HEALTH SYSTEM RESILIENCE: CONCEPT DEVELOPMENT

Abstract

In the past five-ten years, the international health systems agenda has a noticeable new emphasis, that on resilience. The topic of resilience has gained significant attention among policymakers, international organisations and health system researchers, the 2008 global economic crisis and the Zica and Ebola outbreaks catalysing this effect. It is already considered an essential aspect of health system performance and strengthening. Much of the knowledge in resilience is informed by insights from other fields that have embraced it as a research topic. Having originated as a construct in mechanical engineering and psychology, the resilience approach has been borrowed comparatively more recently by a variety of other fields. The aim of the current study is to explore the concept development on a broader level that goes beyond the health care sector. A comprehensive literature review was carried out in April-May 2019. Searches for peer-reviewed articles were conducted in the databases Scopus, PubMed, ScienceDirect, and WHO library. An additional grey literature search was conducted with a focus on publications by international, non-governmental organisations and think tanks. Among the plethora of fields approaching the concept, three strands stand out as underlying the more recent health systems resilient thought – ecological and social-ecological systems, climate change and disasters and organisational theory. The study traces the development of the concept of resilience in these different ‘schools’ and its impact on health systems resilience theory.

Keywords

• resilience
• disasters
• climate change
• ecological systems
• social-ecological systems
• organisational theory