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Handbook of Health System Resilience
In this Handbook, Steve Thomas and Padraic Fleming compile invaluable and original insights on the resilience of health systems in the face of shocks and crises, from economic and climate emergencies, to conflicts and pandemics. They examine how health system resilience has been conceptualised by scholars and applied in specific contexts, assessing different theoretical models for measuring and evaluating resilience, as well as highlighting the growing challenges facing health systems now and in the future.
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Critical Acclaim
Contents
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In this Handbook, Steve Thomas and Padraic Fleming compile invaluable and original insights on the resilience of health systems in the face of shocks and crises, from economic and climate emergencies, to conflicts and pandemics. They examine how health system resilience has been conceptualised by scholars and applied in specific contexts, assessing different theoretical models for measuring and evaluating resilience, as well as highlighting the growing challenges facing health systems now and in the future.
The Handbook of Health System Resilience presents cutting-edge research from an international range of experts on crisis decision-making throughout healthcare. Chapter authors analyse the value of using ‘resilience’ as a theoretical framework, before delving into the durability of health systems in a variety of global case studies, including economic crises across Europe, conflicts in the Middle East, pandemics across the globe, and the climate crisis. Ultimately, the Handbook emphasises the importance of dealing with poor decision-making and austerity, the need to protect vulnerable groups, and the significance of capacity-building to deal with future crises.
This dynamic Handbook is a vital resource for students and scholars of public policy, health, and economics. It will also prove invaluable to health system analysts, as well as those within governments who are responsible for public health and crisis decision-making.
The Handbook of Health System Resilience presents cutting-edge research from an international range of experts on crisis decision-making throughout healthcare. Chapter authors analyse the value of using ‘resilience’ as a theoretical framework, before delving into the durability of health systems in a variety of global case studies, including economic crises across Europe, conflicts in the Middle East, pandemics across the globe, and the climate crisis. Ultimately, the Handbook emphasises the importance of dealing with poor decision-making and austerity, the need to protect vulnerable groups, and the significance of capacity-building to deal with future crises.
This dynamic Handbook is a vital resource for students and scholars of public policy, health, and economics. It will also prove invaluable to health system analysts, as well as those within governments who are responsible for public health and crisis decision-making.
Critical Acclaim
‘The resilience of any system is the real test of its sustainability. In this volume, Steve Thomas and Padraic Fleming bring together the most cutting-edge research on the resilience of these complex health systems, including chapters exploring and questioning the concept itself. Furthermore, these studies emphasise the extent to which more vulnerable segments of the population suffer from shocks and the need to have strategies which take this inequality into account.’
– Gregory P. Marchildon, University of Toronto, Canada
‘COVID, conflict, climate change…the need for resilient health systems in an era of permacrisis should be obvious yet, once again, we are failing to learn lessons. Thomas and Fleming have assembled a wealth of experience from a stellar collection of authors. Now their advice must be acted upon.’
– Martin McKee CBE, London School of Hygiene & Tropical Medicine, UK
– Gregory P. Marchildon, University of Toronto, Canada
‘COVID, conflict, climate change…the need for resilient health systems in an era of permacrisis should be obvious yet, once again, we are failing to learn lessons. Thomas and Fleming have assembled a wealth of experience from a stellar collection of authors. Now their advice must be acted upon.’
