A health systems resilience research agenda: moving from concept to practice

Dell D Saulnier¹, Karl Blanchet², Carmelita Canila³, Daniel Cobos Muñoz^{4

5}, Livia Dal Zennaro⁶, Don de Savigny^{4

5}, Kara N Durski^{7

8}, Fernando Garcia³, Pauline Yongeun Grimm⁴, Aku Kwamie⁹, Daniel Maceira^{10

11}, Robert Marten⁶, Isabelle Peytremann-Bridevaux¹², Camille Poroes¹², Valery Ridde¹³, Laurence Seematter¹², Barbara Stern¹¹, Patricia Suarez¹¹, Gina Teddy¹⁴, Didier Wernli¹⁵, Kaspar Wyss^{4

5}, Fabrizio Tediosi^{16

5}

Affiliations

¹ Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
² Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva and Graduate Institute of International and Development Studies, Geneva, Switzerland.
³ Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines.
⁴ Swiss Tropical and Public Health Institute, Basel, Switzerland.
⁵ University of Basel, Basel, Switzerland.
⁶ Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.
⁷ World Health Organization, Geneva, Switzerland.
⁸ Center for Emerging Infectious Diseases Policy and Research, Boston University, Boston, Massachusetts, USA.
⁹ Alliance For Health Policy and System Research, Geneva, Switzerland.
¹⁰ Department of Economics, University of Buenos Aires, Buenos Aires, Argentina.
¹¹ Center for the Study of State and Society (CEDES), Buenos Aires, Argentina.
¹² Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
¹³ CEPED, Institute for Research on Sustainable Development, IRD-Université de Paris, ERL INSERM SAGESUD, Paris, France.
¹⁴ Centre for Health Systems and Policy Research, Ghana Institute of Management and Public Administration, Accra, Ghana.
¹⁵ Global Studies Institute, University of Geneva, Geneva, Switzerland.
¹⁶ Swiss Tropical and Public Health Institute, Basel, Switzerland fabrizio.tediosi@unibas.ch.

PMID: 34353820
PMCID: PMC8344286
DOI: 10.1136/bmjgh-2021-006779

Review

A health systems resilience research agenda: moving from concept to practice

Dell D Saulnier et al. BMJ Glob Health. 2021 Aug.

. 2021 Aug;6(8):e006779.

doi: 10.1136/bmjgh-2021-006779.

Authors

Affiliations

¹ Department of Global Public Health, Karolinska Institute, Stockholm, Sweden.
² Geneva Centre of Humanitarian Studies, Faculty of Medicine, University of Geneva and Graduate Institute of International and Development Studies, Geneva, Switzerland.
³ Department of Health Policy and Administration, University of the Philippines Manila, Manila, Philippines.
⁴ Swiss Tropical and Public Health Institute, Basel, Switzerland.
⁵ University of Basel, Basel, Switzerland.
⁶ Alliance for Health Policy and Systems Research, World Health Organization, Geneva, Switzerland.
⁷ World Health Organization, Geneva, Switzerland.
⁸ Center for Emerging Infectious Diseases Policy and Research, Boston University, Boston, Massachusetts, USA.
⁹ Alliance For Health Policy and System Research, Geneva, Switzerland.
¹⁰ Department of Economics, University of Buenos Aires, Buenos Aires, Argentina.
¹¹ Center for the Study of State and Society (CEDES), Buenos Aires, Argentina.
¹² Unisanté, Center for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland.
¹³ CEPED, Institute for Research on Sustainable Development, IRD-Université de Paris, ERL INSERM SAGESUD, Paris, France.
¹⁴ Centre for Health Systems and Policy Research, Ghana Institute of Management and Public Administration, Accra, Ghana.
¹⁵ Global Studies Institute, University of Geneva, Geneva, Switzerland.
¹⁶ Swiss Tropical and Public Health Institute, Basel, Switzerland fabrizio.tediosi@unibas.ch.

PMID: 34353820
PMCID: PMC8344286
DOI: 10.1136/bmjgh-2021-006779

Abstract

Health system resilience, known as the ability for health systems to absorb, adapt or transform to maintain essential functions when stressed or shocked, has quickly gained popularity following shocks like COVID-19. The concept is relatively new in health policy and systems research and the existing research remains mostly theoretical. Research to date has viewed resilience as an outcome that can be measured through performance outcomes, as an ability of complex adaptive systems that is derived from dynamic behaviour and interactions, or as both. However, there is little congruence on the theory and the existing frameworks have not been widely used, which as diluted the research applications for health system resilience. A global group of health system researchers were convened in March 2021 to discuss and identify priorities for health system resilience research and implementation based on lessons from COVID-19 and other health emergencies. Five research priority areas were identified: (1) measuring and managing systems dynamic performance, (2) the linkages between societal resilience and health system resilience, (3) the effect of governance on the capacity for resilience, (4) creating legitimacy and (5) the influence of the private sector on health system resilience. A key to filling these research gaps will be longitudinal and comparative case studies that use cocreation and coproduction approaches that go beyond researchers to include policy-makers, practitioners and the public.

Keywords: health policies and all other topics; health policy; health systems.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

References

1. Kruk ME, Myers M, Varpilah ST, et al. . What is a resilient health system? Lessons from Ebola. Lancet 2015;385:1910–2. 10.1016/S0140-6736(15)60755-3 - DOI - PubMed
1. Bene C, Wood RG, Newsham A. IDS Working Paper 405. Resilience: New Utopia or New Tyranny? Reflection about the potentials and limits of the concept of resilience in relation to vulnerability reduction programmes. Institute of Development Studies, 2012.
1. Blanchet K, Nam SL, Ramalingam B, et al. . Governance and capacity to manage resilience of health systems: Towards a new conceptual framework. Int J Health Policy Manag 2017;6:431–5. 10.15171/ijhpm.2017.36 - DOI - PMC - PubMed
1. Ridde V, Gautier L, Dagenais C, et al. . Learning from public health and hospital resilience to the SARS-CoV-2 pandemic: protocol for a multiple case study (Brazil, Canada, China, France, Japan, and Mali). Health Res Policy Syst 2021;19:76. 10.1186/s12961-021-00707-z - DOI - PMC - PubMed
1. Haldane V, De Foo C, Abdalla SM, et al. . Health systems resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nat Med 2021;27:964–80. 10.1038/s41591-021-01381-y - DOI - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

001/WHO_/World Health Organization/International

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Health Information

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

A health systems resilience research agenda: moving from concept to practice

Affiliations

A health systems resilience research agenda: moving from concept to practice

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical