{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:25:54Z","timestamp":1772166354454,"version":"3.50.1"},"reference-count":92,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100006389","name":"University of Geneva","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006389","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Confl Health"],"DOI":"10.1186\/s13031-025-00735-4","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:26:26Z","timestamp":1764084386000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Resilient health systems appraisal model. whole-of-system approach to health system resilience in fragile contexts: a best-fit framework synthesis"],"prefix":"10.1186","volume":"19","author":[{"given":"Maisoon","family":"Elbukhari Ibrahim","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karl","family":"Blanchet","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"issue":"8","key":"735_CR1","doi-asserted-by":"publisher","first-page":"431","DOI":"10.15171\/ijhpm.2017.36","volume":"6","author":"K Blanchet","year":"2017","unstructured":"Blanchet K, Nam SL, Ramalingam B, Pozo-Martin F. Governance and capacity to manage resilience of health systems: towards a new conceptual framework. Int J Health Policy Manag. 2017;6(8):431\u20135.","journal-title":"Int J Health Policy Manag"},{"issue":"9","key":"735_CR2","doi-asserted-by":"publisher","first-page":"e0003658","DOI":"10.1371\/journal.pgph.0003658","volume":"4","author":"SM Dsouza","year":"2024","unstructured":"Dsouza SM, Katyal A, Kalaskar S, Kabeer M, Rewaria L, Satyanarayana S, et al. A scoping review of health systems resilience assessment frameworks. PLoS Glob Public Health. 2024;4(9):e0003658.","journal-title":"PLoS Glob Public Health"},{"issue":"1","key":"735_CR3","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1186\/s12913-023-10022-8","volume":"23","author":"S Copeland","year":"2023","unstructured":"Copeland S, Hinrichs-Krapels S, Fecondo F, Santizo ER, Bal R, Comes T. A resilience view on health system resilience: a scoping review of empirical studies and reviews. BMC Health Serv Res. 2023;23(1):1297.","journal-title":"BMC Health Serv Res"},{"key":"735_CR4","first-page":"1910","volume-title":"What is a resilient health system? Lessons from Ebola","author":"ME Kruk","year":"2015","unstructured":"Kruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. The Lancet: Lancet Publishing Group; 2015. pp. 1910\u20132."},{"issue":"1","key":"735_CR5","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/s13031-023-00560-7","volume":"18","author":"C Truppa","year":"2024","unstructured":"Truppa C, Yaacoub S, Valente M, Celentano G, Ragazzoni L, Saulnier D. Health systems resilience in fragile and conflict-affected settings: a systematic scoping review. Confl Health. 2024;18(1):2.","journal-title":"Confl Health"},{"key":"735_CR6","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/978-3-030-33812-1_6","volume-title":"Understanding the resilience of health systems. health policy and systems responses to forced migration","author":"K Blanchet","year":"2020","unstructured":"Blanchet K, Diaconu K, Witter S. Understanding the resilience of health systems. health policy and systems responses to forced migration. Cham: Springer International Publishing; 2020. pp. 99\u2013117."},{"key":"735_CR7","unstructured":"Thomas S, Sagan A, Larkin J, Cylus J, Figueras J, Karanikolos M. Strengthening health systems resilience POLICY BRIEF 36 key concepts and strategies. HEALTH SYSTEMS AND POLICY ANALYSIS. 2020."},{"issue":"12","key":"735_CR8","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1016\/j.healthpol.2022.10.001","volume":"126","author":"P Fleming","year":"2022","unstructured":"Fleming P, O\u2019Donoghue C, Almirall-Sanchez A, Mockler D, Keegan C, Cylus J, et al. Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries-a systematic review. Health Policy. 2022;126(12):1195\u2013205.","journal-title":"Health Policy"},{"key":"735_CR9","doi-asserted-by":"publisher","unstructured":"Organisation for Economic Cooperation and Development. States of Fragility 2022. 