“We are all Vulnerable, we are all Fragile”: COVID-19 and Health Service Resilience in Colombia

Abstract

One managerial narrative describes COVID-19 as a trigger for innovation in health system planning and delivery. Analysing 32 interviews with national stakeholders in Colombia´s health system, this paper argues that an “innovation” narrative provides a partial account of managerial responses to COVID-19. COVID-19 triggered positive and negative effects on adaptive resilience: as mirror for recognising problems predating the pandemic; as accelerator of service changes; as source of solidarity among professional groups; as workforce trauma; and as disruptor of adjacent improvement activity. The paper concludes that multi-level sources of adaptive resilience, and the costs of its practice, need to be recognised.