ArticleInternational journal of health policy and management2024
Learning From Countries on Measuring and Defining Community-Based Resilience in Health Systems: Voices From Nepal, Sierra Leone, Liberia, and Ethiopia.
Article in International journal of health policy and management, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Spatiotemporal evolution of innovation collaboration networks in China's AI medical device industry: implications for public health governance.Frontiers in public health · 2026Article
- The effectiveness of the Sierra Leone health sector's response to COVID-19: a quantitative analysis.BMC health services research · 2025Article
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11 authors.
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Abstract
backgroundThe best approach for defining and measuring community healthcare (CHC) resilience in times of crisis remains elusive. We aimed to synthesise definitions and indicators of resilience from countries who had recently undergone shocks (ie, outbreaks and natural disasters).
methodsWe purposively selected four countries that had recently or were currently experiencing a shock: Nepal, Ethiopia, Sierra Leone, and Liberia. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with participants at the community, facility, district, sub-national, national, and international levels. Interviews and discussions were translated and transcribed verbatim. Data were open coded in ATLAS.ti using a grounded theory approach and were thematically collated to a pre-specified framework.
resultsA total of 486 people participated in the study (n=378 community members, n=108 non-community members). Emergent themes defining CHC resilience included: the importance of communities, health system characteristics, learning from shocks, preventing and preparing for shocks, and considerations for sustainability and intersectoral engagement. Participants identified 193 potential indicators for measuring resilience, which fell into the domains of: (1) preparedness, (2) response and recovery, (3) communities, (4) health systems, and (5) intersectoral engagement.
conclusionDespite varying definitions and understanding of the concept of resilience, community-centred responses to shocks were key in building resilience. Further insight is needed into how the definitions and indicators identified in this study compare to other shocks and contexts and can be used to further our understanding of health system resilience. Metrics and definitions could assist policy-makers, researchers, and practitioners in evaluating the readiness of systems to respond to shocks and to allow comparability across health systems. We must build health systems that can continue to function and ensure quality, equity, community-focused care, and engagement, regardless of the pressures put upon them and ensure they are linked to strong primary healthcare.
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