and outcomes diverge?
What makes social protection shock responsive?
Does Policy Nexus provide health advice?
What is shock-responsive social protection?
Why does trust matter for health policy?
Does GRF evaluate national health responses?
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