Interrogating resilience in health systems development.

van de Pas, Remco and Ashour, Majdi and Kapilashrami, Anuj and Fustukian, Suzanne (2017) Interrogating resilience in health systems development. Health policy and planning. ISSN 1460-2237

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The Fourth Global Symposium on Health Systems Research was themed around 'Resilient and responsive health systems for a changing world.' This commentary is the outcome of a panel discussion at the symposium in which the resilience discourse and its use in health systems development was critically interrogated. The 2014-15 Ebola outbreak in West-Africa added momentum for the wider adoption of resilient health systems as a crucial element to prepare for and effectively respond to crisis. The growing salience of resilience in development and health systems debates can be attributed in part to development actors and philanthropies such as the Rockefeller Foundation. Three concerns regarding the application of resilience to health systems development are discussed: (1) the resilience narrative overrules certain democratic procedures and priority setting in public health agendas by 'claiming' an exceptional policy space; (2) resilience compels accepting and maintaining the status quo and excludes alternative imaginations of just and equitable health systems including the socio-political struggles required to attain those; and (3) an empirical case study from Gaza makes the case that resilience and vulnerability are symbiotic with each other rather than providing a solution for developing a strong health system. In conclusion, if the normative aim of health policies is to build sustainable, universally accessible, health systems then resilience is not the answer. The current threats that health systems face demand us to imagine beyond and explore possibilities for global solidarity and justice in health. [Abstract copyright: © The Author 2017; all rights reserved. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail:]

Item Type: Article
Additional Information: Listed as 'Free' on publisher's website.
Uncontrolled Keywords: Resilience, catastrophe, governmentality, health systems development, social justice, vulnerability
Divisions: School of Health Sciences > The Institute for Global Health and Development
Date Deposited: 09 Nov 2017 14:07
Last Modified: 17 Jan 2018 13:51


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