A resilience view on health system resilience: a scoping review of empirical studies and reviews.

BACKGROUND: Prompted by recent shocks and stresses to health systems globally, various studies have emerged on health system resilience. Our aim is to describe how health system resilience is operationalised within empirical studies and previous reviews. We compare these to the core conceptualisations and characteristics of resilience in a broader set of domains (specifically, engineering, socio-ecological, organisational and community resilience concepts), and trace the different schools, concepts and applications of resilience across the health literature. METHODS: We searched the Pubmed database for concepts related to 'resilience' and 'health systems'. Two separate analyses were conducted for included studies: a total of n = 87 empirical studies on health system resilience were characterised according to part of health systems covered, type of threat, resilience phase, resilience paradigm, and approaches to building resilience; and a total of n = 30 reviews received full-text review and characterised according to type of review, resilience concepts identified in the review, and theoretical framework or underlying resilience conceptualisation. RESULTS: The intersection of health and resilience clearly has gained importance in the academic discourse with most papers published since 2018 in a variety of journals and in response to external threats, or in reference to more frequent hospital crisis management. Most studies focus on either resilience of health systems generally (and thereby responding to an external shock or stress), or on resilience within hospitals (and thereby to regular shocks and operations). Less attention has been given to community-based and primary care, whether formal or informal. While most publications do not make the research paradigm explicit, 'resilience engineering' is the most prominent one, followed by 'community resilience' and 'organisational resilience'. The social-ecological systems roots of resilience find the least application, confirming our findings of the limited application of the concept of transformation in the health resilience literature. CONCLUSIONS: Our review shows that the field is fragmented, especially in the use of resilience paradigms and approaches from non-health resilience domains, and the health system settings in which these are used. This fragmentation and siloed approach can be problematic given the connections within and between the complex and adaptive health systems, ranging from community actors to local, regional, or national public health organisations to secondary care. Without a comprehensive definition and framework that captures these interdependencies, operationalising, measuring and improving resilience remains challenging.

Blazing the trail: Social innovation supporting wildfire-resilient territories in Catalonia (Spain).

Mediterranean territories have co-evolved and been shaped by fire throughout history. However, global environmental change conditions are increasing the size, intensity and severity of wildfires, which have gone from a regular natural disturbance to a serious threat for civil protection, surpassing firefighting capacities. Therefore, building resilience in fire-prone territories is an increasingly relevant policy and management objective. However, the notion of resilience has been criticized for paying insufficient attention to key social issues such as socio-political dynamics, power imbalances and societal change. At the same time, social science contributions to wildfire research are still rather limited. In this paper, we bridge social innovation theory to resilience theory in order to create a territorially embedded and socially sensitive framework for assessing socio-ecological resilience. From this perspective, we then examine how Forest Defence Groups (ADFs, by their Catalan acronym) have evolved from grassroots, bottom-up initiatives to well-established bottom-linked institutions and we evaluate their contributions to socio-ecological resilience in the territories where they operate. Our results show that ADFs contribute in several aspects to socio-ecological resilience and that the pave the way for opening up spaces of dialogue and collaboration through which local communities can engage with the issues that directly affect them, such as wildfires.

Coping and Adaptation in Response to Environmental and Climatic Stressors in Caribbean Coastal Communities.

Cumulative and synergistic impacts from environmental pressures, particularly in low-lying tropical coastal regions, present challenges for the governance of ecosystems, which provide natural resource-based livelihoods for communities. Here, we seek to understand the relationship between responses to the impacts of El Niño and La Niña events and the vulnerability of mangrove-dependent communities in the Caribbean region of Colombia. Using two case study sites, we show how communities are impacted by, and undertake reactive short-term responses to, El Niño and La Niña events, and how such responses can affect their adaptive capacity to progressive environmental deterioration. We show that certain coping measures to climate variability currently deliver maladaptive outcomes, resulting in circumstances that could contribute to system 'lock-in' and engender undesirable ecological states, exacerbating future livelihood vulnerabilities. We highlight the significant role of social barriers on vulnerabilities within the region, including perceptions of state abandonment, mistrust and conflicts with authorities. Opportunities to reduce vulnerability include enhancing the communities' capacity to adopt more positive and preventative responses based on demonstrable experiential learning capacity. However, these will require close cooperation between formal and informal organisations at different levels, and the development of shared coherent adaptation strategies to manage the complexity of multiple interacting environmental and climatic pressures.

