Resilience and adaptability of traditional healthcare systems: a case study of communities in two regions of Brazil

Abstract

The traditional healthcare systems (THS) of communities in two different regions of Brazil were investigated through the lens of social-ecological resilience, assuming that the resilience of THS and of the communities influence each other. We analyzed what has sustained and changed in the trajectory of THS of different rural and coastal communities in Brazil during the last seven decades, focusing on the domains of social biodiversity (especially on plant diversity for medicinal use), health practices learning, and social organization. The THS analyzed refer to three rural communities in northeastern Brazil, and three Quilombola communities on the southern coast of Brazil. Data were obtained through participatory methods, interviews, and secondary sources. The main drivers affecting the THS were the (1) development of national and regional infrastructure, (2) access to public healthcare, (3) implementation of protected areas, and (4) recognition of Quilombola territories (Quilombos). The components of social biodiversity, learning, and social organization contributed to the adaptive capacity and resilience of the systems through the continuity of knowledge transmission, use of local biodiversity for healthcare, request for local specialists, recovery of cultural practices, and institutional development of local organizations and partnerships. Challenges concerning the resilience of the THS are explained by the urbanization processes, restriction of access and use of some native plants, decrease in economic dependence on local biodiversity resources, and the need to improve social capital. After assessing the factors affecting the resilience of THS, we recommend actions that could enhance socialecological resilience in different communities and under different situations.

Whether and how top management create flexibility in mental healthcare organizations: COVID-19 as a test case

“…This resilience (Alliger et al. , 2015; Zank et al. , 2019) has advantages because it allows old routines to resume and to recover, but the disadvantage may be that it restricts necessary new developments.…”

“…In most interviews, managers reported a temptation to "bounce back" to normal after the first wave of the COVID-19 crisis. This resilience (Alliger et al, 2015;Zank et al, 2019) has advantages because it allows old routines to resume and to recover, but the disadvantage may be that it restricts necessary new developments. As shown in Figure 1, we suggest that resilience is a counterforce of flexibility that prevents the organization from falling into chaos.…”

Mental Health in Settings with COVID-19 Positive Cases in the Spanish Population: The Protective Role of the Capacity to Adapt to Change

“…Finally, the appearance of COVID-19 positive cases in one’s close setting was found to be associated with a lower capacity for adapting to the changes generated and the appearance of more prevalence of health disorders. Close COVID-19 positive cases cause a stressful situation [ 7 , 9 ], which could lead to uncertainty and feeling symptoms compatible with COVID-19, which could then cause alterations in behavior [ 21 , 22 , 23 ], anxiety [ 19 ], and depression because the perceived danger to oneself or one’s family cannot be managed [ 39 ].…”

“…In this adaptation, resilience may help overcome such adverse stressful situations [ 21 ]. Resilience may be defined as “bouncing back” from difficult experiences, so that individuals adapt to stressful changes, traumas, tragedies, or even settings or situations, while their usual social behaviors remain unaltered, that is, stable and functional [ 22 , 23 ]. It is therefore a protective mechanism against the pernicious effects of stress [ 24 ].…”

A new fuzzy FUCOM-QFD approach for evaluating strategies to enhance the resilience of the healthcare sector to combat the COVID-19 pandemic

“…Skilled health workforce (Oraebosi et al, 2020) A fit-for-purpose staff that delivers quality services RA2. Resilient health infrastructure (Zank et al, 2019) Infrastructure that meets the people needs for health services RA3. Epidemic preparedness, surveillance and response system (Mandyata et al, 2017) Strengthen epidemic preparedness, surveillance, and response so that it can detect and respond to current COVID-19 and future health threats RA4.…”