{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T06:06:46Z","timestamp":1784700406123,"version":"3.55.0"},"reference-count":47,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The conceptualization, definition, and measurement of health system resilience remain contested, hindering policy integration. Country-specific empirical evidence from sub-Saharan Africa, where infectious disease shocks recur, is limited. This study explored how national-level Ugandan stakeholders conceptualize health system resilience to infectious disease shocks and its attributes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a descriptive exploratory qualitative study using semi-structured key informant interviews with 15 purposively selected national-level stakeholders from the Ministry of Health, academia, and development and implementing partners between May and July 2025. Data were analyzed using a hybrid deductive\u2013inductive (abductive) thematic analysis approach, drawing on Kruk et al.'s and the WHO's resilience frameworks while remaining open to emergent themes. Reporting follows the Consolidated Criteria for Reporting Qualitative Research (COREQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants conceptualized resilience across five capacities: preparedness, absorptive, adaptive, transformative, and recovery. Recovery-dominated narratives prevailed, while transformative capacity was least articulated, indicating a system oriented toward \u201cbouncing back\u201d rather than reform: A resilient system in Uganda is one that anticipates and prepares for infectious disease shocks; absorbs them while sustaining essential services; adapts through innovation and operational adjustment; recovers core functioning; and institutionalizes learning to transform structures, financing, and service delivery models in preparation for future shocks. Seven interconnected attributes were identified: (1) governance and leadership, (2) preparedness, (3) service delivery, (4) community involvement, (5) adaptability, (6) collaboration and partnerships, and (7) soft skills. Governance and leadership emerged as foundational; preparedness, service delivery, community involvement, adaptability, and collaboration as structural; and soft skills (trust, communication, cultural sensitivity) as relational enablers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>From the perspective of national-level actors, Uganda's health system is predominantly reactive, with recovery prioritized over transformation. Strengthening resilience requires institutionalizing learning, anticipatory financing, empowered subnational structures, and multisectoral partnerships. Future research should triangulate these perspectives with subnational, frontline, and community voices.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2026.1888814","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:53:36Z","timestamp":1784699616000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Resilience as recovery: stakeholder perspectives on Uganda's health system response to infectious disease shocks"],"prefix":"10.3389","volume":"6","author":[{"given":"Denis","family":"Okethwangu","sequence":"first","affiliation":[{"name":"Department of Health Policy, Planning and Management, Makerere University School of Public Health","place":["Kampala, Uganda"]},{"name":"Uganda National Institute of Public Health, Ministry of Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahima","family":"Venkateswaran","sequence":"additional","affiliation":[{"name":"Department of Global Health, Norwegian Institute of Public Health","place":["Oslo, Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex R.","family":"Ario","sequence":"additional","affiliation":[{"name":"Uganda National Institute of Public Health, Ministry of Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Nabatanzi","sequence":"additional","affiliation":[{"name":"Uganda National Institute of Public Health, Ministry of Health","place":["Kampala, Uganda"]},{"name":"Department of Epidemiology and Biostatistics, Makerere University School of Public Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evelyn","family":"Asio","sequence":"additional","affiliation":[{"name":"Uganda National Institute of Public Health, Ministry of Health","place":["Kampala, Uganda"]},{"name":"Department of Epidemiology and Biostatistics, Makerere University School of Public Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Ocom","sequence":"additional","affiliation":[{"name":"Uganda National Institute of Public Health, Ministry of Health","place":["Kampala, Uganda"]},{"name":"National Public Health Emergency Operation Center, Ministry of Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles L.","family":"Okot","sequence":"additional","affiliation":[{"name":"Epidemic Preparedness and Response Cluster, World Health Organization Regional Office for Africa","place":["Brazzaville, Republic of Congo"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Nyisomeh","sequence":"additional","affiliation":[{"name":"Global Health Security Project, Baylor College of Medicine","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Nankabirwa","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Makerere University School of Public Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizeus","family":"Rutebemberwa","sequence":"additional","affiliation":[{"name":"Department of Health Policy, Planning and Management, Makerere University School of Public Health","place":["Kampala, Uganda"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy W.","family":"Mayega","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Makerere University School of Public Health","place":["Kampala, Uganda"]},{"name":"Resilience Africa Network, Makerere University School of Public Health","place":["Kampala, 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