scholarly journals What Makes Health Systems Resilient? A Qualitative Analysis of The Perspectives of Swiss NGOs

2021 ◽  
Author(s):  
Pauline Yongeun Grimm ◽  
Kaspar Wyss
Keyword(s):  
Global Health ◽  
Health System ◽  
Human Resource Development ◽  
Health Systems ◽  
Knowledge Exchange ◽  
Innovative Solutions ◽  
System Resilience ◽  
State Actors

Abstract Background: Resilience has become relevant than ever before with the advent of increasing and intensifying shocks on the health system and its amplified effects due to globalization. Using the example of non-state actors based in Switzerland, the aim of this study is to explore how and to what extent NGOs with an interest in global health have dealt with unexpected shocks on the health systems of their partner countries and to reflect on the practical implications of resilience for the multiple actors involved. Consequently, this paper analyses the key attributes of resilience that targeted investments may influence, and the different roles key stakeholders may assume to build resilience. Methods: This is a descriptive and exploratory qualitative study analysing the perspectives on health system resilience of Swiss-based NGOs through 20 in-depth interviews. Analysis proceeded using a data-driven thematic analysis closely following the framework method. An analytical framework was developed and applied systematically resulting in a complete framework matrix. The results are categorised into the expected role of the governments, the role of the NGOs, and practical future steps for building health system resilience. Results: The following four key ‘foundations of resilience’ were found to be dominant for unleashing greater resilience attributes regardless of the nature of shocks: ‘realigned relationships,’ ‘foresight,’ ‘motivation,’ and ‘emergency preparedness.’ The attribute to ‘integrate’ was shown to be one of the most crucial characteristics of resilience expected of the national governments from the NGOs, which points to the heightened role of governance. Meanwhile, as a key stakeholder group that is becoming inevitably more powerful in international development cooperation and global health governance, non-state actors namely the NGOs saw themselves in a unique position to facilitate knowledge exchange and to support long-term adaptations of innovative solutions that are increasing in demand. The strongest determinant of resilience in the health system was the degree of investments made for building long-term infrastructures and human resource development which are well-functioning prior to any potential crisis. Conclusions: Health system resilience is a collective endeavour and a result of many stakeholders’ consistent and targeted investments. These investments open up new opportunities to seek innovative solutions and to keep diverse actors in global health accountable. Strong governance, a bi-directional knowledge exchange, and the focus on leveraging science for impact can draw greater potential of resilience in the health systems. Governments and the NGOs have unique points of contribution in this journey towards resilience and may support governments to prioritise investing in the key ‘foundations of resilience’ in order to activate greater attributes of resilience.

Harnessing instability as an opportunity for health system strengthening: A review of health system resilience

2019 ◽  
Vol 32 (3) ◽  
pp. 128-135 ◽  
Author(s):  
Caroline Chamberland-Rowe ◽  
François Chiocchio ◽  
Ivy Lynn Bourgeault
Keyword(s):  
Global Health ◽  
Health System ◽  
Health Systems ◽  
Health System Strengthening ◽  
Operational Model ◽  
Academic Literature ◽  
System Resilience

In recent years, resilience has emerged as a prominent topic in global health systems discourse as a result of the increasing variety and volume of sources of instability inflicting strain on systems. In line with this study’s intent to bring together existing literature on health system resilience as a means to understand the process through which systems achieve resilience, a review of academic literature related to health system resilience was conducted. Emerging from this review is an operational model of resilience that builds on existing health systems frameworks. The model highlights health system resilience as a process through which leaders in all sectors need to be mobilized in order to harness instability as an opportunity for health system strengthening rather than a threat to the system’s sustainability and integrity.

scholarly journals Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords

2019 ◽  
Vol 9 (1) ◽  
pp. 6-16 ◽  
Author(s):  
My Fridell ◽  
Sanna Edwin ◽  
Johan von Schreeb ◽  
Dell D. Saulnier
Keyword(s):  
Health System ◽  
Health Systems ◽  
Scoping Review ◽  
World Health ◽  
Systems Research ◽  
Quality Health ◽  
System Resilience ◽  
Health Organization ◽  
Key Terms

