From crisis response to everyday work: Exploring resilient capacities in health systems' governance and frontline...

BackgroundThis scoping review examines health system resilience, shifting the focus to beyond crisis response to include everyday adaptation, governance, and transformative capabilities in universal health systems.ObjectivesDescribe and analyze health system resilience frameworks and their implications for health workers and work systems, identifying how resilience capacities are operationalized through work organization, staffing, and governance in public health settings.MethodsConsensus software was used as a decision-support tool for identifying and extracting insights from peer-reviewed studies, with inclusion decisions and synthesis validated by the authors.ResultsAnalyzing 19 studies (2019-2025), we identify five key resilience capacities: absorptive (maintaining core functions), adaptive (innovation and collaboration), transformative (structural change), governance/leadership (crisis coordination and policy stability), and resource management (surge capacity and steady supply). Resilience capacities were enacted through changes in work organization, workload distribution, and staffing flexibility, with direct implications for burnout, moral distress, and workforce sustainability.ConclusionsFindings highlight that resilience is not just about institutional capacity but also political, historical, and social contexts, with equitable governance and community engagement as critical enablers. The review calls for integrating frontline experiences, addressing systemic inequities, and fostering long-term system strengthening alongside emergency preparedness. The study underscores the need for frameworks that bridge theory and practice, ensuring resilience supports both acute shocks and chronic pressures in public health. By linking health system resilience to everyday work and work-system dynamics, this review contributes to research on work organization, prevention of work-related harm, and the design of more sustainable health work systems.