By Lilian Ogechi Mbah
Health and social care systems across the globe are facing unprecedented pressures—from aging populations and chronic disease to pandemics, climate-related disasters, and workforce burnout. These complex, compounding challenges have made it clear that conventional management models are no longer sufficient. To sustain and advance care delivery in such volatile environments, systems must become resilient. Resilience in health and social care refers not merely to bouncing back from crises, but to adapting, learning, and evolving in response to ongoing and unexpected shocks.
This article delves into the concept of resilience within the realms of health and social care management, analyzing its fundamental dimensions, associated challenges, and facilitating factors through the perspective of recent academic research and global experiences.
Defining Resilience in Health and Social Care
Resilience is commonly defined as the capacity of a system to absorb, adapt, and transform in the face of internal and external stressors (WHO, 2021). In the context of health and social care, this involves maintaining core functions—such as access, safety, and continuity of care—during crises while also strengthening the system for future challenges.
Barasa, Cloete and Gilson (2020) argue for a broader conceptualization of resilience that moves beyond recovery to include nurturing emergence, where health systems actively reorganize themselves based on new knowledge and relationships. This dynamic view emphasizes that resilience is both a technical and a social process.
Core Pillars of Resilient Management
- Governance and Leadership
Strong leadership and transparent governance are fundamental to resilience. Leaders must make rapid, high-stakes decisions, often with limited information. This requires a balance of strategic foresight, decentralization, and stakeholder engagement (Blanchet et al., 2020).
Effective governance also fosters trust—an essential asset in times of uncertainty. According to Haldane et al. (2021), countries that responded most effectively to COVID-19 did so through timely decisions, clear communication, and robust intersectoral coordination.
- Workforce Resilience
The health workforce is the backbone of resilience. Yet the sector is plagued by shortages, burnout, and mental health challenges—factors that erode both care quality and system stability. Kuhlmann et al. (2021) emphasize the need for workforce planning strategies that ensure flexibility, fair conditions, and psychological support.
During crises, health professionals must be supported not only with PPE and staffing reinforcements, but also with mechanisms for rest, rotation, and feedback. Investing in resilient human resources means addressing both capacity and well-being.
- Infrastructure and Supply Chains
Reliable infrastructure and logistics systems are essential to resilient operations. The COVID-19 pandemic revealed dangerous vulnerabilities in global and national supply chains—especially for personal protective equipment, diagnostics, and oxygen (Legido-Quigley et al., 2020). Strategic stockpiles, diversified suppliers, and digital inventory systems are tools that enhance preparedness and response.
Hick et al. (2020) emphasize the importance of “duty to plan” in crisis standards of care—ensuring that health systems prepare in advance for ethical dilemmas and resource allocation under stress.
Adaptive Capacity and Learning
True resilience depends on the ability to learn and adapt. Systems that perform well during crises exhibit learning loops—where data collection, real-time feedback, and decision-making are tightly integrated. As Kruk et al. (2020) note, resilient systems do not simply react to crises—they evolve based on them.
This adaptive capacity is deeply tied to systems thinking, where the focus shifts from fixing isolated problems to understanding interdependencies. Resilient systems foster a culture of inquiry, reflection, and innovation.
Thomas et al. (2020) argue that embedding resilience in policy requires that flexibility be institutionalized—not just encouraged informally. This includes simulation exercises, after-action reviews, and scenario planning.
Social Care Integration
While much of the literature focuses on health systems, social care is equally critical to resilience. The pandemic exposed long-standing fragilities in long-term care, disability support, and community services—often marked by fragmentation and underfunding.
Integrated care models, where health and social services collaborate through shared governance, data, and planning, enhance resilience by supporting vulnerable populations in coordinated ways (WHO, 2021). This is especially important in addressing the social determinants of health during crises.
Barriers to Building Resilience
Several systemic barriers inhibit resilience-building efforts:
- Short-termism in budgeting and planning
- Bureaucratic rigidity that resists change
- Limited data infrastructure for real-time analysis
- Workforce silos and poor interdisciplinary collaboration
Addressing these challenges requires leadership committed to long-term capacity building, as well as reform incentives that reward adaptability rather than mere compliance.