Background: Health systems are based on 6 functions that need to work together at all times to effectively deliver safe and quality health services. These functions are vulnerable to shocks and changes; if a health system is unable to withstand the pressure from a shock, it may cease to function or collapse. The concept of resilience has been introduced with the goal of strengthening health systems to avoid disruption or collapse. The concept is new within health systems research, and no common description exists to describe its meaning. The aim of this study is to summarize and characterize the existing descriptions of health system resilience to improve understanding of the concept. Methods and Analysis: A scoping review was undertaken to identify the descriptions and characteristics of health system resilience. Four databases and gray literature were searched using the keywords "health system" and "resilience" for published documents that included descriptions, frameworks or characteristics of health system resilience. Additional documents were identified from reference lists. Four expert consultations were conducted to gain a broader perspective. Descriptions were analysed by studying the frequency of key terms and were characterized by using the World Health Organization (WHO) health system framework. The scoping review identified eleven sources with descriptions and 24 sources that presented characteristics of health system resilience. Frequently used terms that were identified in the literature were shock, adapt, maintain, absorb and respond. Change and learning were also identified when combining the findings from the descriptions, characteristics and expert consultations. Leadership and governance were recognized as the most important building block for creating health system resilience. Discussion: No single description of health system resilience was used consistently. A variation was observed on how resilience is described and to what depth it was explained in the existing literature. The descriptions of health system resilience primarily focus on major shocks. Adjustments to long-term changes and the element of learning should be considered for a better understating of health system resilience.

The Roles of Sufi Teachings in Social Movements: An HRD Perspective

2019 ◽  
Vol 21 (2) ◽  
pp. 205-223
Author(s):  
Nadir N. Budhwani ◽  
Gary N. McLean
Keyword(s):  
Social Movements ◽  
Social Movement ◽  
Human Resource Development ◽  
Collective Learning ◽  
Unconditional Love ◽  
The Social ◽  
Personal Experiences ◽  
Recommendations For Practice

The Problem There is a growing need to explore the role of the centuries-old tradition of Sufism and its teachings which, through social movements, have contributed to, and continue to influence, human resource development (HRD) at various levels—individual, group, organization, community, nation, and international. The Solution To address this need, we present cases of social movements inspired by Sufi teachings in selected parts of the world. We discuss, using literature and personal experiences, links among Sufi teachings, social movements, and HRD, and provide a framework for understanding Sufi teachings within the context of the social movement phenomenon. We end with recommendations for practice and research. The Stakeholders We target broadening the horizons of HRD researchers, practitioners, civil society members, and social movement activists, encouraging them to address long-term changes and collective learning through the quest for unconditional love and liberation, which represent the core of Sufi teachings.

Beyond the Hegemony of Neoliberal Ideas: Ideational Diversity and Policy Variegation in the Neoliberal State

2021 ◽  
pp. 089692052110523
Author(s):  
Asa Maron
Keyword(s):  
The State ◽  
Adverse Outcomes ◽  
Organizational Goals ◽  
Power Resources ◽  
State Actors ◽  
Policy Agendas ◽  
Bureaucratic State ◽  
Policy Proposals

Sociologists commonly adopt a bifurcated understanding of the neoliberal state, showing how neoliberalism’s advance coincides with the growing authority of specific actors and ideas inside the bureaucratic state as others’ authority declines. This article complicates this view by probing the dynamics of non-neoliberal action inside the state, demonstrating the ways even demoted state actors can strategically muster power resources to forward distinct policy agendas. Taking a long-term perspective on social policy developments since the early 2000s, this article reviews the case of Israel, where neoliberal policies' new hegemony and adverse outcomes triggered counter-actions inside the state, ultimately leading to policy change. Paying particular attention to the role of ideas, this article argues that by rearticulating their policy mission to align with market conventions, non-neoliberal actors were able to persuade neoliberal actors to support their policy proposals, succeeding to advance creative policy alternatives under hostile political conditions. Highlighting this strategic capacity and ideational resilience and acumen in adapting to neoliberal critique reveals how demoted state actors can manage to sustain entrenched organizational goals and institutional motivations even as they help ease the adaptation of their historical mission to the neoliberal zeitgeist.

