Health systems resilience in Canada: a literature review and case studies to inform strengthened resilience

This chapter in the Elgar Handbook of Health System Resilience reviews what is known on health systems resilience in Canada, considering evidence from past pandemics and emergencies, and emerging evidence from COVID-19, and our team’s experiences. Our aim is to shed light on the strengths and challenges with Canada’s health systems to inform policy priorities to strengthen health system resilience. We adopt Thomas et al.’s definition of health systems resilience and organize our review findings according to the WHO health system building blocks. We found there has been limited explicit attention in the literature to health systems resilience, with most studies focusing on the preparedness and response stages of resilience, and most were focused on public health emergencies. The literature has uncovered some strengths, including the adaptability of health systems, particularly at local levels, a dedicated health workforce, and some improved coordination within and across health systems over time. Our review and case studies also underscored persistent challenges that require attention to strengthen health systems resilience in Canada, such as the limited health care capacity, inadequate and fragmented data systems, and lack of attention to sustaining and building public trust in government and public health authorities.