‘We are all vulnerable, we are all fragile’: COVID-19 as opportunity for, or constraint on, health service resilience in Colombia?

Abstract

One managerial narrative describes COVID-19 as a trigger for innovation in health system planning and delivery. Analysing 33 interviews with national stakeholders in Colombia´s health system, this paper argues that an ‘innovation’ narrative provides a partial account of managerial responses to COVID-19. COVID-19 triggered positive and negative effects on adaptive resilience: as mirror for recognizing problems predating the pandemic; as accelerator of service changes; as source of solidarity among professional groups; as workforce trauma; and as disruptor of adjacent improvement activity. The paper concludes that multi-level effects of adaptive resilience, and costs of its practice, need to be recognized.