The role of the Microbial Conveyor Belt on Earth´s system resilience

2021 ◽  
Author(s):  
Mireia Mestre ◽  
Juan Höfer
Keyword(s):  
Human Impacts ◽  
Conveyor Belt ◽  
Earth System ◽  
Planetary Scale ◽  
Microbial Biogeography ◽  
The Earth ◽  
System Resilience ◽  
Global Biogeochemical Cycles

<p>Despite being major players on the global biogeochemical cycles, microorganisms are generally not included in holistic views of Earth’s system. The Microbial Conveyor Belt is a conceptual framework that represents a recurrent and cyclical flux of microorganisms across the globe, connecting distant ecosystems and Earth compartments. This long-range dispersion of microorganisms directly influences the microbial biogeography, the global cycling of inorganic and organic matter, and thus the Earth system’s functioning and long-term resilience. Planetary-scale human impacts disrupting the natural flux of microorganisms pose a major threat to the Microbial Conveyor Belt, thus compromising microbial ecosystem services. Perturbations that modify the natural dispersion of microorganisms are, for example, the modification of the intensity/direction of air fluxes and ocean currents due to climate change, the vanishing of certain dispersion vectors (e.g., species extinction or drying rivers) or the introduction of new ones (e.g., microplastics, wildfires). Transdisciplinary approaches are needed to disentangle the Microbial Conveyor Belt, its major threats and their consequences for Earth´s system resilience.</p>

Incompatible Images

2009 ◽  
pp. 186-200 ◽  
Author(s):  
Michel J. Sassene
Keyword(s):  
Health System ◽  
Health Systems ◽  
Clinical Evidence ◽  
Asthma Management ◽  
Self Management ◽  
Management Systems ◽  
Use Of Self ◽  
Per Se

This chapter investigates asthmatics’ reasons for not adopting an e-health system for asthma selfmanagement. An understanding of these reasons is particularly relevant, because clinical evidence indicates that, if used, such systems lead to better asthma management. The investigated asthma system is, however, based on a taken-for-granted image of asthmatics as, per se, striving to be symptom-free. This image is incompatible with interviewed asthmatics’ day-to-day performances of their asthma, and renders invisible (a) that their asthma performances emphasize an economy of good passages and of feeling capable, (b) that they achieve the objective of feeling capable in quite different ways, and (c) that feeling capable does not per se equal being symptom-free all the time. To attain long-term use of self-management systems and other patient-centred e-health systems, such systems must acknowledge and link into the manifold performances that comprise users’ ways of living with their disease.

scholarly journals What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer B. Nuzzo ◽  
Diane Meyer ◽  
Michael Snyder ◽  
Sanjana J. Ravi ◽  
Ana Lapascu ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Health System ◽  
Natural Hazards ◽  
Health Systems ◽  
Scoping Review ◽  
Disease Outbreaks ◽  
World Health ◽  
Infectious Disease Outbreaks ◽  
System Resilience

Abstract Background The 2014–2016 Ebola outbreak was a wake-up call regarding the critical importance of resilient health systems. Fragile health systems can become overwhelmed during public health crises, further exacerbating the human, economic, and political toll. Important work has been done to describe the general attributes of a health system resilient to these crises, and the next step will be to identify the specific capacities that health systems need to develop and maintain to achieve resiliency. Methods We conducted a scoping review of the literature to identify recurring themes and capacities needed for health system resiliency to infectious disease outbreaks and natural hazards and any existing implementation frameworks that highlight these capacities. We also sought to identify the overlap of the identified themes and capacities with those highlighted in the World Health Organization’s Joint External Evaluation. Sources of evidence included PubMed, Web of Science, OAIster, and the websites of relevant major public health organizations. Results We identified 16 themes of health system resilience, including: the need to develop plans for altered standards of care during emergencies, the need to develop plans for post-event recovery, and a commitment to quality improvement. Most of the literature described the general attributes of a resilient health system; no implementation frameworks were identified that could translate these elements into specific capacities that health system actors can employ to improve resilience to outbreaks and natural hazards in a variety of settings. Conclusions An implementation-oriented health system resilience framework could help translate the important components of a health system identified in this review into specific capacities that actors in the health system could work to develop to improve resilience to public health crises. However, there remains a need to further refine the concept of resilience so that health systems can simultaneously achieve sustainable transformations in healthcare practice and health service delivery as well as improve their preparedness for emergencies.

