Building Resilience: The Key to Health Systems Preparedness

by Jon Scaccia October 16, 2024

In a world increasingly threatened by natural disasters, pandemics, and other crises, health systems face unprecedented challenges. But with every challenge comes an opportunity—an opportunity to build resilience. The COVID-19 pandemic put health systems to the test, revealing gaps in preparedness and response across the globe. Now more than ever, the focus is on resilience: how health systems can not only withstand but adapt to and recover from shocks while continuing to provide essential care.

In a study published in PLOS Global Public Health, researchers sought to understand how health systems’ resilience has been assessed over the past decade and what frameworks exist to guide future improvements. They focused on frameworks developed between 2014 and 2021, examining how these models can be used to measure resilience and what elements are crucial for a health system to thrive under pressure. Through a review of literature and interviews with experts worldwide, they identified key strategies to bolster resilience in health systems, from governance and leadership to financing and workforce development.

Why Resilience Matters

When we think of health systems, we often imagine hospitals, clinics, and healthcare professionals providing care during normal times. But what happens when a disaster strikes? A resilient health system isn’t just about responding to immediate crises—it’s about being prepared for the next one, whether it’s a pandemic, a natural disaster, or a man-made catastrophe. Resilience means having the ability to absorb shocks, adapt, and continue functioning in the face of disruptions.

The Ebola outbreak in West Africa in 2014 was one of the first major wake-up calls, showing how unprepared many health systems were to handle a widespread epidemic. The outbreak overwhelmed already fragile health systems, revealing weaknesses in disease surveillance, contact tracing, and global collaboration. Fast forward to 2020, and COVID-19 exposed similar gaps, even in countries with robust health infrastructure. Health systems struggled to keep up with the surge of patients, shortages of medical supplies, and disruptions to routine care.

This study illuminates how health systems can avoid repeating the same mistakes by adopting resilience frameworks that focus on strengthening every aspect of the system, from leadership to the supply chain.

What the Research Reveals

The researchers reviewed six resilience frameworks that applied to health systems at multiple levels—from local clinics to national and international scales. These frameworks weren’t just about medical care; they also considered factors like disaster management, city-specific resilience, and even e-resilience, which deals with the role of technology during crises.

For instance, one framework by the Rockefeller Foundation emphasized city resilience, highlighting the importance of public health systems alongside emergency response and quality healthcare. Another focus is on disaster risk reduction and how health systems can mitigate the impact of future disasters through better preparedness.

However, the study didn’t stop at reviewing existing frameworks. It also included interviews with experts from seven different countries who offered firsthand insights into what it takes to build a resilient health system. Their experiences underscored the importance of collaboration—between countries, sectors, and the public and private spheres. One expert noted the critical role the private sector played during the COVID-19 pandemic, helping to ensure that essential services continued despite overwhelming demand.

Leadership and Governance: The Foundation of Resilience

One of the recurring themes in the study was the importance of leadership and governance in building resilient health systems. Effective leadership isn’t just about making decisions during a crisis—it’s about fostering a culture of transparency, accountability, and forward-thinking. Countries that demonstrated strong governance structures during the pandemic were able to coordinate responses more effectively, ensuring that resources were distributed where they were needed most.

Governance also plays a role in fostering collaboration between countries. The experts interviewed for this study emphasized the need for a global agenda for health systems resilience, one that encourages knowledge-sharing and resource allocation across borders. COVID-19 was a stark reminder that pandemics don’t respect national boundaries, and neither should our preparedness strategies.

Financing: Ensuring Sustainability in Times of Crisis

Another crucial element of resilience is financing. As the study revealed, many health systems, particularly in low- and middle-income countries, struggle with limited resources, making it difficult to scale up services during emergencies. Financial resilience means more than just having enough money to keep the lights on during a crisis—it’s about having flexible funds that can be quickly redirected to areas of need.

For example, during the COVID-19 pandemic, some countries were able to repurpose existing funds to ramp up vaccine distribution, while others scrambled to secure emergency financing. The study suggests that countries need to establish financial safety nets, such as public health emergency funds, to ensure that they can respond quickly and effectively to future crises.

A Skilled Workforce: The Backbone of Health System Resilience

No health system can function without a skilled and dedicated workforce. The study highlighted the importance of training healthcare workers not just in clinical care but also in emergency response. One expert noted that even non-medical personnel, such as administrative staff, should be trained in disaster preparedness protocols. This ensures that everyone in the health system is ready to respond when a crisis hits.

Workforce resilience also means addressing issues like burnout, which became a major concern during the COVID-19 pandemic. Ensuring that healthcare workers have the support they need, both during and after a crisis, is essential for maintaining a functioning health system.

Join the Conversation

What do you think is the most important aspect of health system resilience? Have you seen any examples of resilience in your local health system that you’d like to share? Join the conversation in the comments below or on social media—we’d love to hear your thoughts!

Conclusion: Preparing for the Next Crisis

As the world continues to face new and evolving threats, building resilient health systems is no longer a luxury—it’s a necessity. The frameworks reviewed in this study offer valuable insights into what makes a health system resilient, but they also highlight areas for improvement. Moving forward, health systems must prioritize collaboration, leadership, and financial sustainability to ensure that they can withstand the shocks of the future.

Resilience isn’t just about surviving the next crisis—it’s about thriving in the face of adversity. By investing in strong governance, sustainable financing, and a well-trained workforce, we can build health systems that are not only prepared for the worst but capable of delivering the best care, no matter the circumstances.

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