2022 edition .19 Sept 2022. https:\/\/doi.org\/10.1787\/c7fedf5e-en","DOI":"10.1787\/c7fedf5e-en"},{"key":"735_CR10","volume-title":"States of fragility 2025","author":"Organisation for Economic Cooperation and Development","year":"2025","unstructured":"Organisation for Economic Cooperation and Development. States of fragility 2025. Paris: Organisation for Economic Cooperation and Development; 2025. 18 February 2025."},{"issue":"1","key":"735_CR11","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1186\/s12913-022-08544-8","volume":"22","author":"L Forsgren","year":"2022","unstructured":"Forsgren L, Tediosi F, Blanchet K, Saulnier DD. Health systems resilience in practice: a scoping review to identify strategies for building resilience. BMC Health Serv Res. 2022;22(1):1173.","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"735_CR12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-006779","volume":"6","author":"DD Saulnier","year":"2021","unstructured":"Saulnier DD, Blanchet K, Canila C, Cobos Munoz D, Dal Zennaro L, de Savigny D, et al. A health systems resilience research agenda: moving from concept to practice. BMJ Glob Health. 2021;6(8):e006779-e.","journal-title":"BMJ Glob Health"},{"key":"735_CR13","unstructured":"World Health Organization. World health statistics 2025: monitoring health for the SDGs, Sustainable Development Goals2025."},{"key":"735_CR14","volume-title":"Report 2000: health systems: improving performance","author":"The world health","year":"2000","unstructured":"The world health. Report 2000: health systems: improving performance. Geneva: World Health Organization; 2000."},{"key":"735_CR15","volume-title":"Soucat,Agnes;Figueras, Josep health system performance assessment, a framework for policy analysis","author":"IR Papanicolas","year":"2022","unstructured":"Papanicolas IR, Karanikolos D. Marina; Soucat,Agnes;Figueras, Josep health system performance assessment, a framework for policy analysis. Geneva: World Health Organization; 2022."},{"key":"735_CR16","doi-asserted-by":"publisher","first-page":"iii91","DOI":"10.1093\/heapol\/czx118","volume":"32","author":"EW Barasa","year":"2017","unstructured":"Barasa EW, Cloete K, Gilson L. From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening. Health Policy Plann. 2017;32:iii91\u20134.","journal-title":"Health Policy Plann"},{"key":"735_CR17","unstructured":"World Health O. Everybody\u2019s business: strengthening health systems to improve health outcomes : WHO\u2019s framework for action. World Health Organization. 2007; pp. 44\u2013p."},{"key":"735_CR18","doi-asserted-by":"publisher","DOI":"10.1093\/heapol\/czs084","author":"T Adam","year":"2012","unstructured":"Adam T, De Savigny D. Systems thinking for strengthening health systems in LMICs: need for a paradigm shift. Health Policy Plan. 2012. https:\/\/doi.org\/10.1093\/heapol\/czs084.","journal-title":"Health Policy Plan"},{"key":"735_CR19","doi-asserted-by":"publisher","DOI":"10.1186\/1478-4505-12-51","author":"DH Peters","year":"2014","unstructured":"Peters DH. The application of systems thinking in health: why use systems thinking? Health Res Policy Syst. 2014. https:\/\/doi.org\/10.1186\/1478-4505-12-51.","journal-title":"Health Res Policy Syst"},{"key":"735_CR20","doi-asserted-by":"crossref","unstructured":"Blanchet K. Thinking Shift on Health Systems: From Blueprint Health Programmes towards Resilience of Health Systems; Comment on Constraints to Applying Systems Thinking Concepts in Health Systems: A Regional Perspective from Surveying Stakeholders in Eastern Mediterranean Countries. 2015.","DOI":"10.15171\/ijhpm.2015.49"},{"key":"735_CR21","doi-asserted-by":"publisher","first-page":"151","DOI":"10.12688\/wellcomeopenres.17834.1","volume":"7","author":"SA Ismail","year":"2022","unstructured":"Ismail SA, Bell S, Chalabi Z, Fouad FM, Mechler R, Tomoaia-Cotisel A, et al. Conceptualising and assessing health system resilience to shocks: a cross-disciplinary view. Wellcome Open Res. 2022;7:151.","journal-title":"Wellcome Open Res"},{"key":"735_CR22","volume-title":"Basics of qualitative research: Techniques and procedures for developing grounded theory","author":"J Corbin","year":"2014","unstructured":"Corbin J, Strauss A. Basics of qualitative research: Techniques and procedures for developing grounded theory. Sage publications; 2014."