Economics, socio-ecological resilience and ecosystem services.

The economic process transforms raw materials and energy into economic products and waste. On a finite planet, continued economic growth threatens to surpass critical socio-ecological thresholds and undermine ecosystem services upon which humans and all other species depend. For most systems, whether such thresholds exist, where they lie and whether they are reversible cannot be known with certainty until they are crossed. We argue that our central economic challenge is to maintain the resilience of the current socio-ecological regime. We must reduce net impacts of economic activity to avoid critical ecological thresholds while ensuring economic necessities. Conventional economists pursue continuous growth as the central goal of economic activity, and assume that the price mechanism and technological breakthroughs ensure system resilience. Unfortunately, the price mechanism fails to address ecological thresholds because it ignores unowned ecosystem services, and fails to address economic thresholds because it ignores the needs of the poorest individuals, who live on the edge of them. Panarchy theory suggests that systems go through a cycle of growth, conservation, release and renewal. Managing a subsystem too long for growth or conservation-which many consider to be the goal of sustainability-actually threatens to collapse the higher-level system upon which that subsystem depends. Black Swan theory suggests we should seek to reduce the risk of catastrophic thresholds and promote the likelihood of technological breakthroughs. Economic degrowth, or planned release, is required to avoid catastrophic collapse. At the same time, publicly funded, open source information can help stimulate the technological breakthroughs economists count on to ensure resilience.

The Socio-ecological Fit of Human Responses to Environmental Degradation: An Integrated Assessment Methodology.

The scientific and policy interest in the human responses to environmental degradation usually focuses on responses sensu stricto and 'best practices' that potentially abate degradation in affected areas. The transfer of individual, discrete instruments and 'best practices' to different contexts is challenging, however, because socio-ecological systems are complex and environmental degradation is contextual and contingent. To sensibly assess the effectiveness of formal and informal interventions to combat environmental degradation, the paper proposes an integrative, non-reductionist analytic, the 'response assemblage', for the study of 'responses-in-context,' i.e., products of human decisions to utilize environmental resources to satisfy human needs in socio-ecological systems. Response assemblages are defined as geographically and historically unique, provisional, open, territorial wholes, complex compositions emerging from processes of assembling biophysical and human components, including responses sensu stricto, from affected focal and other socio-ecological systems, to serve human goals, one of which may be combatting environmental degradation. The degree of match among the components, called the socio-ecological fit of the response assemblage, indicates how effectively their contextual and contingent interactions maintain the socio-ecological resilience, promote sustainable development, and secure the continuous provision of ecosystem services in a focal socio-ecological system. The paper presents a conceptual approach to the analysis of the socio-ecological fit of response assemblages and details an integrated assessment methodology synthesizing the resilience, assemblage, and 'problem of fit' literature. Lastly, it summarizes the novelty, value, and policy relevance of conceptualizing human responses as response assemblages and of the integrated assessment methodology, reconsiders 'best practices' and suggests selected future research directions.

Access restrictions to forest resources, rather than COVID-19 bans, drive the selection of firewood species for bonfires during Festas Juninas in northeastern Brazil.

BACKGROUND: The complex interplay of social and environmental factors shapes ecosystems, potentially leading to harmony or conflict, highlighting the importance of understanding these dynamics for coexistence. In developing countries, firewood serves as a primary energy source and plays a role in cultural-religious rituals and festivities. However, the specific patterns of woody species used for the latter remain poorly understood, including the impact of access restrictions to resources and local bans on practices. Therefore, our research focuses on examining how access restrictions to forest resources and bonfire bans due to the coronavirus disease 2019 (COVID-19) impact the cultural-religious tradition of bonfire making during Festas Juninas (June festivities) in northeastern Brazil. METHODS: Ethnobotanical fieldwork was conducted in two rural populations in northeastern Brazil between 2021 and 2022. Data were collected through semi-structured interviews, observations, and the guided tour technique. The cultural-religious tradition of bonfire making (i.e., richness of native and exotic firewood species, firewood volume, and the number of bonfires related to this practice) was compared between populations (i.e., differing in access restrictions) and years (i.e., differing in COVID-19-related bans) using Mann-Whitney U tests. RESULTS: Results revealed significant differences in the richness of native (p value = 0.001) and exotic (p value < 0.001) firewood species for bonfire making due to access restrictions to forest resources. The number of native species used was higher among the population residing in the area with unrestricted access than among those with restricted access, while a greater number of exotic species was used in the population with restricted access. The rest of the variables were not influenced by access restrictions, and no variables were influenced by COVID-19 bans. CONCLUSIONS: Our study demonstrated that access restrictions to forest resources, rather than COVID-19 bans, drive the selection of firewood species for bonfires during Festas Juninas in northeastern Brazil. In addition, as populations remain deeply entrenched in cultural-religious practices amid temporary bans imposed by health crises, there is a pressing need for culturally sensitive environmental policies. Fostering socio-ecological resilience demands a comprehensive approach that encompasses not only environmental factors but also cultural dimensions, which wield a pivotal influence on long-term sustainability.

