Abstract
The concept of community resilience has gained considerable attention in the global health discussions since the Ebola outbreak of West Africa in 2014–2015. However, there are no measurement models to quantify community resilience. Without measurement models, it is unclear how to test strategies for building community resilience or to describe their likely intended and unintended results and their impact on health outcomes. We propose a measurement model for community resilience with relevant constructs and indicators to measure these constructs. We conducted a scoping review, systematically searching, screening and selecting relevant articles from two bibliographic databases (PUBMED and Google Scholar) for literature using search terms such as “resilience”, “community resilience” and “health systems resilience”. We screened 500 papers, then completed a full text review of 112 identified as relevant based on their title and abstract. A total of 27 papers and reports were retained for analysis. We then aggregated and synthesised the various definitions of community resilience and the frameworks for understanding these definitions. We identified key constructs from these frameworks and organised these constructs into domains and sub-domains. We proposed indicators to capture aspects of these domains and sub-domains and operationalised these indicators as a measurement model for quantifying community resilience in health systems. We propose a model with 20 indicators to assess community resilience. These indicators tap into various constructs from different theoretical frameworks of community resilience and are useful for assessing the level of knowledge, financial resources, and human, social and physical capital that are needed (or lacking) to respond to any types of shock, including health shock at the community level. This is an initial attempt to describe a multilevel measurement model for quantifying community resilience. This model will help to guide the development and testing of strategies for strengthening community resilience and will require further work to assess its relevance, reliability and validity in different LMIC settings.
Highlights
The concept of resilience has gained a lot of attention in global health discussion since the Ebola outbreak in West Africa between 2014 and 2015 [1, 2] due to a recognition of the weakness of national health systems and early failings of global health agencies to adequately respond to the epidemic [3–5]
While this review focuses on low- and middle-income countries (LMICs), we chose to include papers from highincome countries (HICs) in identifying specific attributes of community resilience because some of these attributes apply across both LMIC and HIC settings
Definitions of community resilience With community defined as a geographically bounded entity including people and institutions operating within a common environment, Norris et al [18] compiled a list of sample definitions of community resilience which we have expanded to include more recent definitions (Table 2)
Summary
The concept of resilience has gained a lot of attention in global health discussion since the Ebola outbreak in West Africa between 2014 and 2015 [1, 2] due to a recognition of the weakness of national health systems (conceptualised as a lack of resilience) and early failings of global health agencies to adequately respond to the epidemic [3–5]. The concept mostly prioritises maintaining the status quo or stable functioning of health systems and not necessarily beneficial population health outcomes (such as the effective and equitable distribution of health services coverage) [9, 10] Such criticisms have noted the possibility of maintaining the stability of health systems while perpetuating pre-existing vulnerabilities and societal imbalances that may underlie some currently stable but poorly performing health systems [11, 12]. It is not clear how the concept links to traditional health services and health outcomes, such as universal access to effective health services, equitable distribution of such services and improvement of population health, neither are there measurement models to quantify resilience and its relationships with these outcomes [9]. It is unclear how to develop and test strategies build resilience in health systems or to describe the likely intended and unintended results of these strategies and the impact they may have on health outcomes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
