head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2020, vol. 26, issue3
Subject Area: Medicine
DOI: 10.5272/jimab.2020263.3251
Published online: 29 July 2020

Review articles

J of IMAB. 2020 Jul-Sep;26(3):3251-3258
Stefka KoevaORCID logo, Maria RohovaORCID logo Corresponding Autoremail,
Department of Health Economics and Management, Faculty of Public Health, Medical University-Varna, Bulgaria.

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,

pdf - Download FULL TEXT /PDF 522 KB/
Please cite this article as: Koeva S, Rohova M. Health System Resilience: Concept Development. J of IMAB. 2020 Jul-Sep;26(3):3251-3258. DOI: 10.5272/jimab.2020263.3251

Corresponding AutorCorrespondence to: Maria Rohova, Department of Health Economics and Management, Faculty of Public Health, Medical University – Varna; 55, Marin Drinov Str., Varna, Bulgaria; E-mail: mariarohova@abv.bg

1. Kruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. Lancet. 2015 May 9;385(9980):1910-2. [PubMed] [Crossref]
2. Kieny MP, Dovlo D. Beyond Ebola: a new agenda for resilient health systems. Lancet. 2015 Jan 10;385(9963):91-2. [PubMed] [Crossref]
3. Ager AK, Lembani M, Mohamme A, Ashir GM, Abdulwaha A, de Pinho H, et al. Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building. Confl Health. 2015 Oct 5;9:30. [PubMed] [Crossref]
4. Ammar W, Kdouh O, Hammoud R, Hamadeh R, Harb H, Ammar Z, et al. Health system resilience: Lebanon and the Syrian refugee crisis. J Glob Health. 2016 Dec;6(2):020704. [PubMed] [Crossref]
5. Ozawa S, Paina L, Qiu M. Exploring Pathways for Building Trust in Vaccination and Strengthening Health System Resilience. BMC Health Serv Res. 2016 Nov 15;16(Suppl 7):639. [PubMed] [Crossref]
6. Witter S, Pavignani E. Review of Global Fund investments in resilient and sustainable systems for health in challenging operating environments. Report for Global Fund for AIDS, Tuberculosis and Malaria. Geneva; 2016. [Crossref]
7. 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 Aug 1;6(8):431-35. [PubMed] [Crossref]
8. Lovell E, Bahadur A, Tanner T, Morsi H. Resilience: the big picture − top themes and trends. London: Overseas Development Institute; 2015. [Internet]
9. Woods DD, Wreathall J. Stress-strain plots as a basis for modelling organizational resilience. In: Hollnagel E, Nemeth C, Dekker S (Eds.). Resilience engineering: remaining open to the possibility of failure. Ashgate studies in resilience engineering. Aldershot, UK: Ashgate Publishing; 2008, pp 145-161.
10. American Psychological Association. The road to resilience. Washington DC: American Psychological Association; 2014.
11. Graber R, Pichon F, Carabine E (Eds.). Psychological resilience. State of knowledge and future research agendas. Working Paper 425. London: Overseas Development Institute; 2015. [Internet]
12. Cicchetti D. Resilience under conditions of extreme stress: a multilevel perspective. World Psychiatry. 2010 Oct;9(3):145-54. [PubMed] [Crossref]
13. Panter-Brick C, Leckman JF. Editorial commentary: Resilience in child development – interconnected pathways to wellbeing. J Child Psychol Psychiatry. 2013 Apr;54(4):333-6. [PubMed] [Crossref]
14. Southwick SM, Bonanno GA, Masten AS, Panter-Brick C, Yehuda R. Resilience definitions, theory, and challenges: Interdisciplinary perspectives. Eur J Psychotraumatol. 2014 Oct 1;5. [PubMed] [Crossref]
15. Holling CS. Resilience and stability of ecological systems. Ann Rev Ecol Syst. 1973 Nov;4:1-23. [Crossref]
16. Holling CS. Engineering resilience versus ecological resilience. In: Schulze PE (Ed.). Engineering within ecological constraints. Washington DC: National Academy Press; 1996, pp. 31-43.
17. Gunderson LH. Ecological resilience – in theory and application. Ann Rev Ecol Syst. 2000 Nov;31:425-39. [Crossref]
18. Walker B, Holling CS, Carpenter SR, Kinzig A. Resilience, adaptability and transformability in social-ecological systems. Ecol Soc. 2004;9(2):5. [Internet]
19. Carpenter S, Walker B, Anderies JM, Abel N. From metaphor to measurement: resilience of what to what? Ecosystems. 2001;4:765-81. [Crossref]
20. Folke C. Resilience: the emergence of a perspective for social-ecological systems analyses. Glob Environ Chang. 2006 Aug;16(3):253-67. [Crossref]
21. Resilience Alliance. Key concepts: Resilience. 2019. [Internet].
22. Norris FH, Stevens SP, Pfefferbaum B, Wyche KF, Pfefferbaum RL. Community resilience as a metaphor, theory, set of capacities, and strategy for disaster readiness. Am J Community Psychol. 2008 Mar;41(1-2):127-50. [PubMed] [Crossref]
23. Carlson JL, Haffenden RA, Bassett GW, Buehring WA, Collins III MJ, Folga SM, et al. Resilience: theory and application. Technical Report. Argonne: Argonne National Lab; 2012. [Crossref]
24. Longstaff PH, Armstrong NJ, Perrin K, Parker WM, Hidek MA. Building resilient communities: a preliminary framework for assessment. Homel Sec Aff. 2010 Sep;6(3):6. [Internet]
