Re-evaluating the Conceptual Framework of Health System Resilience: Insights From Economic Sanctions; Comment on “Re-evaluating Our Knowledge of Health System Resilience During COVID-19: Lessons From the First Two Years of the Pandemic”

Document Type : Commentary

Authors

1 Knowledge Utilization Research Center, University Research and Development Center, Tehran University of Medical Sciences, Tehran, Iran

2 Interdisciplinary Research and Practice Division, School of Health and Social Care, University of Essex, Colchester, UK

Abstract

Health system resilience in the context of economic sanctions (ES) is an underexplored area. We used data from recent studies on the impact of ES on the health systems to cross-reference and assess the applicability of the conceptual framework of health system resilience (CFHSR). Reviewing the interventions implemented under ES and aligning them with the CFHSR and COVID-19 responses, we found that the CFHSR domains encompass most strategies from the ES and COVID-19 studies. However, CFHSR does not cover several strategies related to equity and teamwork. Additionally, monitoring the consequences is missing from the experiences of COVID-19 and ES. The CFHSR appears to be reasonably effective in categorizing strategies for both COVID-19 and ES. Nonetheless, its domains can be further refined. Specifically, incorporating an intersectional equity lens could enhance this conceptual framework. The next step is to develop a practical guide to apply CFHSR to strengthen health system resilience. 

Keywords

References

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History

  • Received Date: 10 July 2024
  • Revised Date: 29 April 2025
  • Accepted Date: 07 May 2025
  • First Published Date: 12 May 2025

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