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Understanding fragility: implications for global health research and practice
Karin Diaconu1, Jennifer Falconer1, Nicole Vidal1
1NIHR Research Unit on Health in Situations of Fragility, Institute for Global Health and Development, Queen Margaret University, Edinburgh, EH21 6UU, UK.
Health Policy and Planning
|December 11, 2019
Summary
Global health progress is threatened by
Area of Science:
- Global Health
- Health Systems Research
- Population Health Management
Background:
- The concept of 'fragility' is increasingly applied in global health.
- Its precise relationship to health outcomes, service delivery, and utilization is unclear.
- This ambiguity risks hindering advancements in population health.
Purpose of the Study:
- To clarify the meaning, definitions, and applications of 'fragility' in global health literature.
- To conduct the first scoping review on this topic.
- To identify key attributes and themes related to health fragility.
Main Methods:
- A scoping review methodology was employed.
- Searched bibliographic and grey literature (10 sources) and key journals (5).
- Included documents applying 'fragility' to health systems, services, outcomes, or populations.
Main Results:
- 377 documents met inclusion criteria, with a significant increase in publications over the last decade.
- While formal definitions focus on 'fragile and conflict-affected states', diverse applications exist.
- Fragility is applied at various levels (state to community) and considers stressors beyond conflict, focusing on health system/community interfaces.
Conclusions:
- Trust emerges as a critical factor at the health system-community interface, influencing health-seeking behaviors.
- Understanding the multifaceted nature of health fragility is crucial for resilience.
- Addressing fragility is essential to prevent reversals in population health outcomes.
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