25. United Nations International Strategy for Disaster Reduction/ UNISDR. Terminology: basic terms of disaster risk reduction. Geneva: United Nations Office for Disaster Risk Reduction; 2009. [Internet]
26. Gilbert SW. Disaster resilience: a guide to the literature. NIST Special Publication 1117. U.S. Department of Commerce, National Institute of Standards and Technology; 2010. [Internet]
27. Bruneau M, Chang SE, Eguchi RT, Lee GS, O’Rourke TD, Reinhorn AM et al. A framework to quantitatively assess and enhance the seismic resilience of communities. Earthq Spectra. 2003 Nov;19(4):733-52. [Crossref]
28. Almedom AM. Resilience research and policy/practice discourse in health, social, behavioral, and environmental sciences over the last ten years. Afr Health Sci. 2008 Dec;8 Suppl 1(Suppl 1):S5-13. [PubMed]
29. Manyena SB. The concept of resilience revisited. Disasters. 2006 Nov;30(4):433-50. [Crossref]
30. Bahadur AV, Peters K, Wilkinson E, Pichon F, Gray K, Tanner T. The 3As: tracking resilience across BRACED. Working Paper. London: Overseas Development Institutes; 2015. [Internet]
31. United Nations International Strategy for Disaster Reduction/ UNISDR. Hyogo Framework for 2005–2015: building the resilience of nations and communities to disasters. Geneva: United Nations Office for Disaster Risk Reduction; 2005. [Internet]
32. United Nations International Strategy for Disaster Reduction/ UNISDR. Sendai Framework for disaster risk reduction 2015-2030. Geneva, Switzerland: United Nations Office for Disaster Risk Reduction; 2015. [Internet]
33. Intergovernmental Panel on Climate Change/ IPCC. Managing the risks of extreme events and disasters to advance climate change adaptation. Cambridge: Cambridge University Press; 2012. [Internet]
34. Intergovernmental Panel on Climate Change/ IPCC. Glossary. In: Field CB, Barros VR, Dokken DJ, Mach KJ, Mastrandrea MD, Bilir TE, et al. (Eds.). Climate change 2014: impacts, adaptation, and vulnerability. Part A: Global and sectoral aspects contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge, UK & New York, USA: Cambridge University Press; 2014.
35. Rodin J. The resilience dividend: being strong in a world where things go wrong. New York: Public Affairs; 2014.
36. Mitchell A. Risk and resilience: from good idea to good practice. OECD Development Co-operation Working Papers No. 13, Paris: OECD Publishing; 2013. [Internet]
37. OECD. Guidelines for resilience systems analysis. OECD Publishing. 2014. [Internet]
38. WHO. Strengthening resilience: a priority shared by Health 2020 and the Sustainable Development Goals. WHO Regional Office for Europe. 2017. [Internet]
39. Almedom AM, Tumwine JK. Resilience to Disasters: A Paradigm Shift From Vulnerability to Strength. Afr Health Sci. 2008 Dec;8 Suppl 1(Suppl 1):S1-4. [PubMed]
40. Cutter SL, Barnes L, Berry M, Burton C, Evans E, Tate E, et al. A place-based model for understanding community resilience to natural disasters. Glob Environ Chang. 2008 Oct;18:598-606. [Crossref]
41. Kais SM, Islam MS. Community Capitals as Community Resilience to Climate Change: Conceptual Connections. Int J Environ Res Public Health. 2016 Dec 6;13(12):1211. [PubMed] [Crossref]
42. Dovers S, Handmer J. Uncertainty, sustainability and change. Glob Environ Chang. 1992 Dec;2(4):262-76. [Crossref]
43. Brand FS, Jax, K. Focusing the meaning(s) of resilience: resilience as a descriptive concept and a boundary object. Ecol Soc. 2007;12(1):23. [Internet]
44. Adger WN. Social and ecological resilience: are they related? Prog Hum Geogr. 2000 Sep;24(3):347-64. [Crossref]
45. Dalziell EP, McManus ST. Resilience, vulnerability, and adaptive capacity: implications for system performance. Proceedings of the International Forum for Engineering Decision Making (IFED); Stoos, Switzerland. 5-8 Dec 2004. [Internet]
46. Woods DD. Essential characteristics of resilience. In: Hollnagel E, Woods DD, Leveson N (Eds.). Resilience engineering. Concepts and precepts. Aldershot, UK: Ashgate Publishing; 2006.
47. Woods DD. Four concepts for resilience and the implications for the future of resilience engineering. Reliab Eng Syst Saf. 2015 Sep;141(C):5-9. [Crossref]
48. Vogus TJ, Sutcliffe KM. Organizational resilience: towards a theory and research agenda. Proceedings of the IEEE International Conference on Systems, Man and Cybernetics; Montréal, Canada. 7-10 Oct 2007. [Internet]
49. Fairbanks RJ, Wears R, Woods DD, Hollnagel R, Plsek P, Cook RI. Resilience and Resilience Engineering in Health Care. Jt Comm J Qual Patient Saf. 2014 Aug;40(8):376-83. [PubMed] [Crossref]
50. Haimes YY. On the definition of resilience in systems. Risk Anal. 2009 Mar;29(4):498-501. [Crossref]
51. Sutcliffe KM, Vogus TJ. Organizing for resilience. In: Cameron K, Dutton JE, Quinn RE (Eds.). Positive organizational scholarship. San Francisco: Berrett-Koehler; 2003, pp 94-110.
52. Rudolph JW, Repenning NP. Disaster dynamics: understanding the role of quantity in organizational collapse. Adm Sci Q. 2002 Mar;47(1):1-30. [Crossref]

Received: 30 August 2019
Published online: 29 July 2020

back to Online Journal