Building Back Better: Development of Health System Resilience in Liberia During and After the Ebola Virus Disease and COVID-19 Outbreaks

• Author / Creator

  Villarroel Ocando, Hector Alonso

• It is widely accepted that fostering resilience in health systems is a crucial measure to increase
  preparedness to public health emergencies, preserve the health system’s functions, and protect
  population health. International organisations and individual global health actors have long
  endorsed efforts to understand the determinants of health system resilience in hopes of
  developing operational guidelines. However, much of the scientific work has so far focused on
  establishing conceptual approaches to frame resilience in health systems, and in measuring
  resilience as a set of cross-sectional indicators that cursorily assess the system’s aptitudes.
  Through a descriptive case study, this paper looks at the transformative dimension of health
  system resilience in Liberia (understood as functional and structural changes to the system’s
  institutions to improve resilience) to identify drivers and determinants organised under an
  operational framework and guided by the health system’s main functions. A literature review
  is used to develop a theory, and primary data collection through key informant interviews and
  technical document reviews explore evidence to refine the theory and draw conclusions.
  This study finds that, in operationalising transformative resilience, the Liberian health system
  fostered institutional evolution in nine areas (leadership and governance, health financing,
  health workforce, health service delivery, health infrastructure, health information systems,
  medical products and technologies, community trust and ownership, and interinstitutional
  collaboration). The study also concludes that policy mechanisms to enable resilience must be
  embedded into health system planning to successfully undertake transformative change in the
  system’s institutions and improve their performance during public health emergencies.

• Subjects / Keywords

  • Health Systems
  • Health Systems Resilience
  • Transformative Resilience
  • Health Systems Thinking

• Graduation date

  Fall 2024

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-3vg6-w908

• License

  This thesis is made available by the University of Alberta Library with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.