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


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          Background: 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. We conducted a review of empirical literature from both the health and other sectors to synthesize evidence on organizational resilience.

          Methods: We systematically searched for literature in PubMed, Econlit, EBSCOHOST databases, google, and Google Scholar and manually searched the reference lists of selected papers. We identified 34 papers that met our inclusion criteria. We analysed data from the selected papers by thematic review.

          Results: Resilience was generally taken to mean a system’s ability to continue to meet its objectives in the face of challenges. The concepts of resilience that were used in the selected papers emphasized not just a system’s capacity to withstand shocks, but also to adapt and transform. The resilience of organizations was influenced by the following factors: Material resources, preparedness and planning, information management, collateral pathways and redundancy, governance processes, leadership practices, organizational culture, human capital, social networks and collaboration.

          Conclusion: A common theme across the selected papers is the recognition of resilience as an emergent property of complex adaptive systems. Resilience is both a function of planning for and preparing for future crisis (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.

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          Most cited references29

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          Adaptive comanagement for building resilience in social-ecological systems.

          Ecosystems are complex adaptive systems that require flexible governance with the ability to respond to environmental feedback. We present, through examples from Sweden and Canada, the development of adaptive comanagement systems, showing how local groups self-organize, learn, and actively adapt to and shape change with social networks that connect institutions and organizations across levels and scales and that facilitate information flows. The development took place through a sequence of responses to environmental events that widened the scope of local management from a particular issue or resource to a broad set of issues related to ecosystem processes across scales and from individual actors, to group of actors to multiple-actor processes. The results suggest that the institutional and organizational landscapes should be approached as carefully as the ecological in order to clarify features that contribute to the resilience of social-ecological systems. These include the following: vision, leadership, and trust; enabling legislation that creates social space for ecosystem management; funds for responding to environmental change and for remedial action; capacity for monitoring and responding to environmental feedback; information flow through social networks; the combination of various sources of information and knowledge; and sense-making and arenas of collaborative learning for ecosystem management. We propose that the self-organizing process of adaptive comanagement development, facilitated by rules and incentives of higher levels, has the potential to expand desirable stability domains of a region and make social-ecological systems more robust to change.
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            Resilience, adaptation and adaptability

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              Resilient cities: meaning, models, and metaphor for integrating the ecological, socio-economic, and planning realms


                Author and article information

                Int J Health Policy Manag
                Int J Health Policy Manag
                Kerman University of Medical Sciences
                Int J Health Policy Manag
                International Journal of Health Policy and Management
                Kerman University of Medical Sciences
                June 2018
                06 February 2018
                : 7
                : 6
                : 491-503
                1Health Economics Research Unit, KEMRI Wellcome Trust Research Programme, Nairobi, Kenya.
                2Nuffield Department of Medicine, University of Oxford, Oxford, UK.
                3School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.
                4Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
                Author notes
                [* ] Correspondence to: Edwine Barasa Email: edwinebarasa@ 123456gmail.com
                © 2018 The Author(s); Published by Kerman University of Medical Sciences

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                : 22 July 2017
                : 20 January 2018
                Page count
                Figures: 1, Tables: 2, References: 62, Pages: 13
                Systematic Reviews

                health system resilience,complex adaptive systems,everyday resilience,health system shocks


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