International Journal of Health Policy and Management

International Journal of Health Policy and Management

Governance and Capacity to Manage Resilience of Health Systems: Towards a New Conceptual Framework

Document Type : Perspective

Authors
Karl Blanchet 1
Sara L. Nam 2
Ben Ramalingam 3
Francisco Pozo-Martin 1
1 Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
2 Options Consultancy Services Ltd, London, UK
3 Institute of Development Studies, Brighton, UK
10.15171/ijhpm.2017.36
Abstract
The term resilience has dominated the discourse among health systems researchers since 2014 and the onset of the Ebola outbreak in West Africa. There is wide consensus that the global community has to help build more resilient health systems. But do we really know what resilience means, and do we all have the same vision of resilience? The present paper presents a new conceptual framework on governance of resilience based on systems thinking and complexity theories. In this paper, we see resilience of a health system as its capacity to absorb, adapt and transform when exposed to a shock such as a pandemic, natural disaster or armed conflict and still retain the same control over its structure and functions.
Keywords
Resilience
Health Systems
Governance
Management
Complexity
Subjects

"Watch the Video Summary"

  1. Nam SL, Blanchet K. We mustn’t forget other essential health services during the Ebola crisis. BMJ. 2014;349:g6837. doi:10.1136/bmj.g6837
  2. Kieny MP, Evans DB, Schmets G, Kadandale S. Health-system resilience: reflections on the Ebola crisis in western Africa. Bull World Health Organ. 2014;92(12):850. doi:10.2471/BLT.14.149278
  3. Cornwall A. Buzzwords and fuzzwords: deconstructing development discourse. Dev Pract. 2007;17(4-5):471-484.
  4. Scoones I. Sustainability. Dev Pract. 2007;17(4-5):589-596.
  5. Gieryn T. Cultural Boundaries of Science: Credibility on the Line. Chicago: Chicago University Press; 1999.
  6. Wilson F. Faust: the developer. CDR; 1992.
  7. Leach M, Scoones I, Stirling A. Governing epidemics in an age of complexity: Narratives, politics and pathways to sustainability. Glob Environ Change. 2010;20(3):369-377. doi:10.1016/j.gloenvcha.2009.11.008
  8. de Savigny D, Adam T. System Thinking for Health Systems Strengthening. Geneva: World Health Organisation, Alliance for Health Policy and Systems Research; 2009.
  9. Blanchet K, Palmer J, Palanchowke R, Boggs D, Jama A, Girois S. Advancing the application of systems thinking in health: analysing the contextual and social network factors influencing the use of sustainability indicators in a health system--a comparative study in Nepal and Somaliland. Health Res Policy Syst. 2014;12:46. doi:10.1186/1478-4505-12-46
  10. Plsek PE, Greenhalgh T. Complexity science: the challenge of complexity in health care. BMJ. 2001;323(7313):625-628.
  11. Lebel L, Anderies JM, Campbell B, et al. Governance and the capacity to manage resilience in regional social-ecological systems. Ecol Soc. 2006;11(1):19.
  12. Berkes F, Colding JF, Folke C. Navigating Nature’s Dynamics: Building Resilience for Complexity and Change. New York: Cambridge University Press; 2003.
  13. Ramalingam B. Aid on the Edge of Chaos. Oxford: OUP; 2013.
  14. Allen T, Starr T. Hierarchy: Perspectives for Ecological Complexity. Chicago: University of Chicago Press; 1982.
  15. O’Neill RV, Johnson AR, King AW. A hierarchical framework for the analysis of scale. Landscape Ecology. 1989;3(3-4):193-205.
  16. Wilbanks TJ, Kates RW. Global change in local places: how scale matters. Clim Change. 1999;43:601-628.
  17. Turner MG, Gardner RH, O’Neill RV. Landscape Ecology in Theory and Practice: Pattern and Process. New York: Springer; 2001.
  18. Janssen MA, Bodin Ö, Anderies JM, et al. Toward a Network Perspective of the Study of Resilience in Social-ecological Systems. Ecol Soc. 2006;11(1):15.
  19. Carpenter S, Walker B, Anderies JM, Abel N. From metaphor to measurement: resilience of what to what? Ecosystems. 2001;4:765-781.
  20. Holling CS. Understanding the complexity of economic, ecological, and social systems. Ecosystems. 2001;4:390-405.
  21. Campbell J, Cometto G, Rasanathan K, et al. Improving the resilience and workforce of health systems for women’s, children’s, and adolescents’ health. BMJ. 2015;351. doi:10.1136/bmj.h4148
  22. Thomas S, Keegan C, Barry S, Layte R, Jowett M, Normand C. A framework for assessing health system resilience in an economic crisis: Ireland as a test case. BMC Health Serv Res. 2013;13(1):450.
  23. Sabatier PA. Theories of the Policy Process. Westview Press; 2007.
