How can we strengthen health systems to respond to everyday challenges? What considerations under Covid-19?

Health systems face persistent everyday challenges related to health system inputs/hardware (e.g. technology, infrastructure, funding, human resource) and processes/software (e.g. knowledge, decision-making processes, values, norms, relationships). These routine challenges are compounded by periodic shocks (e.g. disease outbreaks, industrial actions, etc.) to health system, making it important for health systems to build “everyday resilience”. Everyday resilience is the maintenance of positive adjustment under challenging conditions such that the organisation emerges from those conditions strengthened and more resourceful’. Previous studies have characterized strategies that health systems enact in response to stressors as absorptive, adaptive or transformative. Absorptive strategies buffer the system from shocks and result in no change in system structure and processes, adaptive strategies result in some limited adjustments in system structure or processes, while transformative strategies result in significant functional or structural changes. These strategies are enabled by organizational capacities which include cognitive (capacity to problem-solve and learn), behavioural (the ability to act either in a routine or unconventional manner) and contextual (resources and connections including social capital) capacities.

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For more information on this brief contact Nancy Kagwanja, Email: