Discover the Blueprint for Health System Resilience in an Unpredictable World!
The recent Ebola Virus Disease (EVD) outbreak in West Africa, alongside the European financial crisis, climate change disasters, and the refugee crisis, have starkly highlighted a critical need: health systems must be not just stronger, but profoundly more ‘resilient’ in the face of acute and chronic shocks. The ability to adapt and respond effectively to these unforeseen challenges is identified as a key feature of resilience.
A groundbreaking article by Johanna Hanefeld and colleagues, “Towards an understanding of resilience: responding to health systems shocks,” delves into how health systems behave during such crises, drawing vital lessons from a comparative analysis of these four distinct contemporary shocks. The research presents a pragmatic and insightful framework to enhance health system resilience, crucial for policymakers and practitioners alike.
The article introduces a ‘3 plus 2’ framework of critical dimensions that are particularly relevant to a health system’s ability to adapt and respond successfully to shocks. These include:
- Three Core Health System Functions:
- Health Management Information Systems (HMIS): Essential for having the necessary information and knowledge to make timely decisions during a crisis, though current systems often fall short in integrating diverse data or forecasting long-term impacts.
- Funding/Financing Mechanisms: The nature and predictability of funding are core to a system’s ability to withstand shocks. Adequate public funding, built-in stabilizers, and appropriate management of international aid are critical to prevent exacerbated negative impacts and ensure staff motivation.
- Health Workforce: Frontline health workers are pivotal first responders, yet they are often the most vulnerable. Effective responses require their development, appropriate training, cross-sector collaboration, and sustained support beyond the emergency phase.
- Two Cross-Cutting Aspects:
- Governance: A fundamental function influencing all other system dimensions, yet often overlooked during crises. Effective governance requires both top-down and bottom-up approaches, fostering coordination and integration within and beyond the health sector.
- Values: These deeply shape the response to shocks and how it is experienced at individual and community levels. Societal, political, and personal values, including trust, compassion, and the prioritization of health, significantly influence decision-making and the effectiveness of interventions.
The authors emphasize that integration within the health system and connecting with local communities are key contributors to resilience. While inequalities often grow during shocks, the article highlights that government action plays a critical role in mitigating these impacts. Learning from past shocks offers invaluable insights, but context remains paramount, as each crisis is unique.
This comprehensive analysis provides a vital new approach to understanding and building health systems resilience, paving the way for more effective and adaptive responses to future shocks.
Reference for this article:
Hanefeld, J., Mayhew, S., Legido-Quigley, H., Martineau, F., Karanikolos, M., Blanchet, K., Liverani, M., Mokuwa, E. Y., McKay, G., & Balabanova, D. (2018). Towards an understanding of resilience: responding to health systems shocks. Health Policy and Planning, 33, 355–367. https://doi.org/10.1093/heapol/czx183
