Favorable strategies and barriers to the attainment of resilience in healthcare systems: scoping review

The resilience of a healthcare system regards the ability of health actors, institutions, and the population to maintain their essential functions in the face of adversity and reorganize based on the lessons learned. Resilient systems can achieve and maintain equity in the health and well-being of populations and respond to public health emergencies. The present scoping review involved a search of the PubMed, Virtual Health Library, Web of Science, and SciELO databases and employed the protocol of the Joanna Briggs Institute to answer the following research question: "What does the scientific evidence indicate as strategies and barriers to the attainment of a resilient healthcare system?". The results revealed that the most strongly indicated strategies were decentralization of the system, a committed, motivated workforce, good governance and leadership, multisectoral partnerships, community involvement, an adequate information system, and investments that favor the sustainability of the healthcare system. In contrast, ineffective management without leadership, inadequate monitoring, an ineffective workforce, a lack of global solidarity, and failure to learn from past experiences constitute barriers to resilience. Understanding strategies and barriers is fundamental to the creation of a resilient healthcare system capable of dealing with chronic and acute stressors.