What Is Resilience and How Can It Be Nurtured? A Systematic Review of Empirical Literature on Organizational Resilience

June 2018
Edwine Barasa, Rahab Mbau, Lucy Gilson

Recent health system shocks such as the Ebola outbreak of 2014–2016 and the global financial crisis of 2008 have generated global health interest in the concept of resilience. The concept is however not new, and has been applied to other sectors for a longer period of time. This paper conducted a review of empirical literature from both the health and other sectors to synthesize evidence on organizational resilience.

A common theme across the selected papers for review was the recognition of resilience as an emergent property of complex adaptive systems. Resilience is both a function of planning for future crises (planned resilience), and adapting to chronic stresses and acute shocks (adaptive resilience). Beyond resilience to acute shocks, the resilience of health systems to routine and chronic stress (everyday resilience) is also key.

"Health system software is as, if not more important, as its hardware in nurturing health system resilience."

Understanding the attributes of resilient systems and strategies that can be employed to nurture resilience will be useful in informing global health efforts to strengthen health systems. The authors call for further studies that focus on testing the attributes identified by this review in the health sector, as well as indentifying other factors that characterise resilient health systems.

Governance Everyday resilience