},{"key":"735_CR23","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-13-37","volume":"13","author":"C Carroll","year":"2013","unstructured":"Carroll C, Booth A, Leaviss J, Rick J. Best fit\" framework synthesis: refining the method. BMC Med Res Methodol. 2013;13:37.","journal-title":"BMC Med Res Methodol"},{"key":"735_CR24","doi-asserted-by":"publisher","DOI":"10.15171\/ijhpm.2018.06","author":"E Barasa","year":"2018","unstructured":"Barasa E, Mbau R, Gilson L. What is resilience and how can it be nurtured? A systematic review of empirical literature on organizational resilience. Int J Health Policy Manag. 2018. https:\/\/doi.org\/10.15171\/ijhpm.2018.06.","journal-title":"Int J Health Policy Manag"},{"key":"735_CR25","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/1741-7015-9-39","volume":"9","author":"M Dixon-Woods","year":"2011","unstructured":"Dixon-Woods M. Using framework-based synthesis for conducting reviews of qualitative studies. BMC Med. 2011;9:39.","journal-title":"BMC Med"},{"issue":"1","key":"735_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-025-01410-z","volume":"23","author":"M Elbukhari Ibrahim","year":"2025","unstructured":"Elbukhari Ibrahim M, Hassan SEH, Saulnier DD, Blanchet K. Measuring what matters: key indicators for performance and resilience in fragile, low-income contexts. A scoping review. Health Res Policy Syst. 2025;23(1):146.","journal-title":"Health Res Policy Syst"},{"issue":"1","key":"735_CR27","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1186\/s12874-018-0611-x","volume":"18","author":"Z Munn","year":"2018","unstructured":"Munn Z, Peters MDJ, Stern C, Tufanaru C, McArthur A, Aromataris E. Systematic review or scoping review? Guidance for authors when choosing between a systematic or scoping review approach. BMC Med Res Methodol. 2018;18(1):143.","journal-title":"BMC Med Res Methodol"},{"key":"735_CR28","unstructured":"Murray CJL, Frenk J. A framework for assessing the performance of health systems. Bulletin of the World Health Organization. 2000."},{"key":"735_CR29","volume-title":"Covidence systematic review software","author":"VH Innovation","year":"2024","unstructured":"Innovation VH. Covidence systematic review software. Melbourne,Australia.: Veritas Health Innovation; 2024."},{"key":"735_CR30","doi-asserted-by":"crossref","unstructured":"Elbukhari Ibrahim M, Hassan SE-D, Saulnier D, Blanchet K. Measuring what matters: key indicators for performance and resilience in fragile and Low-Income contexts. A scoping review. 2024.","DOI":"10.1186\/s12961-025-01410-z"},{"key":"735_CR31","unstructured":"UHC2030. Harmonizing and Aligning Health Systems Assessments (HSA).Review of HSA tools and approaches. 2017."},{"key":"735_CR32","unstructured":"World Health O. Monitoring the Building blocks of health systems: a handbook of indicators and their measurement strategies. World Health Organization. 2010;pp. 92\u2013p."},{"key":"735_CR33","volume-title":"The health system assessment approach: A How-To Manual. Version 3.0","author":"USAID","year":"2017","unstructured":"USAID. The health system assessment approach: A How-To Manual. Version 3.0. Washington, D.C.: USAID; 2017."},{"key":"735_CR34","volume-title":"International Health Regulations (2005): State Party Self-assessment annual reporting tool, second edition","author":"World Health Organization","year":"2021","unstructured":"World Health Organization. International Health Regulations (2005): State Party Self-assessment annual reporting tool, second edition. Geneva: World Health Organization; 2021."},{"key":"735_CR35","volume-title":"Health system resilience indicators: an integrated package for measuring and monitoring health system resilience in countries","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. Health system resilience indicators: an integrated package for measuring and monitoring health system resilience in countries. Geneva: World Health Organization; 2024."