Articulating Concepts Matters! Resilient Actions in the Norwegian Governmental Response to the COVID-19 Pandemic; Comment on "Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada"

Document Type : Commentary


Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Stavanger, Norway


The COVID-19 pandemic has challenged our healthcare systems and required collaboration from both centralized and decentralized system levels to adapt to the changes and challenges. This commentary offers a look into the Norwegian governmental healthcare system and response within a resilience in healthcare perspective, by analyzing the situated, structural, and systemic resilience. Such a conceptualization of resilience into three scales of organizational activity may assist our efforts to understand and explain governmental actions throughout the pandemic. Research application of resilience in healthcare to explain and discuss government actions during the COVID-19 pandemic, needs to ensure sensitivity to the overall structural, cultural, and human factor aspects of the relevant healthcare system under scrutiny as well as sensitivity to specific context within the various system levels.


  1. Wiig, S. & O’Hara, J. Resilient and responsive healthcare services and systems: challenges and opportunities in a changing world. BMC Health Services Research (2021) 21:1037
  2. Hollnagel, E. Safety-II in Practice. Developing the Resilience Potentials. Routledge; 2018.
  3. Smaggus, A., Long, J., Ellis, L., Clay-Williams, R., Braithwaite, J. Government Actions and Their Relation to Resilience in Healthcare During the COVID-19 Pandemic in New South Wales, Australia and Ontario, Canada. International Journal of Health Policy and Management, 2021; (): -. doi: 10.34172/ijhpm.2021.67
  4. The Coronavirus Commission. NOU 2021:6. In Norwegian: Myndighetenes håndtering av koronapandemien — Rapport fra Koronakommisjonen. In English: “The authorities´ handling of the COVID-19 pandemic”.
  5. Ministry of Health and Care Services. In Norwegian: Tildelings- og oppdragsbrev fra Helse- og omsorgsdepartementet. In English: Assignment letter from the Ministry of Health and Care Services. Oslo; 2021.
  6. Ministry of Health and Care Services. In Norwegian: Lov 15. juni 2001 nr. 93 om helseforetak m.m. (helseforetaksloven). In English: Act of 15 June 2001 nr. 93 relating to Health Trusts.
  7. Ministry of Health and Care Services. In Norwegian: Nasjonal Helseberedskapsplan. In English: The National Healthcare Contingency Plan. Oslo; 2018.
  8. Ese, J., Bjørkquist, C., Fineide, M., J. et al. En gjennomgang av hvordan statsforvalterne i Norge håndterte innføring av omfattende nasjonale smitteverntiltak som følge av covid-19 pandemien våren 2020. Høgskolen i Østfold Oppdragsrapport 2021:2.
  9. Ministry of Health and Care Services. St. 11 (2020-2021). In Norwegian Kvalitet og pasientsikkerhet 2019. In English: “Quality and patient safety 2019”.
  10. Wiig, S., Aase, K., Billett, S., Canfield, C., Røise, O., Njå, O., Guise, V., Haraldseid-Driftland, C., Ree, E., Anderson, J. E., & Macrae, C.  Defining the boundaries and operational concepts of resilience in the resilience in healthcare research program. BMC Health Services Research, 2020; 20, 330.
  11. Macrae, C. Moments of Resilience: Time, Space and the Organisation of Safety in Complex Sociotechnical Systems. In Wiig, S. & Falbruch, B. editors. Exploring Resilience. A scientific Journey from Practice to Theory. Springer Open; 2019.
  12. Lyng HB, Ree E, Wibe T, Wiig S. Healthcare leaders' use of innovative solutions to ensure resilience in healthcare during the Covid-19 pandemic: a qualitative study in Norwegian nursing homes and home care services. BMC Health Serv Res. 2021 Aug 27;21(1):878. doi: 10.1186/s12913-021-06923-1. PMID: 34446000; PMCID: PMC8390181.
  13. Riess H. Institutional Resilience: The Foundation for Individual Resilience, Especially During COVID-19. Global Advances in Health and Medicine. January 2021. doi:1177/21649561211006728
  14. OECD, 2021. The territorial impact of COVID-19: Managing the crisis across levels of government.

Articles in Press, Accepted Manuscript
Available Online from 12 January 2022
  • Receive Date: 26 October 2021
  • Revise Date: 08 January 2022
  • Accept Date: 11 January 2022