What makes health systems resilient against infectious disease outbreaks and natural hazards? Results from a scoping review

Nuzzo, Jennifer B.; Meyer, Diane; Snyder, Michael; Ravi, Sanjana J.; Lapascu, Ana; Souleles, Jon; Andrada, Carolina I.; Bishai, David

No frameworks were identified in the search that translated these high-level themes into specific and actionable steps that health system actors can employ to improve and support health system resilience to both infectious diseases and natural hazards, and that can be undertaken in low-, middle-, and high-income settings alike. Frameworks that did articulate specific capacities were either 1) only applicable in the US context [22] or 2) did not cohesively address both infectious diseases and natural disasters [50] . For example, Meyer et al. created a checklist for health sector resilience to highconsequence infectious diseases [22] , but the data for this checklist was informed by the US domestic response to the 2014-2016 West Africa Ebola outbreak. While some of the identified capacities may be generalizable to other countries, some are only pertinent in the US context. Similarly, the Hospital Safety Index, a tool developed by WHO, does identify capacities that are relevant to some health facilities, but the tool is largely aimed at evaluating the vulnerability of hospital infrastructure to natural hazards (an updated version includes limited consideration of the potential impact of infectious disease threats to hospitals) [50] .