– Martin McKee CBE, London School of Hygiene & Tropical Medicine, UK
Contents
Contents
1 Introduction: health system resilience – a concept whose time has come 1
Steve Thomas and Padraic Fleming
PART I UNDERSTANDING HEALTH SYSTEMS RESILIENCE
2 Key ideas and future directions for health system resilience 13
Dell D. Saulnier and Karl Blanchet
3 Economics insights into shocks and health system resilience 29
Steve Thomas
4 Everyday health system resilience: the theory 44
Lucy Gilson and Edwine Barasa
5 Critiquing the concept of health system resilience 61
Stephanie M. Topp
PART II FRAMEWORKS AND PERSPECTIVES
6 Assessing health system sustainability and resilience: reporting on the
Partnership for Health System Sustainability and Resilience (PHSSR) 73
George Wharton and Alistair McGuire
7 Using health system performance assessment to examine health system
resilience 89
Irene Papanicolas, Moytrayee Guha, Marina Karanikolos, Julia
Zimmermann, Jennifer Nuzzo, Andrea Prado, Piya Hanvoravongchai, and
Anne Liu
8 Enabling health system resilience through resilient cities 113
Laura C. Rosella
PART III RESILIENCE AND HEALTH SYSTEM FUNCTIONING
9 Building health system resilience in and through service delivery 129
Erin Webb, Astrid Eriksen, and Ewout van Ginneken
10 Building health system resilience in financing 144
Riya D. Doshi and Jonathan Cylus
11 Building health system resilience in and through governance: lessons
from the Danish response to the first phase of the Covid-19 pandemic 156
Karsten Vrangbæk
12 Building health system resilience in and through the workforce 173
Padraic Fleming
PART IV LEARNING FROM DIFFERENT SHOCKS
SECTION IVA: ECONOMIC CRISIS
13 Learning from an economic crisis – health system resilience in Portugal 198
Pedro Pita Barros
14 Learning from the economic and the pandemic crisis. Health system
resilience in Greece: from Skylla to Charibdis 212
Charalampos Economou
15 Learning from the economic shock – health system resilience in Ireland 230
Sara Burke, Sarah Parker, Catherine O’Donoghue, Steve Thomas, Sarah
Barry, and Padraic Fleming
16 Health system resilience in Spain 248
José R. Repullo
17 Learning lessons from the austerity period and the COVID-19 crisis in
England to help build a more resilient health system 262
Gemma A. Williams
SECTION IVB: CLIMATE AND CONFLICT
18 Mapping health systems resilience in fragile and conflict-affected settings 280
Alastair Ager and Elyse Callahan
19 Health systems in conflict: governance fragmentation and health system
resilience in the context of COVID-19 in Yemen 292
Bothaina Attal and Sharif A. Ismail
20 Developing health system resilience for the climate crisis 307
Peter Berry, Kristie L. Ebi and Paddy Enright
SECTION IVC: PANDEMICS
21 Lessons from 2003 SARS in Taiwan – decisions against threat matter 330
Shu-Ti Chiou
22 Best practice reflections on health system responses to COVID-19 in Europe 348
Anna Sagan, Scott L. Greer, and Holly Jarman
23 Resilience in the Brazilian health system: impacts of the COVID-19 pandemic 365
Michelle Fernandez, Marco Antonio Catussi Paschoalotto, Gabriela Lotta,
and Adriano Massuda
24 What can we learn about everyday health system resilience and
pandemic response and preparedness from Kenyan and South African
COVID-19 experiences? 380
Lucy Gilson, Edwine Barasa, Keith Cloete, Kadondi Kasera, Benjamin Tsofa,
and Krishna Vallabhjee
25 Health systems resilience in Canada: a literature review and case studies
to inform strengthened resilience 403
Sara Allin, Fahad Razak, Amol Verma, and Brian Baigrie
26 U.S. health system resilience 419
Lynn Unruh
27 Health system resilience and COVID-19 – reflections from South Asia 439
Malabika Sarker, Syeda Tahmina Ahmed, Mrittika Barua, and Syed Masud Ahmed
PART V LOOKING FORWARD
28 Into the unknown—preparing for and learning from health system shocks 452
Ossi Heino, Laura Kihlström, Pauli Rautiainen, Marjaana Viita-aho, Ilmo
Keskimäki, and Liina-Kaisa Tynkkynen
29 Conclusions: so what have we learned? 465
Steve Thomas, Liz Farsaci, Catherine O’Donoghue, Arianna
Almirall-Sanchez, Lucy Gilson, Stephanie M. Topp, Alastair Ager, Laura C.
