Determinants and typologies of health system resilience: A data-driven framework for prioritising investment
- 1Department of Biometry, School of Mathematical Sciences, University of Technology and Applied Sciences, Navrongo, Ghana
- 2Department of Epidemiology and Biostatistics, School of Public Health, University of Technology and Applied Sciences, Navrongo, Ghana
Abstract
Health system resilience is essential for effective pandemic response and health security, yet existing assessments often lack actionable guidance for policymakers. This study develops a data-driven framework to identify key resilience contributors and country capability profiles using the complete 2021 Global Health Security Index (GHSI) dataset for 195 countries. Through a multi-method analytical approach, we derive a composite resilience measure that captures 70.6% of shared variance across six GHSI domains. After accounting for inter-domain correlations, Detection, Health Capacity, and Prevention show the strongest independent associations with overall resilience (ridge coefficients of 0.242, 0.228, and 0.219, respectively), with Detection contributing most. Cluster analysis reveals two distinct country typologies: a high-performing, balanced-capability group (33% of countries) spanning both high-income and several upper-middle-income countries, and a larger group (67%) with lower and more structurally uneven capabilities, particularly in Prevention and Health Capacity. These profiles suggest different strategic pathways for system strengthening—from sustaining advanced capacities in high-performing countries to targeted investments in detection and core health functions in settings with more fragmented capabilities. Our findings provide an essential framework for comparing resilience across countries and prioritising investments where they matter most, offering practical guidance for national and global health security planning.
Related
- A Survival Weighted Resilience Framework for the Marshall–Olkin Distribution with Applications in Environmental and Biomedical Modeling
- Cognitive Warfare, Hybrid Pressure, and Sovereign Resilience: An Operations Research Framework Applied to the Iranian Case (2017--2026)
- A Spectral Framework Based on the FKF Transform for Supply Chain Dynamics and Resilience
- Agency and resilience among young persons in Sweden: Patterns of interrelated resources within the WHO Adolescent Well-being Framework
- What drives generation Z's appetite for crypto investment? The role of financial literacy, gender, and channels of influence
BibTeX
@article{adda2026determinants,
title = {{Determinants and typologies of health system resilience: A data-driven framework for prioritising investment}},
author = {Richmond Balinia Adda and Conrad Pwayirane},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0340560},
url = {https://doi.org/10.1371/journal.pone.0340560},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Determinants and typologies of health system resilience: A data-driven framework for prioritising investment
AU - Richmond Balinia Adda
AU - Conrad Pwayirane
PY - 2026
DA - 2026/09/23
JO - PLOS One
DO - 10.1371/journal.pone.0340560
UR - https://doi.org/10.1371/journal.pone.0340560
AB - Health system resilience is essential for effective pandemic response and health security, yet existing assessments often lack actionable guidance for policymakers. This study develops a data-driven framework to identify key resilience contributors and country capability profiles using the complete 2021 Global Health Security Index (GHSI) dataset for 195 countries. Through a multi-method analytical approach, we derive a composite resilience measure that captures 70.6% of shared variance across six GHSI domains. After accounting for inter-domain correlations, Detection, Health Capacity, and Prevention show the strongest independent associations with overall resilience (ridge coefficients of 0.242, 0.228, and 0.219, respectively), with Detection contributing most. Cluster analysis reveals two distinct country typologies: a high-performing, balanced-capability group (33% of countries) spanning both high-income and several upper-middle-income countries, and a larger group (67%) with lower and more structurally uneven capabilities, particularly in Prevention and Health Capacity. These profiles suggest different strategic pathways for system strengthening—from sustaining advanced capacities in high-performing countries to targeted investments in detection and core health functions in settings with more fragmented capabilities. Our findings provide an essential framework for comparing resilience across countries and prioritising investments where they matter most, offering practical guidance for national and global health security planning.
SN - 1932-6203
ER -