scholarly journals Rational trust in resilient health systems

2019 ◽  
Vol 34 (7) ◽  
pp. 553-557 ◽  
Author(s):  
Sonja Kristine Kittelsen ◽  
Vincent Charles Keating
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Systems ◽  
The Public ◽  
Public Health Emergencies ◽  
Health Authorities ◽  
Cast Doubt ◽  
Public Health Authorities ◽  
System Resilience ◽  
Relevant Component

AbstractThe 2014–15 Ebola epidemic in West Africa highlighted the significance of trust between the public and public health authorities in the mitigation of health crises. Since the end of the epidemic, there has been a focus amongst scholars and practitioners on building resilient health systems, which many see as an important precondition for successfully combatting future outbreaks. While trust has been acknowledged as a relevant component of health system resilience, we argue for a more sustained theoretical engagement with underlying models of trust in the literature. This article takes a first step in showing the importance of theoretical engagement by focusing on the appeal to rational models of trust in particular in the health system resilience literature, and how currently unconsidered assumptions in this model cast doubt on the effectiveness of strategies to generate trust, and therein resilience, during acute public health emergencies.

scholarly journals The role of tobacco and alcohol use in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

2020 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Health Systems ◽  
Social Determinants ◽  
Economic Status ◽  
Non Communicable Diseases ◽  
Causal Loop ◽  
Socio Economic Status

Abstract Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study was a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n=12) at different levels (policy, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Results: Three key interacting themes emerged during the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on prevention by health systems and policy influence of tobacco and alcohol companies were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. These interacting themes were utilised to develop causal loop diagrams and system archetypes. Conclusion: Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and policy influence. A multi-sectoral response led by the health system is urgently needed.

scholarly journals Contexts and mechanisms that promote access to healthcare for populations experiencing homelessness: a realist review

2020 ◽  
Author(s):  
Rikke Siersbaek ◽  
John Ford ◽  
Sara Burke ◽  
Clíona Ní Cheallaigh ◽  
Steve Thomas
Keyword(s):  
Health System ◽  
Health Systems ◽  
Healthcare Access ◽  
Grey Literature ◽  
Realist Review ◽  
Access To Healthcare ◽  
Staff Retention ◽  
Programme Theory ◽  
Eligibility Criteria

Abstract Objective: The objective of this study was to identify and understand the health system contexts and mechanisms that allow for homeless populations to access appropriate healthcare when needed.Design: A realist review.Data sources: Ovid MEDLINE, embase.com, CINAHL, ASSIA and grey literature until April 2019. Eligibility criteria for selecting studies: The purpose of the review was to identify health system patterns which enable access to healthcare for people who experience homelessness. Peer reviewed articles were first identified through a systematic search, grey literature searching, citation tracking and expert recommendations. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded to identify data relating to contexts, mechanisms and/or outcomes.Analysis: Inductive coding was used to generate Context-Mechanism-Outcome configurations which were refined and then used to build several iterations of the overarching programme theory.Results: Searching identified 330 review articles, of which 24 were included. Additional searching of grey literature yielded 50 records of which 12 were included. An additional 11 grey literature and primary sources were identified through citation tracking and expert recommendation for a total of 47 included sources. The analysis found that healthcare access for populations experiencing homelessness is improved when services are coordinated and delivered in a way that is organised around the person with a high degree of flexibility and a culture that rejects stigma generating trusting relationships between patients and staff/providers. Health systems should provide long-term, dependable funding for services to ensure sustainability and staff retention. Conclusions: With homelessness on the rise internationally, this study will inform health systems policy-making and implementation. It contributes to our understanding how healthcare systems can be more accessible for populations experiencing homelessness by providing long-term stable funding, promoting inclusive cultures and limiting stigma. Health systems should be flexible, timely and connected.

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