},{"key":"735_CR36","doi-asserted-by":"publisher","first-page":"j2323","DOI":"10.1136\/bmj.j2323","volume":"357","author":"ME Kruk","year":"2017","unstructured":"Kruk ME, Ling EJ, Bitton A, Cammett M, Cavanaugh K, Chopra M, et al. Building resilient health systems: a proposal for a resilience index. BMJ. 2017;357:j2323.","journal-title":"BMJ"},{"issue":"1","key":"735_CR37","doi-asserted-by":"publisher","DOI":"10.1186\/s12961-023-01031-4","volume":"21","author":"NA Pradhan","year":"2023","unstructured":"Pradhan NA, Samnani A, Abbas K, Rizvi N. Resilience of primary healthcare system across low- and middle-income countries during COVID-19 pandemic: a scoping review. Health Res Policy Syst. 2023;21(1):98.","journal-title":"Health Res Policy Syst"},{"issue":"1","key":"735_CR38","first-page":"26","volume":"35","author":"Z Jamal","year":"2020","unstructured":"Jamal Z, Alameddine M, Diaconu K, Lough G, Witter S, Ager A, et al. Health system resilience in the face of crisis: analysing the challenges, strategies and capacities for UNRWA in Syria. Health Policy Plan. 2020;35(1):26\u201335.","journal-title":"Health Policy Plan"},{"key":"735_CR39","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2022-010683","author":"T Lerosier","year":"2023","unstructured":"Lerosier T, Toure L, Diabate S, Diarra Y, Ridde V. Minimal resilience and insurgent conflict: qualitative analysis of the resilience process in six primary health centres in central Mali. BMJ Glob Health. 2023. https:\/\/doi.org\/10.1136\/bmjgh-2022-010683.","journal-title":"BMJ Glob Health"},{"issue":"3","key":"735_CR40","doi-asserted-by":"publisher","first-page":"355","DOI":"10.1093\/heapol\/czx183","volume":"33","author":"J Hanefeld","year":"2018","unstructured":"Hanefeld J, Mayhew S, Legido-Quigley H, Martineau F, Karanikolos M, Blanchet K, et al. Towards an understanding of resilience: responding to health systems shocks. Health Policy Plann. 2018;33(3):355\u201367.","journal-title":"Health Policy Plann"},{"key":"735_CR41","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1137865","volume":"11","author":"L Ako-Egbe","year":"2023","unstructured":"Ako-Egbe L, Seifeldin R, Saikat S, Wesseh SC, Bolongei MB, Ngormbu BJ, et al. Liberia health system\u2019s journey to long-term recovery and resilience post-Ebola: a case study of an exemplary multi-year collaboration. Front Public Health. 2023;11:1137865.","journal-title":"Front Public Health"},{"key":"735_CR42","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0261904","author":"HC Karamagi","year":"2022","unstructured":"Karamagi HC, Titi-Ofei R, Kipruto HK, Seydi ABW, Droti B, Talisuna A, et al. On the resilience of health systems: a methodological exploration across countries in the WHO African Region. PLoS One. 2022. https:\/\/doi.org\/10.1371\/journal.pone.0261904.","journal-title":"PLoS One"},{"key":"735_CR43","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s13690-017-0221-9","volume":"75","author":"T Manyazewal","year":"2017","unstructured":"Manyazewal T. Using the world health organization health system building blocks through survey of healthcare professionals to determine the performance of public healthcare facilities. Arch Public Health. 2017;75:50.","journal-title":"Arch Public Health"},{"key":"735_CR44","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-004618","author":"HC Karamagi","year":"2021","unstructured":"Karamagi HC, Tumusiime P, Titi-Ofei R, Droti B, Kipruto H, Nabyonga-Orem J, et al. Towards universal health coverage in the WHO African Region: assessing health system functionality, incorporating lessons from COVID-19. BMJ Glob Health. 2021. https:\/\/doi.org\/10.1136\/bmjgh-2020-004618.","journal-title":"BMJ Glob Health"},{"key":"735_CR45","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2020-002429","author":"D Meyer","year":"2020","unstructured":"Meyer D, Bishai D, Ravi SJ, Rashid H, Mahmood SS, Toner E, et al. A checklist to improve health system resilience to infectious disease outbreaks and natural hazards. BMJ Glob Health. 2020. https:\/\/doi.org\/10.1136\/bmjgh-2020-002429.","journal-title":"BMJ Glob Health"},{"issue":"7","key":"735_CR46","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1093\/heapol\/czad032","volume":"38","author":"MA Peters","year":"2023","unstructured":"Peters MA, Ahmed T, Azais V, Amor Fernandez P, Baral P, Drouard S, et al. Resilience of front-line facilities during COVID-19: evidence from cross-sectional rapid surveys in eight low- and middle-income countries. Health Policy Plann. 