A Global Imperative
Haldane et al. (2021), in a study of 28 countries’ COVID-19 responses, found that resilience was not simply a function of wealth or technology, but of governance, equity, and learning systems. High-performing countries engaged communities, protected frontline workers, and adapted their responses over time.
Similarly, Abimbola and Topp (2020) argue that integrity—defined as consistent, ethical decision-making that serves public good—is essential for resilience. Systems that violate trust during crises are likely to suffer long-term consequences, including reduced public cooperation.
Building resilience in health and social care management is not about preparing for a single catastrophic event—it is about strengthening the everyday systems that allow us to withstand, adapt to, and grow from disruptions. Resilience emerges from smart governance, empowered workforces, integrated infrastructures, and continuous learning.
Read also: Integrated Care Pathways In Health and Social Care Sectors
To make resilience a permanent feature of health and social care, we must embed it in our strategic planning, institutional culture, and investment priorities. In an age of uncertainty, resilience is not only a survival strategy—it is the foundation of long-term sustainability and equitable care.
Lilian Ogechi Mbah, HND, PGD, is a dynamic strategic business executive and seasoned specialist in health and social care, renowned for her ability to drive cross-sector innovation and sustainable impact. With a keen understanding of both corporate strategy and community health systems, she seamlessly integrates business acumen with compassionate care delivery. Her leadership has advanced operational excellence, stakeholder engagement, and policy implementation across diverse settings. Passionate about equity and quality, Lilian empowers teams to align organizational goals with human-centered outcomes. Her visionary approach and commitment to systemic improvement position her as a transformative leader at the intersection of business strategy and social care.
References
Abimbola, S. and Topp, S.M., 2020. Adaptation with integrity: Building health system resilience in uncertain times. BMJ Global Health, 5(6), e002633. https://doi.org/10.1136/bmjgh-2020-002633
Barasa, E., Cloete, K. and Gilson, L., 2020. From bouncing back to nurturing emergence: Reframing health systems resilience. The Lancet Global Health, 8(5), pp.e606–e613. https://doi.org/10.1016/S2214-109X(20)30135-7
Blanchet, K., Nam, S.L., Ramalingam, B. and Pozo-Martin, F., 2020. Governance and capacity to manage resilience of health systems: Towards a new conceptual framework. International Journal of Health Policy and Management, 9(10), pp.431–445. https://doi.org/10.15171/ijhpm.2020.14
Haldane, V., De Foo, C., Abdalla, S.M., et al., 2021. Health systems resilience in managing the COVID-19 pandemic: Lessons from 28 countries. Nature Medicine, 27, pp.964–980. https://doi.org/10.1038/s41591-021-01381-y
Hick, J.L., Hanfling, D., Wynia, M.K. and Pavia, A.T., 2020. Duty to plan: Health care, crisis standards of care, and COVID-19. New England Journal of Medicine, 382(21), pp.e96. https://doi.org/10.1056/NEJMp2005114
Kruk, M.E., Myers, M., Varpilah, S.T. and Dahn, B.T., 2020. What is a resilient health system? Lessons from Ebola. BMJ, 350, h2204. https://doi.org/10.1136/bmj.h2204
Kuhlmann, E., Batenburg, R., Dussault, G. and Larsen, C., 2021. Health labour market analysis for health system resilience: Lessons from COVID-19. The European Journal of Public Health, 31(Supplement_4), pp.iv12–iv17. https://doi.org/10.1093/eurpub/ckab154
Legido-Quigley, H., Asgari-Jirhandeh, N., De Maeseneer, J. and Greer, S.L., 2020. Are high-performing health systems resilient and responsive? The Lancet, 396(10260), pp.943–945. https://doi.org/10.1016/S0140-6736(20)31827-2
Thomas, S., Sagan, A., Larkin, J., Cylus, J., Figueras, J. and Karanikolos, M., 2020. Strengthening health systems resilience: Key concepts and strategies. WHO European Observatory Policy Brief. https://eurohealthobservatory.who.int
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