Multi-paddock grazing on rangelands: why the perceptual dichotomy between research results and rancher experience?

Maintaining or enhancing the productive capacity and resilience of rangeland ecosystems is critical for the continued support of people who depend on them for their livelihoods, especially in the face of climatic change. This is also necessary for the continued delivery of ecosystem services derived from rangelands for the broader benefit of societies around the world. Multi-paddock grazing management has been recommended since the mid-20th century as an important tool to adaptively manage rangelands ecosystems to sustain productivity and improve animal management. Moreover, there is much anecdotal evidence from producers that, if applied appropriately, multi-paddock grazing can improve forage and livestock production. By contrast, recent reviews of published rangeland-based grazing systems studies have concluded that, in general, field trials show no superiority of vegetation or animal production in multi-paddock grazing relative to continuous yearlong stocking of single-paddock livestock production systems. Our goal is to provide a framework for rangeland management decisions that support the productivity and resiliency of rangelands and then to identify why different perceptions exist among rangeland managers who have effectively used multi-paddock grazing systems and research scientists who have studied them. First, we discuss the ecology of grazed ecosystems under free-ranging herbivores and under single-paddock fenced conditions. Second, we identify five principles underpinning the adaptive management actions used by successful grazing managers and the ecological, physiological, and behavioral framework they use to achieve desired conservation, production, and financial goals. Third, we examine adaptive management principles needed to successfully manage rangelands subjected to varying environmental conditions. Fourth, we describe the differences between the interpretation of results of grazing systems research reported in the scientific literature and the results reported by successful grazing managers; we highlight the shortcomings of most of the previously conducted grazing systems research for providing information relevant for rangeland managers who aim to achieve desired environmental and economic goals. Finally, we outline knowledge gaps and present testable hypotheses to broaden our understanding of how planned multi-paddock grazing management can be used at the ranching enterprise scale to facilitate the adaptive management of rangelands under dynamic environmental conditions.

A resilience-based robustness evaluation framework for sustainable urban flood management under uncertainty.

Urban drainage systems (UDSs) may experience failure encountering uncertain future conditions. These uncertainties arise from internal and external threats such as sedimentation, blockage, and climate change. In this paper, a new resilience-based framework is proposed to assess the robustness of urban flood management strategies under some distinct future scenarios. The robustness values of flood management strategies are evaluated by considering reliability, resiliency, and socio-ecological resilience criteria. The socio-ecologic resilience criteria are proposed considering the seven principles of building resilience proposed by Biggs et al. (2012). The evidential reasoning (ER) approach and the regret theory are utilized to calculate the total robustness of the flood management strategies. In this framework, the non-dominated sorting genetic algorithms III (NSGA-III) optimization model and the storm water management model (SWMM) simulation model are linked and run to quantify the criteria. The novelty of this paper lies in presenting a new framework to increase the sustainability and resilience of cities against floods considering the deep uncertainties in the main economic, social, and hydrological factors. This methodology provides policies for redesigning and sustainable operation of urban infrastructures to deal with floods. To evaluate the applicability and efficiency of the framework, it is applied to the East drainage catchment of the Tehran metropolitan area in Iran. The results show that real-time operation of existing flood detention reservoirs, along with implementing five new relief tunnels with a construction cost of 37.1 million dollars, is the most robust non-dominated strategy for flood management in the study area. Comparing the results of the proposed framework with those of a traditional framework shows that it can increase the robustness value by about 40% with the same implementation cost.

The socio-ecological resilience and sustainability implications of seafood supply chain disruption.