2023;38(7):789\u201398.","journal-title":"Health Policy Plann"},{"issue":"6","key":"735_CR47","doi-asserted-by":"publisher","first-page":"911","DOI":"10.1093\/heapol\/czx031","volume":"32","author":"N Qirbi","year":"2017","unstructured":"Qirbi N, Ismail SA. Health system functionality in a low-income country in the midst of conflict: the case of Yemen. Health Policy Plan. 2017;32(6):911\u201322.","journal-title":"Health Policy Plan"},{"issue":"suppl_3","key":"735_CR48","doi-asserted-by":"publisher","first-page":"iii40","DOI":"10.1093\/heapol\/czx109","volume":"32","author":"EJ Ling","year":"2017","unstructured":"Ling EJ, Larson E, Macauley RJ, Kodl Y, VanDeBogert B, Baawo S, et al. Beyond the crisis: did the Ebola epidemic improve resilience of Liberia\u2019s health system? Health Policy Plan. 2017;32(suppl_3):iii40\u20137.","journal-title":"Health Policy Plan"},{"issue":"1","key":"735_CR49","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1109\/TCSS.2024.3451519","volume":"12","author":"M Wang","year":"2025","unstructured":"Wang M, Wang J, Wang H. Conceptualizing resilience in healthcare systems through domain modeling. IEEE Trans Comput Social Syst. 2025;12(1):113\u201327.","journal-title":"IEEE Trans Comput Social Syst"},{"key":"735_CR50","unstructured":"Robinson DBL. Domain analysis. In: Bawden D, Robinson L, editors. Introduction to information science. 2 ed. Facet. 2022; pp. 113\u201332."},{"issue":"6","key":"735_CR51","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1016\/0021-9681(87)90003-8","volume":"40","author":"E Ware","year":"1987","unstructured":"Ware E. Standards for validating health measures: definition and content. J Chronic Dis. 1987;40(6):473\u201380.","journal-title":"J Chronic Dis"},{"issue":"5","key":"735_CR52","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1093\/heapol\/czr054","volume":"27","author":"L Paina","year":"2012","unstructured":"Paina L, Peters DH. Understanding pathways for scaling up health services through the lens of complex adaptive systems. Health Policy Plan. 2012;27(5):365\u201373.","journal-title":"Health Policy Plan"},{"key":"735_CR53","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/978-3-030-03189-3_15","volume-title":"Exploring resilience: A scientific journey from practice to theory","author":"C Macrae","year":"2019","unstructured":"Macrae C, Wiig S, Resilience. From practice to theory and back again. In: Wiig S, Fahlbruch B, editors. Exploring resilience: A scientific journey from practice to theory. Cham: Springer International Publishing; 2019. pp. 121\u20138."},{"key":"735_CR54","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2021.114523","volume":"292","author":"M Hennink","year":"2022","unstructured":"Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: a systematic review of empirical tests. Soc Sci Med. 2022;292:114523.","journal-title":"Soc Sci Med"},{"key":"735_CR55","doi-asserted-by":"crossref","unstructured":"Morse JM. Qual Health Res. Data were saturated.\u00a02015;25(5):587\u20138.","DOI":"10.1177\/1049732315576699"},{"key":"735_CR56","volume-title":"Operational framework for primary health care: transforming vision into action","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. Operational framework for primary health care: transforming vision into action. Geneva: World Health Organization and the United Nations Children\u2019s Fund (UNICEF),; 2020."},{"key":"735_CR57","unstructured":"Ettelt S, Nolte E, Thomson S, Mays N. A Review of the Role and Responsibilities of National Ministries of Health in Five Countries. 2007."},{"key":"735_CR58","unstructured":"Future of Global Health Initiatives. The Lusaka Agenda: Conclusions of the Future of Global Health Initiatives Process. Lusaka: Future of Global Health Initiatives. 2023 December 12, 2023."