Kayvan Bozorgmehr - Department of Population Medicine and Health Services Research, School of Public Health, Bielefeld University, Bielefeld, Germany
Andreas Zick - Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany
Tobias Hecker - Institute for Interdisciplinary Research on Conflict & Violence (IKG), Bielefeld University, Bielefeld, Germany

The coronavirus disease ۲۰۱۹ (COVID-۱۹) pandemic has created opportunities to study resilience in multiple, interrelated societal systems while considering the institutional, community and individual level. We aim to discuss critical, yet underrepresented, issues in resilience discourses which are fundamental to advance theories, concepts and measurement of health system resilience. These relate to a better understanding of (i) how government’s handle and use uncertainties to facilitate or impede change, including the role of negotiation and conflicts, (ii) the intersections of health with multiple, co-occurring crises (systemic intersections), and (iii) cross-level interactions, ie, the interrelation between individual-level resilience, the collective resilience of groups and communities, and the resilience of a system as a whole (and vice versa). Analyses of these aspects can help to “contextualize” our understanding of resilience in complex adaptive systems. However, conceptual clarity is needed whether resilience is considered an underlying feature, outcome, or intermediate determinant of a (health) system’s performance.

Resilience, Uncertainty, Governance, Multi-Scale Dynamics, Conflict, Health System