Institute for Research on Sustainable Development, CEPED (IRD-Université de Paris), Université de Paris, ERL INSERM SAGESUD, 45 Rue des Saints-Pères, 75006, Paris, France.
Department of Social and Preventive Medicine, University of Montreal, Montreal, Canada; Public Health Research Institute, University of Montreal, 2900, Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada; CESSMA (IRD-Paris-Diderot University), Université Sorbonne Paris Cité, Bâtiment Olympe de Gouges (8ème étage - secrétariat bureau 817) rue Albert Einstein, 75013, PARIS, France.
Soc Sci Med. 2019 Jul;232:168-180. doi: 10.1016/j.socscimed.2019.04.020. Epub 2019 Apr 30.
System resilience has long been an area of study, and the term has become increasingly used across different sectors. Studies on resilience in health systems are more recent, multiplying particularly since the 2014 Ebola epidemic in West Africa. The World Health Organization (WHO) is calling for national governments to increase the resilience of their health systems. Concepts help define research objects and guide the analysis. Yet, to be useful, concepts need to be clear and precise. We aimed to improve the conceptual understanding of health systems resilience by conducting a scoping review to describe the state of knowledge in this area. We searched for literature in 10 databases, and analyzed data using a list of themes. We evaluated the clarity and the precision of the concept of health systems resilience using Daigneault & Jacob's three dimensions of a concept: term, sense, and referent. Of the 1091 documents initially identified, 45 met the inclusion criteria. Term: multiple terms are used, switching from one to the other to speak about the same subject. Sense: there is no consensus yet on a unique definition. Referent: the magnitude and nature of events that resilient health systems face differ with context, covering a broad range of situations from sudden crisis to everyday challenges. The lack of clarity in this conceptualization hinders the expansion of knowledge, the creation of reliable analytical tools, and the effectiveness of communication. The current conceptualization of health systems resilience is too scattered to enable the enhancement of this concept with great potential, opening a large avenue for future research.
系统弹性长期以来一直是研究领域，并且该术语在不同领域的使用越来越多。关于卫生系统弹性的研究较新，自 2014 年西非埃博拉疫情以来，其数量呈指数级增长。世界卫生组织（WHO）呼吁各国政府提高其卫生系统的弹性。概念有助于定义研究对象并指导分析。然而，要使概念有用，就需要清晰和准确。我们旨在通过进行范围审查来提高对卫生系统弹性的概念理解，以描述该领域的知识状况。我们在 10 个数据库中搜索文献，并使用主题列表分析数据。我们使用 Daigneault 和 Jacob 的概念的三个维度（术语、意义和指称）来评估卫生系统弹性概念的清晰度和准确性。在最初确定的 1091 份文件中，有 45 份符合纳入标准。术语：使用多个术语，从一个术语切换到另一个术语来讨论同一主题。意义：尚未就独特的定义达成共识。指称：弹性卫生系统面临的事件的规模和性质因背景而异，涵盖从突发危机到日常挑战等广泛情况。这种概念化缺乏清晰度阻碍了知识的扩展、可靠分析工具的创建以及沟通的有效性。卫生系统弹性的当前概念化过于分散，无法利用这一具有巨大潜力的概念进行增强，为未来的研究开辟了广阔的途径。
