ArticleBMJ open2022
'We have a plan for that': a qualitative study of health system resilience through the perspective of health workers managing antenatal and childbirth services during floods in Cambodia.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- Exploring Determinants of Community Flood Resilience in Southeast Asia: A Systematic Review.International journal of environmental research and public health · 2026Pooled it
- Responder perspectives on preparedness for healthcare needs of vulnerable populations during floods and heatwaves: a qualitative study in Emilia-Romagna, Italy.BMJ public health · 2025Article
- Favorable strategies and barriers to the attainment of resilience in healthcare systems: scoping review.Cadernos de saude publica · 2025Article
- A community-based ambulance model: lessons for emergency medical services and everyday health systems resilience from South Africa.Health policy and planning · 2024Article
- Paediatric mass casualty response through the lens of Functional Resonance Analytical Methodology- lessons learned.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Extreme weather events and maternal health in low-income and middle-income countries: a scoping review.BMJ open · 2024Article
- Staying afloat: community perspectives on health system resilience in the management of pregnancy and childbirth care during floods in Cambodia.BMJ global health · 2020Article
- Rapid review of the impacts of climate change on the health system workforce and implications for action.The journal of climate change and healthReview
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveHealth system resilience can increase a system's ability to deal with shocks like floods. Studying health systems that currently exhibit the capacity for resilience when shocked could enhance our understanding about what generates and influences resilience. This study aimed to generate empirical knowledge on health system resilience by exploring how public antenatal and childbirth health services in Cambodia have absorbed, adapted or transformed in response to seasonal and occasional floods.
designA qualitative study using semi-structured interviews and thematic analysis and informed by the Dimensions of Resilience Governance framework.
settingPublic sector healthcare facilities and health departments in two districts exposed to flooding.
participantsTwenty-three public sector health professionals with experience providing or managing antenatal and birth services during recent flooding.
resultsThe theme 'Collaboration across the system creates adaptability in the response' reflects how collaboration and social relationships among providers, staff and the community have delineated boundaries for actions and decisions for services during floods. Floods were perceived as having a modest impact on health services. Knowing the boundaries on decision-making and having preparation and response plans let staff prepare and respond in a flexible yet stable way. The theme was derived from ideas of (1) seasonal floods as a minor strain on the system compared with persistent, system-wide organisational stresses the system already experiences, (2) the ability of the health services to adjust and adapt flood plans, (3) a shared purpose and working process during floods, (4) engagement at the local level to fulfil a professional duty to the community, and (5) creating relationships between health system levels and the community to enable flood response.
conclusionThe capacity to absorb and adapt to floods was seen among the public sector services. Strategies that enhance stability and flexibility may foster the capacity for health system resilience.
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Registered trials
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