Health workforce resilience in the age of polycrisis: A framework to support health workforce policy and planning
Olivier Onvlee1, Eelco Jacobs2, Noor Tromp2
1KIT Royal Tropical Institute, Amsterdam, The Netherlands; Department of Human Geography and Spatial Planning, Utrecht University, Utrecht, The Netherlands.
Background:
Many countries face prolonged health workforce crises, marked by shortages, maldistribution, skills mix imbalances and attrition. When workforces are overstretched, they become more vulnerable to external shocks and chronic strains, including infectious disease outbreaks, climate-related effects and political instability. This is particularly concerning as an emerging global "polycrisis" means such external pressures increasingly interact and amplify one another in unpredictable ways. Strengthening health workforce resilience must therefore become a priority for policy and planning.
Objective:
To introduce a resilience lens for health workforce policy and planning.
Methods:
This conceptual paper synthesises literature from health workforce and systems research, resilience, and complex adaptive systems theory, complemented by practical insights from workforce planning and governance.
Results:
The paper introduces the Health Workforce Resilience framework, which illustrates how the multilevel nature of health workforce resilience connects individual health workers, teams and organisations, and the national health workforce level. It shows how shocks and long-term pressures ripple through these interconnected levels, affecting the capacity, composition, and performance of the workforce. Impacts and responses at one level can amplify or dampen effects at others. The framework highlights two critical interfaces: the workforce-community interface, capturing how societal, economic, and security conditions shape workforce motivation, performance, and retention, and the workforce-governance interface, reflecting how institutional arrangements, policies, and decision-making processes enable or constrain workforce system responses.
Conclusions:
Adopting a resilience lens underscores the need to view workforce planning as a systems approach that emphasises anticipatory, needs-based planning and integrates political, social, and contextual realities to strengthen workforce resilience under pressure.
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