},{"issue":"1","key":"735_CR59","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1093\/heapol\/17.1.14","volume":"17","author":"TJ Bossert","year":"2002","unstructured":"Bossert TJ, Beauvais JC. Decentralization of health systems in Ghana, Zambia, Uganda and the Philippines: a comparative analysis of decision space. Health Policy Plan. 2002;17(1):14\u201331.","journal-title":"Health Policy Plan"},{"issue":"2","key":"735_CR60","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1111\/1468-0009.12327","volume":"96","author":"A Dwicaksono","year":"2018","unstructured":"Dwicaksono A, Fox AM. Does decentralization improve health system performance and outcomes in low- and middle-income countries? A systematic review of evidence from quantitative studies. Milbank Q. 2018;96(2):323\u201368.","journal-title":"Milbank Q"},{"issue":"8","key":"735_CR61","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1093\/heapol\/czz055","volume":"34","author":"S Abimbola","year":"2019","unstructured":"Abimbola S, Baatiema L, Bigdeli M. The impacts of decentralization on health system equity, efficiency and resilience: a realist synthesis of the evidence. Health Policy Plan. 2019;34(8):605\u201317.","journal-title":"Health Policy Plan"},{"key":"735_CR62","doi-asserted-by":"publisher","first-page":"1081068","DOI":"10.3389\/fpubh.2022.1081068","volume":"10","author":"L Zhao","year":"2023","unstructured":"Zhao L, Jin Y, Zhou L, Yang P, Qian Y, Huang X, Min M. Evaluation of health system resilience in 60 countries based on their responses to COVID-19. Front Public Health. 2023;10:1081068. https:\/\/doi.org\/10.3389\/fpubh.2022.1081068","journal-title":"Front Public Health"},{"key":"735_CR63","volume-title":"Systems Thinking for Health Systems Strengthening","author":"D De Savigny","year":"2009","unstructured":"De Savigny D, Adam T. Systems Thinking for Health Systems Strengthening. Geneva: WHO Library Cataloguing-in-Publication Data; 2009."},{"key":"735_CR64","unstructured":"Derick W, Brinkerhoff DJ, Kanthor J. Dheepa Rajan and Katie Shepard. Accountability, health Governance, and health systems: Uncovering the linkages. U.S. Agency for International Development (USAID). 2017."},{"issue":"4","key":"735_CR65","doi-asserted-by":"publisher","first-page":"836","DOI":"10.1111\/1468-0009.12301","volume":"95","author":"J Veillard","year":"2017","unstructured":"Veillard J, Cowling K, Bitton A, Ratcliffe H, Kimball M, Barkley S, et al. Better measurement for performance improvement in low- and middle-income countries: the primary health care performance initiative (PHCPI) experience of conceptual framework development and indicator selection. Milbank Q. 2017;95(4):836\u201383.","journal-title":"Milbank Q"},{"issue":"1","key":"735_CR66","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1186\/s12960-022-00742-z","volume":"20","author":"T Martineau","year":"2022","unstructured":"Martineau T, Ozano K, Raven J, Mansour W, Bay F, Nkhoma D, et al. Improving health workforce governance: the role of multi-stakeholder coordination mechanisms and human resources for health units in ministries of health. Hum Resour Health. 2022;20(1):47.","journal-title":"Hum Resour Health"},{"issue":"1","key":"735_CR67","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s12960-022-00749-6","volume":"20","author":"S Garg","year":"2022","unstructured":"Garg S, Tripathi N, McIsaac M, Zurn P, Zapata T, Mairembam DS, et al. Implementing a health labour market analysis to address health workforce gaps in a rural region of India. Hum Resour Health. 2022;20(1):50.","journal-title":"Hum Resour Health"},{"issue":"1","key":"735_CR68","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s12960-023-00880-y","volume":"21","author":"PA McQuide","year":"2023","unstructured":"McQuide PA, Brown AN, Diallo K, Siyam A. The transition of human resources for health information systems from the MDGs into the SDGs and the post-pandemic era: reviewing the evidence from 2000 to 2022. Hum Resour Health. 2023;21(1):93.","journal-title":"Hum Resour Health"},{"issue":"1","key":"735_CR69","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1186\/s12960-023-00872-y","volume":"21","author":"H Toure","year":"2023","unstructured":"Toure H, Aranguren Garcia M, Bustamante Izquierdo JP, Coulibaly S, Nganda B, Zurn P. Health expenditure: how much is spent on health and care worker remuneration? An analysis of 33 low- and middle-income African countries. Hum Resour Health. 2023;21(1):96.","journal-title":"Hum Resour Health"},{"issue":"1","key":"735_CR70","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1186\/s12960-022-00744-x","volume":"20","author":"AE Micah","year":"2022","unstructured":"Micah AE, Solorio J, Stutzman H, Zhao Y, Tsakalos G, Dieleman JL. Development assistance for human resources for health, 1990\u20132020. Hum Resour Health. 