Communiqué from the SYSTAC Global launch meetings in November 2021

The SYSTAC Global Meeting was convened by the Alliance to share and showcase SYSTAC’s
inception work during 2021. This document summarises regional perspectives on systems thinking, multidisciplinary experiences in systems thinking for health, and lessons from breakout sessions on systems thinking challenges.

A health systems resilience research agenda: moving from concept to practice.
Saulnier DD, Blanchet K, Canila C, et al. BMJ Global Health, 2021.

Five key research areas for health system resilience are proposed to move resilience research from concept to practice: the effect of governance on resilience, measuring and managing dynamic performance, health system legitimacy, the link between health system resilience and societal resilience, and the influence of the private and voluntary sectors on resilience.

Governance and Capacity to Manage Resilience of Health Systems: Towards a New Conceptual Framework.
Blanchet K, Nam SL, Ramalingam B, Pozo-Martin F. International Journal of Health Policy and Management, 2017.

The paper introduces a conceptual framework on governance and the capacity to manage resilience in health systems, using systems thinking and complexity theories. The framework describes four dimensions that a health system needs to be able to manage to be resilient: interdependence, knowledge, legitimacy, and uncertainty.

Health System Resilience: What Are We Talking About? A Scoping Review Mapping Characteristics and Keywords.
Fridell M, Edwin S, von Schreeb J, Saulnier DD. International Journal of Health Policy and Management, 2020.

A scoping review that summarizes the characteristics of health system resilience based on existing definitions and relates the characteristics to health system functions.

From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening.
Barasa EW, Cloete K, Gilson L. Health Policy Planning, 2017.

The concept of ‘everyday resilience’ is defined in this paper as the ability of health system to continue delivering quality services and respond effectively when experiencing chronic or multiple stresses rather than shocks. The paper discusses everyday resilience as a property of complex adaptive systems.

‘Resilience thinking: Integrating resilience, adaptability and transformability’
Folke CSR, Carpenter B, Walker M et al. Ecology and Society, 2010

Resilience is discussed as a property of dynamic and complex systems, and the paper explains the theory behind resilience in complex systems and its relationship to adaptation and transformation.

Strengthening health systems resilience: Key concepts and strategies (Policy Brief 36)
WHO Europe, 2021.

The brief addresses the gaps in understanding on what resilience means, how to strengthen it and how to assess it. The aim is to support a more consistent understanding and use of the concept.

Resilience capacities of health systems: Accommodating the needs of Palestinian refugees from Syria.
Alameddine M, Fouad FM, Diaconu K, et al. Social Science and Medicine, 2019.

To explore the capacity of the system to absorb, adapt, and transform while delivering health services during the Syrian crisis, interviews were conducted with staff working for the United Nations Relief and Works Agency for Palestine Refugees in the Near East in Lebanon and Jordan.

Staying afloat: A qualitative study of community perspectives on health system resilience explored through the management of pregnancy and childbirth care during floods in Cambodia.
Saulnier DD, Hom H, Thol D, et al. BMJ Global Health, 2020.

The capacity of the Cambodian health system to manage resilience is explored in relation to the capacity of communities to manage their own health needs during floods.

Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building.
Ager, A.K., Lembani, M., Mohammed, A. et al. Conflict and Health, 2015.

A systems dynamic analysis was conducted to identify pathways of threat and pathways of adaptation for health service provision at public healthcare facilities in the context of the Boko Haram insurgency in Nigeria.

How do health workers experience and cope with shocks? Learning from four fragile and conflict-affected health systems in Uganda, Sierra Leone, Zimbabwe and Cambodia.
Witter S, Wurie H, Chandiwana P, et al. Health Policy Planning, 2017.

Improving the performance of the health workforce may contribute to a health system’s resilience. The coping capacity and vulnerability of healthcare workers are explored in four post-conflict settings.

Health system resilience in the face of crisis: Analysing the challenges, strategies and capacities for UNRWA in Syria.
Jamal Z, Alameddine M, Diaconu K et al. Health Policy Planning, 2020.

Using a systems lens, the strategies that UNWRA adopted to maintain service delivery during the Syrian conflict were explored to understand the process of resilience.

Health systems resilience during COVID-19: Lessons for building back better.
Health Policy Series 56. World Health Organization: 2021.

Lessons on absorption, adaptation, and transformation are developed in an analysis from European region country responses to COVID-19. It provides policymakers with evidence from other countries to assess their own responses to COVID-19 and incorporate adjustments that are appropriate for their national contexts. The lessons offer strategies to draw experience from the pandemic to improve the response to future health systems shocks.