  24. OCHA. Key figures: Syrian Arab Republic. http://www.unocha.org/syria.  Accessed June 12, 2015. Published 2015.
  25. Adger WN, Brown K, Fairbrass J, et al. Governance for sustainability: towards a 'thick' analysis of environmental decisionmaking. Environ Plan A. 2003;35(6):1095-1110. doi:10.1068/A35289
  26. Walker B, Carpenter S, Anderies J, et al. Resilience management in social-ecological systems: a working hypothesis for a participatory approach. Conservation Ecology. 2002;6(1):14.
  27. Walker BH, Holling CS, Carpenter SR, Kinzig AP. Resilience, Adaptability, and Transformability. Ecology and Society. 2004;9(5).
  28. Folke C, Hahn P, Olsson P, Norberg J. Adaptive giovernance of socio-ecological systems. Annu Rev Environ Resour. 2005;30:441-473.
  29. Castleden M, McKee M, Murray V, Leonardi G. Resilience thinking in health protection. J Public Health (Oxf). 2011;33(3):369-377. doi:10.1093/pubmed/fdr027
  30. Olsson P, Folke C, Hahn T. Social-ecological transformation for ecosystem management: the development of adaptive co-management of a wetland landscape in southern Sweden. Ecol Soc. 2004;9(4):2.
  31. Moon S, Sridhar D, Pate MA, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. Lancet. 2015;386(10009):2204-2221. doi:10.1016/S0140-6736(15)00946-0
  32. Kooiman J. Governance and Governability. In: Osborne S, ed. The new public governance? Emerging perspectives on the theory and practice of public governance. London: Routledge; 2010:72-86.
  33. Leach M, Bloom G, Ely A, et al. Understanding Governance: Pathways to Sustainability. Brighton: STEPS Centre; 2007.
  34. Dodgson R, Lee K. Global Health Governance: a Conceptual Review. In: Wilkinson R, Hughes S, eds. Global Governance: Critical Perspectives. London: Routledge; 2002.
  35. Fidler D. SARS, Governance and the Globalization of Disease. Basingstoke: Palgrave Macmillan; 2004.
  36. Borgatti SP, Mehra A, et al. Network Analysis in the Social Sciences. Science. 2009;323(5916):892-895.
  37. Thompson GN, Estabrooks CA, Degner LF. Clarifying the concepts in knowledge transfer: a literature review. J Adv Nurs. 2006;53(6):691-701.
  38. Burt RS. The Social Capital of Structural Holes. In: Guillen MF, Collins R, England P, Meyer M, eds. The New Economic Sociology: Developments in an Emerging Field. New York: Russell Sage Foundation; 2003:148-189.
  39. Newman L, Dale A. Network Structure, Diversity, and Proactive Resilience Building: a Response to Tompkins and Adger. Ecol Soc. 2005;10(1):2.
  40. Blanchet K, James P. The role of social networks in the governance of health systems: the case of eye care systems in Ghana. Health Policy Plan. 2013;28(2):143-156. doi:10.1093/heapol/czs031
  41. Westley F, Zimmerman B, Patton MQ. Getting to Maybe: How the World is Changed. Toronto: Random House; 2006.
  42. Gunderson LH, Holling CS. Panarchy: Understanding Transformations in Human and Natural Systems. Washington, DC: Island; 2002.
  43. MacKenzie A, Abdulwahab A, Sokpo E, Mecaskey JW. Building a Resilient Health System: Lessons From Northern Nigeria. Brighton: IDS; 2015.
  44. Midgley D. The Essential Mary Midgley. London: Routledge; 2005.
  45. Levine S, Mosel I. Supporting Resilience in Difficult Places. London: ODI; 2014.
  46. Bloom G, MacGregor H, McKenzie A, Sokpo E. Strengthening Health Systems for Resilience. Brighton: IDS; 2015.
  47. Gilson L. Editorial: building trust and value in health systems in low- and middle-income countries. Soc Sci Med. 2005;61(7):1381-1384. doi:10.1016/j.socscimed.2004.11.059
  48. Wilkinson A, Leach M. Briefing: ebola - myths, realities and structural violence. African Affairs. 2015;114;138-148.
  49. Kieny MP, Dovlo D. Beyond Ebola: a new agenda for resilient health systems. Lancet. 2015;385(9963):91-92. doi:10.1016/S0140-6736(14)62479-X
  50. UNFPA, Options. Rapid Assessment of Ebola Impact on Reproductive Health Services and Service Seeking Behaviour in Sierra Leone. Freetown, Sierra Leone: UNFPA; 2015.
  51. Delamou A, Beavogui AH, Kondé MK, van Griensven J, De Brouwere V. Ebola: better protection needed for Guinean health-care workers. Lancet. 2015;385(9967):503-504. doi:10.1016/S0140-6736(15)60193-3
  52. Yilla M, Nam SL, Adeyemo A, Kargbo SA. Using scorecards to achieve facility improvements for maternal and newborn health. Int J Gynaecol Obstet. 2014;127(1):108-112.
  53. Evidence for Action. MamaYe Evidence for Action Stories of Change: Selected Case Studies. London: E4A; 2015.
International Journal of Health Policy and Management
Volume 6, Issue 8
2017
Pages 431-435

  • Received Date 04 October 2016
  • Revised Date 10 January 2017
  • Accepted Date 13 March 2017
  • First Published Date 01 August 2017
  • Published Date 01 August 2017