2022;20(1):51.","journal-title":"Hum Resour Health"},{"key":"735_CR71","volume-title":"Global strategy on human resources for health: workforce 2030","author":"World Health Organization","year":"2016","unstructured":"World Health Organization. Global strategy on human resources for health: workforce 2030. editor. Geneva: World Health Organization,;: World Health Organization; 2016."},{"issue":"1","key":"735_CR72","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s12960-023-00799-4","volume":"21","author":"A Dedeilia","year":"2023","unstructured":"Dedeilia A, Papapanou M, Papadopoulos AN, Karela NR, Androutsou A, Mitsopoulou D, et al. Health worker education during the COVID-19 pandemic: global disruption, responses and lessons for the future-a systematic review and meta-analysis. Hum Resour Health. 2023;21(1):13.","journal-title":"Hum Resour Health"},{"issue":"1","key":"735_CR73","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12960-022-00785-2","volume":"20","author":"O Enabulele","year":"2022","unstructured":"Enabulele O, Enabulele JE. Pre-service medical education course completion and drop-out rates. Hum Resour Health. 2022;20(1):88.","journal-title":"Hum Resour Health"},{"key":"735_CR74","unstructured":"Abdul Rahim HF, Fendt-Newlin M, Al-Harahsheh ST, Campbell J. Our duty of care: A global call to action to protect the mental health of health and care workers Doha (Qatar): World Innovation Summit for Health (WISH); 2022 [Available from: https:\/\/www.researchgate.net\/publication\/364309627_Our_duty_of_care_A_global_call_to_action_to_protect_the_mental_health_of_health_and_care_workers"},{"key":"735_CR75","unstructured":"World Health Organization. Support tool to strengthen health information systems: guidance for health information system assessment and strategy development. Second edition. Copenhagen: WHO Regional Office for Europe. 2024 [cited 2025 31 May 2025]."},{"key":"735_CR76","unstructured":"World Health Organization. WHO Glossary of Health Data, Statistics and Public Health Indicators. 2024."},{"key":"735_CR77","volume-title":"WHO Global Benchmarking Tool (GBT) for evaluation of national regulatory system of medical products: manual for benchmarking and formulation of institutional development plans","author":"World Health Organization","year":"2024","unstructured":"World Health Organization. WHO Global Benchmarking Tool (GBT) for evaluation of national regulatory system of medical products: manual for benchmarking and formulation of institutional development plans. Geneva: World Health Organization; 2024."},{"key":"735_CR78","volume-title":"Good storage and distribution practices for medical products: Annex 7","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. Good storage and distribution practices for medical products: Annex 7. Geneva, Switzerland: World Health Organization; 2020."},{"issue":"1","key":"735_CR79","doi-asserted-by":"publisher","first-page":"36","DOI":"10.12927\/hcq.2021.26467","volume":"24","author":"AW Snowdon","year":"2021","unstructured":"Snowdon AW, Saunders M, Wright A. Key characteristics of a fragile healthcare supply chain: learning from a pandemic. Healthc Q. 2021;24(1):36\u201343.","journal-title":"Healthc Q"},{"key":"735_CR80","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2024-015136","author":"M Puri","year":"2024","unstructured":"Puri M, Veillard JH, Brown A, Klein D. A comparative analysis of supply chain factors impacting COVID-19 vaccine security in high-income countries (HICs) and low-income and middle-income countries (LMICs). BMJ Glob Health. 2024. https:\/\/doi.org\/10.1136\/bmjgh-2024-015136.","journal-title":"BMJ Glob Health"},{"key":"735_CR81","unstructured":"World Health Organization. Joint assessment of National health strategies and plans. Combined Joint Assessment Tool and Guidelines. Geneva 2013."},{"key":"735_CR82","volume-title":"The health financing progress matrix: country assessment guide. Health financing guidance, no 9","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. The health financing progress matrix: country assessment guide. Health financing guidance, no 9. Geneva: World Health Organization; 2020."