Understanding the Resilience of Health Systems



Globally, displacement is now at the highest level ever recorded with 68.5 million people being forcibly displaced due to violence, political instability or poor economic conditions. Migration towards neighbouring countries or more distant high-income settings in Europe is creating new challenges for national health systems. This chapter explores health systems resilience, i.e. the capacity of health systems to adapt and transform themselves in response to challenges. We offer reflections and a new conceptual framework on resilience based on systems thinking and complexity theories. This chapter also offers examples of migration-related challenges and resilience responses in health systems and policies in order to illustrate the utility and relevance of the developed conceptual framework for European and neighbouring health systems faced by population flows and conflict. Finally, we make recommendations for a new research agenda.


Health system resilience Resilience capacities Conceptual framework Resilience index Migration Health systems research 

List of Abbreviations


Health System Assessment


Universal Health Coverage


Migration Integration Policy Index


United Nations System for Disaster Risk Reduction


European Union


United Nations Relief and Works Agency for Palestine Refugees in the Near East


Mental health and psychosocial support


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.CERAH - Geneva Centre for Education and Research in Humanitarian ActionA Joint Centre of Université de Genève/The Graduate Institute (IHEID)GenevaSwitzerland
  2. 2.Queen Margaret UniversityMusselburghUK

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