Evidence map›Paper›PMID 41943161›Full record

ArticleGlobalization and health2026

An account of health systems resilience to emergencies in Africa: a scoping review.

Martin Ankomah, Gordon Abekah-Nkrumah, Grace Adjei Okai, Lily Yarney, Anita Asiwome Adzo Baku

Abstract readScoping Review
In one paragraph

Article in Globalization and health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Martin AnkomahDepartment of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana.
Gordon Abekah-NkrumahDepartment of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana. gabekah-nkrumah@ug.edu.gh.
Grace Adjei OkaiDepartment of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana.
Lily YarneyDepartment of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana.
Anita Asiwome Adzo BakuDepartment of Health Services Management, University of Ghana Business School, P. O. Box 78, Legon, Accra, Ghana.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHealthcare systems across Africa continue to face a wide range of shocks. Using Ebola and COVID-19 as case studies, this study examines the various resilience strategies implemented in different countries and synthesises them in a way that can serve as a practical guide to make health systems in Africa more resilient for future emergencies. METHODOLOGY: The study is a scoping review that synthesises evidence from peer-reviewed journal articles and grey literature, structured around a conceptual framework developed by the authors. We focused on various aspects of health system resilience during the Ebola outbreaks and the COVID-19 pandemic in Africa. KEY

findingsThis review identifies six key elements vital to health system resilience in Africa: strong leadership and governance, equitable social protection, digital health innovation, trusted community engagement, a sustainable and flexible workforce, and adaptable infrastructure. However, several gaps must be addressed to strengthen resilience against future health emergencies. While political commitment and coordination mechanisms improved integration and awareness, poor decentralisation, weak accountability, and fragmented governance undermined effectiveness. Social protection initiatives and digital tools enabled rapid responses but persistent inequities in access and data gaps hindered their reach. Telemedicine and workforce expansion showed adaptability but lacked sustainability. Community trust and local innovations supported resilience, yet their potential was curtailed by top-down strategies and insufficient institutional support.

conclusionThis review emphasises the need for equitable, inclusive, and coherent strategies to strengthen resilient health systems in Africa. It calls for a shift from reactive, fragmented approaches to a long-term system-wide transformation grounded in inclusive governance, equitable social protection, robust digital health systems, a sustainable workforce, integrated and trusted community engagement, and adaptive physical infrastructure. Importantly, the review affirms that addressing deep-seated political, structural, and social inequities is crucial to ensuring resilience does not become an empty concept. The framework developed from this review provides a roadmap for policymakers to embed resilience as a core, institutional principle of long-term health system transformation, rather than a temporary emergency measure.

Indexed as

COVID-19Delivery of Health CareEmergenciesAfricaDigital HealthDisease OutbreaksHemorrhagic Fever, EbolaHumansPublic Health InfrastructureCOVID-19 pandemicEbola virus diseaseEmergency preparednessEmergency responseHealth emergenciesHealth systemHealth system resilienceShock

Identifiers

PMID41943161
PMCPMC13182007

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.