},{"key":"735_CR83","unstructured":"ReBUILD Consortium. Strengthening innovative health financing in fragile and Shock-Prone settings (2018\u20132022). ReBUILD Consortium. 2024."},{"issue":"3","key":"735_CR84","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1093\/heapol\/czz160","volume":"35","author":"J Odhiambo","year":"2020","unstructured":"Odhiambo J, Jeffery C, Lako R, Devkota B, Valadez JJ. Measuring health system resilience in a highly fragile Nation during protracted conflict: South Sudan 2011-15. Health Policy Plan. 2020;35(3):313\u201322.","journal-title":"Health Policy Plan"},{"issue":"6","key":"735_CR85","doi-asserted-by":"publisher","first-page":"1314","DOI":"10.1038\/s41591-022-01750-1","volume":"28","author":"C Arsenault","year":"2022","unstructured":"Arsenault C, Gage A, Kim MK, Kapoor NR, Akweongo P, Amponsah F, et al. COVID-19 and resilience of healthcare systems in ten countries. Nat Med. 2022;28(6):1314\u201324.","journal-title":"Nat Med"},{"issue":"1","key":"735_CR86","doi-asserted-by":"publisher","first-page":"6","DOI":"10.15171\/ijhpm.2019.71","volume":"9","author":"M Fridell","year":"2019","unstructured":"Fridell M, Edwin S, Schreeb Jv, Saulnier DD. Health system resilience: what are we talking about? A scoping review mapping characteristics and keywords. Int J Health Policy Manag. 2019;9(1):6\u201316.","journal-title":"Int J Health Policy Manag"},{"issue":"10","key":"735_CR87","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.1093\/heapol\/czy100","volume":"33","author":"JF Naimoli","year":"2018","unstructured":"Naimoli JF, Saxena S. Realizing their potential to become learning organizations to foster health system resilience: opportunities and challenges for health ministries in low- and middle-income countries. Health Policy Plan. 2018;33(10):1083\u201395.","journal-title":"Health Policy Plan"},{"key":"735_CR88","doi-asserted-by":"publisher","first-page":"168","DOI":"10.1016\/j.socscimed.2019.04.020","volume":"232","author":"CP Turenne","year":"2019","unstructured":"Turenne CP, Gautier L, Degroote S, Guillard E, Chabrol F, Ridde V. Conceptual analysis of health systems resilience: a scoping review. Soc Sci Med. 2019;232:168\u201380.","journal-title":"Soc Sci Med"},{"key":"735_CR89","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-7707-z","author":"JB Nuzzo","year":"2019","unstructured":"Nuzzo JB, Meyer D, Snyder M, Ravi SJ, Lapascu A, Souleles J, et al. What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review. BMC Public Health. 2019. https:\/\/doi.org\/10.1186\/s12889-019-7707-z.","journal-title":"BMC Public Health"},{"key":"735_CR90","unstructured":"Brinkerhoff D, Jacobstein D, Kanthor J, Rajan D, Shephard K, Accountability. Health Governance, and Health Systems: Uncovering the Linkages. 2017."},{"key":"735_CR91","unstructured":"(OECD). OfEC-oaD. Methodology for Assessing Procurement Systems 2025 2025 [Available from: https:\/\/www.mapsinitiative.org\/"},{"issue":"1","key":"735_CR92","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1186\/s12992-021-00702-7","volume":"17","author":"AW Tadesse","year":"2021","unstructured":"Tadesse AW, Gurmu KK, Kebede ST, Habtemariam MK. Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia. Glob Health. 2021;17(1):53.","journal-title":"Glob Health"}],"container-title":["Conflict and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13031-025-00735-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13031-025-00735-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13031-025-00735-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T19:02:16Z","timestamp":1766343736000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13031-025-00735-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":92,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["735"],"URL":"https:\/\/doi.org\/10.1186\/s13031-025-00735-4","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-7269670\/v1","asserted-by":"object"}]},"ISSN":["1752-1505"],"issn-type":[{"value":"1752-1505","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,25]]},"assertion":[{"value":"1 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not Applicable, the study doesn\u2019t report on or involve the use of any animal or human data.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"94"}}