Rosella, Lynn Unruh, Shu-Ti Chiou, Marco Antonio Catussi Paschoalotto,
Brian Baigrie, Sarah Barry, Sara Burke, Riya D. Doshi, Charalampos
Economou, Paddy Enright, Astrid Eriksen, Michelle Fernandez, Moytrayee
Guha, Laura Kihlström, José R. Repullo, Dell D. Saulnier, Malabika Sarker,
Ewout van Ginneken, Karsten Vrangbæk, and Gemma A. Willi
1 Introduction: health system resilience – a concept whose time has come 1
Steve Thomas and Padraic Fleming
PART I UNDERSTANDING HEALTH SYSTEMS RESILIENCE
2 Key ideas and future directions for health system resilience 13
Dell D. Saulnier and Karl Blanchet
3 Economics insights into shocks and health system resilience 29
Steve Thomas
4 Everyday health system resilience: the theory 44
Lucy Gilson and Edwine Barasa
5 Critiquing the concept of health system resilience 61
Stephanie M. Topp
PART II FRAMEWORKS AND PERSPECTIVES
6 Assessing health system sustainability and resilience: reporting on the
Partnership for Health System Sustainability and Resilience (PHSSR) 73
George Wharton and Alistair McGuire
7 Using health system performance assessment to examine health system
resilience 89
Irene Papanicolas, Moytrayee Guha, Marina Karanikolos, Julia
Zimmermann, Jennifer Nuzzo, Andrea Prado, Piya Hanvoravongchai, and
Anne Liu
8 Enabling health system resilience through resilient cities 113
Laura C. Rosella
PART III RESILIENCE AND HEALTH SYSTEM FUNCTIONING
9 Building health system resilience in and through service delivery 129
Erin Webb, Astrid Eriksen, and Ewout van Ginneken
10 Building health system resilience in financing 144
Riya D. Doshi and Jonathan Cylus
11 Building health system resilience in and through governance: lessons
from the Danish response to the first phase of the Covid-19 pandemic 156
Karsten Vrangbæk
12 Building health system resilience in and through the workforce 173
Padraic Fleming
PART IV LEARNING FROM DIFFERENT SHOCKS
SECTION IVA: ECONOMIC CRISIS
13 Learning from an economic crisis – health system resilience in Portugal 198
Pedro Pita Barros
14 Learning from the economic and the pandemic crisis. Health system
resilience in Greece: from Skylla to Charibdis 212
Charalampos Economou
15 Learning from the economic shock – health system resilience in Ireland 230
Sara Burke, Sarah Parker, Catherine O’Donoghue, Steve Thomas, Sarah
Barry, and Padraic Fleming
16 Health system resilience in Spain 248
José R. Repullo
17 Learning lessons from the austerity period and the COVID-19 crisis in
England to help build a more resilient health system 262
Gemma A. Williams
SECTION IVB: CLIMATE AND CONFLICT
18 Mapping health systems resilience in fragile and conflict-affected settings 280
Alastair Ager and Elyse Callahan
19 Health systems in conflict: governance fragmentation and health system
resilience in the context of COVID-19 in Yemen 292
Bothaina Attal and Sharif A. Ismail
20 Developing health system resilience for the climate crisis 307
Peter Berry, Kristie L. Ebi and Paddy Enright
SECTION IVC: PANDEMICS
21 Lessons from 2003 SARS in Taiwan – decisions against threat matter 330
Shu-Ti Chiou
22 Best practice reflections on health system responses to COVID-19 in Europe 348
Anna Sagan, Scott L. Greer, and Holly Jarman
23 Resilience in the Brazilian health system: impacts of the COVID-19 pandemic 365
Michelle Fernandez, Marco Antonio Catussi Paschoalotto, Gabriela Lotta,
and Adriano Massuda
24 What can we learn about everyday health system resilience and
pandemic response and preparedness from Kenyan and South African
COVID-19 experiences? 380
Lucy Gilson, Edwine Barasa, Keith Cloete, Kadondi Kasera, Benjamin Tsofa,
and Krishna Vallabhjee
25 Health systems resilience in Canada: a literature review and case studies
to inform strengthened resilience 403
Sara Allin, Fahad Razak, Amol Verma, and Brian Baigrie
26 U.S. health system resilience 419
Lynn Unruh
27 Health system resilience and COVID-19 – reflections from South Asia 439
Malabika Sarker, Syeda Tahmina Ahmed, Mrittika Barua, and Syed Masud Ahmed
PART V LOOKING FORWARD
28 Into the unknown—preparing for and learning from health system shocks 452
Ossi Heino, Laura Kihlström, Pauli Rautiainen, Marjaana Viita-aho, Ilmo
Keskimäki, and Liina-Kaisa Tynkkynen
29 Conclusions: so what have we learned? 465
Steve Thomas, Liz Farsaci, Catherine O’Donoghue, Arianna
Almirall-Sanchez, Lucy Gilson, Stephanie M. Topp, Alastair Ager, Laura C.
Rosella, Lynn Unruh, Shu-Ti Chiou, Marco Antonio Catussi Paschoalotto,
Brian Baigrie, Sarah Barry, Sara Burke, Riya D. Doshi, Charalampos
Economou, Paddy Enright, Astrid Eriksen, Michelle Fernandez, Moytrayee
Guha, Laura Kihlström, José R. Repullo, Dell D. Saulnier, Malabika Sarker,
Ewout van Ginneken, Karsten Vrangbæk, and Gemma A. Willi
