Resilience of Health Systems: Understanding Uncertainty Uses, Intersecting Crises and Cross-level Interactions; 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

Authors

1 Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany

2 Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany

3 Section for Health Equity Studies & Migration, University Hospital Heidelberg, Heidelberg, Germany

4 Faculty of Educational Science, Bielefeld University, Bielefeld, Germany

5 Research Institute Social Cohesion (FGZ/RISC), Bielefeld, Germany

6 Working Unit Clinical Developmental Psychopathology, Faculty for Psychology and Sport Sciences, Bielefeld University, Bielefeld, Germany

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has created opportunities to study resilience in multiple, interrelated societal systems while considering the institutional, community and individual level. We aim to discuss critical, yet underrepresented, issues in resilience discourses which are fundamental to advance theories, concepts and measurement of health system resilience. These relate to a better understanding of (i) how government’s handle and use uncertainties to facilitate or impede change, including the role of negotiation and conflicts, (ii) the intersections of health with multiple, co-occurring crises (systemic intersections), and (iii) cross-level interactions, ie, the interrelation between individual-level resilience, the collective resilience of groups and communities, and the resilience of a system as a whole (and vice versa). Analyses of these aspects can help to “contextualize” our understanding of resilience in complex adaptive systems. However, conceptual clarity is needed whether resilience is considered an underlying feature, outcome, or intermediate determinant of a (health) system’s performance.

Keywords

Main Subjects

References

  1. Holling CS. Resilience and stability of ecological systems. Annu Rev Ecol Syst. 1973;4(1):1-23. doi:1146/annurev.es.04.110173.000245
  2. Gunderson LH, Holling CS. Panarchy: Understanding Transformations in Human and Natural Systems. Island Press; 2002.
  3. Hill PS. Understanding global health governance as a complex adaptive system. Glob Public Health. 2011;6(6):593-605. doi:1080/17441691003762108
  4. Biddle L, Wahedi K, Bozorgmehr K. Health system resilience: a literature review of empirical research. Health Policy Plan. 2020;35(8):1084-1109. doi:1093/heapol/czaa032
  5. Foroughi Z, Ebrahimi P, Aryankhesal A, Maleki M, Yazdani S. Toward a theory-led meta-framework for implementing health system resilience analysis studies: a systematic review and critical interpretive synthesis. BMC Public Health. 2022;22(1):287. doi:1186/s12889-022-12496-3
  6. Elcheroth G, Drury J. Collective resilience in times of crisis: lessons from the literature for socially effective responses to the pandemic. Br J Soc Psychol. 2020;59(3):703-713. doi:1111/bjso.12403
  7. Nimako K, Kruk ME. Seizing the moment to rethink health systems. Lancet Glob Health. 2021;9(12):e1758-e1762. doi:1016/s2214-109x(21)00356-9
  8. 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(6):964-980. doi:1038/s41591-021-01381-y
  9. World Health Organization (WHO). Everybody's Business: Strengthening Health Systems to Improve Health Outcomes: WHO's Framework for Action. Geneva: WHO; 2007.
  10. Smaggus A, Long JC, Ellis LA, 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. Int J Health Policy Manag. 2021. doi:34172/ijhpm.2021.67
  11. Hollnagel E. Safety-II in Practice: Developing the Resilience Potentials. Routledge; 2017.
  12. United Nations Office for Disaster Risk Reduction (UNDRR). Global Assessment Report on Disaster Risk Reduction. Geneva: UNDRR; 2015.
  13. Horton R. Offline: COVID-19-a crisis of power. Lancet. 2020;396(10260):1383. doi:10.1016/s0140-6736(20)32262-5
  14. Dalglish SL. COVID-19 gives the lie to global health expertise. Lancet. 2020;395(10231):1189. doi:1016/s0140-6736(20)30739-x
  15. Haider N, Yavlinsky A, Chang YM, et al. The Global Health Security index and Joint External Evaluation score for health preparedness are not correlated with countries' COVID-19 detection response time and mortality outcome. Epidemiol Infect. 2020;148:e210. doi:1017/s0950268820002046
  16. Blanchet K, Nam SL, Ramalingam B, Pozo-Martin F. Governance and capacity to manage resilience of health systems: towards a new conceptual framework. Int J Health Policy Manag. 2017;6(8):431-435. doi:15171/ijhpm.2017.36
  17. Bennett N, Lemoine GJ. What a difference a word makes: understanding threats to performance in a VUCA world. Bus Horiz. 2014;57(3):311-317. doi:1016/j.bushor.2014.01.001
  18. Bayerlein M, Boese VA, Gates S, Kamin K, Murshed SM. Populism and COVID-19: How Populist Governments (Mis) Handle the Pandemic. V-Dem Working Paper. 2021;121. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3849284.
  19. Petersen MB, Christiansen LE, Bor A, et al. Communicate hope to motivate the public during the COVID-19 pandemic. Sci Rep. 2022;12(1):2502. doi:1038/s41598-022-06316-2
  20. Capano G, Howlett M, Jarvis DSL, Ramesh M, Goyal N. Mobilizing policy (in) capacity to fight COVID-19: understanding variations in state responses. Policy Soc. 2020;39(3):285-308. doi:1080/14494035.2020.1787628
  21. Bozorgmehr K, Saint V, Kaasch A, Stuckler D, Kentikelenis A. COVID and the convergence of three crises in Europe. Lancet Public Health. 2020;5(5):e247-e248. doi:1016/s2468-2667(20)30078-5
  22. Blanchet K, Diaconu K, Witter S. Understanding the resilience of health systems. In: Bozorgmehr K, Roberts B, Razum O, Biddle L, eds. Health Policy and Systems Responses to Forced Migration. Cham: Springer International Publishing; 2020. p. 99-117. doi:1007/978-3-030-33812-1_6
  23. Bozorgmehr K, Biddle L, Razum O. Das Jahr 2015 und die Reaktion des Gesundheitssystems: Bilanz aus einer Resilienzperspektive. In: Spallek J, Zeeb H, eds. Handbuch Migration und Gesundheit. Bern: Hogrefe; 2021: 243-256.
  24. The Lancet. Ukraine's humanitarian disaster: priorities for health. Lancet. 2022;399(10329):1023. doi:1016/s0140-6736(22)00472-x
  25. Berkes F. Understanding uncertainty and reducing vulnerability: lessons from resilience thinking. Nat Hazards. 2007;41(2):283-295. doi:1007/s11069-006-9036-7
  26. Devi S. COVID-19 exacerbates violence against health workers. Lancet. 2020;396(10252):658. doi:1016/s0140-6736(20)31858-4
  27. Ezell JM. The medicalization of freedom: how anti-science movements use the language of personal liberty and how we can address it. Nat Med. 2022;28(2):219. doi:1038/s41591-021-01640-y
  28. Gilson L, Barasa E, Nxumalo N, et al. Everyday resilience in district health systems: emerging insights from the front lines in Kenya and South Africa. BMJ Glob Health. 2017;2(2):e000224. doi:1136/bmjgh-2016-000224
  29. Bronfenbrenner U, Morris PA. The bioecological model of human development. In: Handbook of Child Psychology. Vol 1. John Wiley & Sons; 2007.
International Journal of Health Policy and Management
Volume 11, Issue 9
September 2022
Pages 1956-1959

Files

History

  • Receive Date: 23 March 2022
  • Revise Date: 20 May 2022
  • Accept Date: 23 May 2022
  • First Publish Date: 24 May 2022

Share

How to cite

Statistics