12 August 2022

Many terms are used to talk about improvement to healthcare services and health systems: readiness, preparedness, resilience, strengthening, sustainability. These terms often appear in similar contexts, but they mean different things.

Readiness is the ability of a health system to rapidly and sustainably adapt its policies, infrastructure and processes to keep pace with societal changes and the evolving evidence.

Whole health systems or individual organisations can be assessed for readiness for individual treatments, diagnostics and care pathways. Such an assessment usually considers the availability of the workforce, guidelines, infrastructure, equipment, data, diagnostics and medicines

Preparedness is defined by the Pan American Health Organization (PAHO) as having the ‘knowledge and capacities’ required to effectively anticipate, respond to and recover from the impacts of hazardous events or conditions.

Health system preparedness is usually discussed in terms of emergency preparedness for sudden events: terrorism, pandemics and natural disasters. Administrative preparedness is another way to think about this concept. This type of preparedness is often associated with administrative and financial flexibility. It measures the ability of a health system to expedite or rapidly change procurement, contracting, hiring etc. due to adverse events.

Resilience is defined by the Organisation for Economic Co-operation and Development (OECD) as the ability of a health system to: prepare for and effectively respond to anticipated or unanticipated shocks; maintain core functions when a crisis hits; and use lessons learnt to influence future decisions.

Resilience can be considered alongside preparedness in priming health systems for emergencies. It can also include long-term changes in the health system that affect everyday functioning. Health system resilience is often linked to sustainability, which is the ability of a health system to deliver a solid healthcare infrastructure designed to be responsive to the needs of the population it serves.

Strengthening is defined by the World Health Organization (WHO) as the process of using policy and practice to identify and implement changes. This makes a health system better able to respond to challenges and provide health system services that improve access to and coverage, quality and efficiency of care. Strengthening can involve any health interventions.

Ensuring preparedness, resilience and readiness can help to strengthen a health system.

Emily Medhurst, Project Officer at The Health Policy Partnership