A scoping review to explore the materialisation of health system resilience across three Caribbean countries, Saint Lucia, Dominica, and Haiti: A protocol

Abstract

Background: The COVID-19 pandemic offers a window of opportunity for building resilient health systems. As such, it is important to use this opportunity to redesign, strengthen, and adapt health systems to meet current population needs. Health system resilience (HSR) is even more critical in Caribbean countries, which face health, environmental, and economic shocks and,in certain cases, political and social upheavals. This study aims to explore the extent to which Haiti, Dominica, and Saint Lucia have developed HSR into their respective contexts. Methods: This study will consist of a scoping review of the available literature on HSR and/or health systemstrengthening (HSS) covering Saint Lucia, Dominica, and Haiti from 2010 to 2023. It will follow the five-point methodological framework proposed by Arksey and O'Malley (2005) and will answer the following question. What approaches, strategies or interventions contribute to building or strengthening HSR in dealing with shocks across these three countries? The perspectives, concepts, dimensions, and definitions from relevant scientific literature will be combined to generate the research equations. The papers identified via PubMed, Scopus, ProQuest, Google Scholar and OpenGrey will then be processed on EndNote and independently filtered by two researchers, reinforced by a third researcher in case of disagreement, according to the PRISMA method adjusted to scoping reviews. Following a deductive-inductive method, the material will be analysed thematically to identify the key approaches, strategies and interventions outlined in the retained materials. Results: This scoping review intends to produce a preliminary assessment of how HSR is implemented in the three participating countries. It holds the potential to shed new light on the experiences of these three countries in their efforts to attain resilience in their health systems. Conclusions: This study might offer insight into the role of stakeholders and processes activated for the achievement of HSR in the Caribbean. In addition, it provides the starting point for the development of a tool to understand and realise HSR tailored to the three countries.