Remaining resilient under disruption, while also being sustainable, is essential for continued and equitable seafood supply in a changing world. However, despite the wide application of resilience thinking to sustainability research and the multiple dimensions of social-ecological sustainability, it can be difficult to ascertain how to make a supply chain both resilient and sustainable. In this review, we draw upon the socio-ecological resilience and sustainability literature to identify links and highlight concepts for managing and monitoring adaptive and equitable seafood supply chains. We then review documented responses of seafood supply networks to disruption and detail a case study to describe the attributes of a resilient seafood supply system. Finally, we outline the implications of these responses for social (including wellbeing and equity), economic and environmental sustainability. Disruptions to supply chains were categorised based on their frequency of occurrence (episodic, chronic, cumulative) and underlying themes were derived from supply chain responses for each type of disruption. We found that seafood supply chains were resilient when they were diverse (in either products, markets, consumers or processing), connected, supported by governments at all scales, and where supply chain actors were able to learn and collaborate through trust-based relationships. With planning, infrastructure and systematic mapping, these attributes also can help to build socio-ecological sustainability and move towards more adaptive and equitable seafood supply.

Quantifying resilience of multiple ecosystem services and biodiversity in a temperate forest landscape.

Resilience is increasingly being considered as a new paradigm of forest management among scientists, practitioners, and policymakers. However, metrics of resilience to environmental change are lacking. Faced with novel disturbances, forests may be able to sustain existing ecosystem services and biodiversity by exhibiting resilience, or alternatively these attributes may undergo either a linear or nonlinear decline. Here we provide a novel quantitative approach for assessing forest resilience that focuses on three components of resilience, namely resistance, recovery, and net change, using a spatially explicit model of forest dynamics. Under the pulse set scenarios, we explored the resilience of nine ecosystem services and four biodiversity measures following a one-off disturbance applied to an increasing percentage of forest area. Under the pulse + press set scenarios, the six disturbance intensities explored during the pulse set were followed by a continuous disturbance. We detected thresholds in net change under pulse + press scenarios for the majority of the ecosystem services and biodiversity measures, which started to decline sharply when disturbance affected >40% of the landscape. Thresholds in net change were not observed under the pulse scenarios, with the exception of timber volume and ground flora species richness. Thresholds were most pronounced for aboveground biomass, timber volume with respect to the ecosystem services, and ectomycorrhizal fungi and ground flora species richness with respect to the biodiversity measures. Synthesis and applications. The approach presented here illustrates how the multidimensionality of stability research in ecology can be addressed and how forest resilience can be estimated in practice. Managers should adopt specific management actions to support each of the three components of resilience separately, as these may respond differently to disturbance. In addition, management interventions aiming to deliver resilience should incorporate an assessment of both pulse and press disturbances to ensure detection of threshold responses to disturbance, so that appropriate management interventions can be identified.

Searching for resilience: addressing the impacts of changing disturbance regimes on forest ecosystem services.

1. The provisioning of ecosystem services to society is increasingly under pressure from global change. Changing disturbance regimes are of particular concern in this context due to their high potential impact on ecosystem structure, function and composition. Resilience-based stewardship is advocated to address these changes in ecosystem management, but its operational implementation has remained challenging. 2. We review observed and expected changes in disturbance regimes and their potential impacts on provisioning, regulating, cultural and supporting ecosystem services, concentrating on temperate and boreal forests. Subsequently, we focus on resilience as a powerful concept to quantify and address these changes and their impacts, and present an approach towards its operational application using established methods from disturbance ecology. 3. We suggest using the range of variability concept - characterizing and bounding the long-term behaviour of ecosystems - to locate and delineate the basins of attraction of a system. System recovery in relation to its range of variability can be used to measure resilience of ecosystems, allowing inferences on both engineering resilience (recovery rate) and monitoring for regime shifts (directionality of recovery trajectory). 4. It is important to consider the dynamic nature of these properties in ecosystem analysis and management decision-making, as both disturbance processes and mechanisms of resilience will be subject to changes in the future. Furthermore, because ecosystem services are at the interface between natural and human systems, the social dimension of resilience (social adaptive capacity and range of variability) requires consideration in responding to changing disturbance regimes in forests. 5.Synthesis and applications. Based on examples from temperate and boreal forests we synthesize principles and pathways for fostering resilience to changing disturbance regimes in ecosystem management. We conclude that future work should focus on testing and implementing these pathways in different contexts to make ecosystem services provisioning more robust to changing disturbance regimes and advance our understanding of how to cope with change and uncertainty in ecosystem management.