IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v162y2025ics0168851025001861.html

High health system performance, low health system resilience: Navigating vulnerability – an illustrative example using Small and Island States

Author

Listed:
  • McGuire, Finn
  • Rao, Megha
  • Walker, Simon
  • Meessen, Bruno
  • Nabyonga-Orem, Juliet
  • Jarjue, Gibril
  • Ginindza, Ntombifuthi
  • Odame, Emmanuel
  • Bland, Simon
  • Bershteyn, Anna
  • Revill, Paul

Abstract

While health system vulnerability and resilience are gaining traction among even the best-performing health systems in high-income countries, low-income countries have been concerned with such issues for some time. Small and island states grapple with substantial challenges, including being uniquely vulnerable to exogeneous shocks including climate disasters and economic shocks, which impact health system functionality and population health. As shocks are increasing in frequency and severity, S&IS may provide lessons applicable to high-income health systems.

Suggested Citation

  • McGuire, Finn & Rao, Megha & Walker, Simon & Meessen, Bruno & Nabyonga-Orem, Juliet & Jarjue, Gibril & Ginindza, Ntombifuthi & Odame, Emmanuel & Bland, Simon & Bershteyn, Anna & Revill, Paul, 2025. "High health system performance, low health system resilience: Navigating vulnerability – an illustrative example using Small and Island States," Health Policy, Elsevier, vol. 162(C).
    • Handle: RePEc:eee:hepoli:v:162:y:2025:i:c:s0168851025001861
    DOI: 10.1016/j.healthpol.2025.105431
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851025001861
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2025.105431?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Easterly, William & Kraay, Aart, 2000. "Small States, Small Problems? Income, Growth, and Volatility in Small States," World Development, Elsevier, vol. 28(11), pages 2013-2027, November.
    2. Farrugia, Charles, 1993. "The special working environment of senior administrators in small states," World Development, Elsevier, vol. 21(2), pages 221-226, February.
    3. Edgardo M. Favaro, 2008. "Small States, Smart Solutions : Improving Connectivity and Increasing the Effectiveness of Public Services," World Bank Publications - Books, The World Bank Group, number 6416, April.
    4. Patrick Guillaumont, 2009. "An Economic Vulnerability Index: Its Design and Use for International Development Policy," Oxford Development Studies, Taylor & Francis Journals, vol. 37(3), pages 193-228.
    5. Alan Winters, L. & Martins, Pedro M. G., 2004. "When comparative advantage is not enough: business costs in small remote economies," World Trade Review, Cambridge University Press, vol. 3(3), pages 347-383, November.
    6. Melissa Dell & Benjamin F. Jones & Benjamin A. Olken, 2012. "Temperature Shocks and Economic Growth: Evidence from the Last Half Century," American Economic Journal: Macroeconomics, American Economic Association, vol. 4(3), pages 66-95, July.
    7. Lino Briguglio & Gordon Cordina & Nadia Farrugia & Stephanie Vella, 2009. "Economic Vulnerability and Resilience: Concepts and Measurements," Oxford Development Studies, Taylor & Francis Journals, vol. 37(3), pages 229-247.
    8. Rahman, Muhammad Habibur & Anbarci, Nejat & Ulubaşoğlu, Mehmet A., 2022. "“Storm autocracies”: Islands as natural experiments," Journal of Development Economics, Elsevier, vol. 159(C).
    9. Briguglio, Lino, 1995. "Small island developing states and their economic vulnerabilities," World Development, Elsevier, vol. 23(9), pages 1615-1632, September.
    10. Patrick Guillaumont, 2008. "An Economic Vulnerability Index: Its Design and Use for International Development Policy," Post-Print hal-00364455, HAL.
    11. Paul Collier, 2007. "Africa's Economic Growth: Opportunities and Constraints," African Development Review, African Development Bank, vol. 19(1), pages 6-25.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Montalbano, Pierluigi, 2011. "Trade Openness and Developing Countries' Vulnerability: Concepts, Misconceptions, and Directions for Research," World Development, Elsevier, vol. 39(9), pages 1489-1502, September.
    2. Mirjalili, Seyed hossein, 2025. "Economic Resilience and Vulnerability: Concepts and Indices," MPRA Paper 126492, University Library of Munich, Germany, revised 11 Jul 2025.
    3. Blancard, Stéphane & Hoarau, Jean-François, 2013. "A new sustainable human development indicator for small island developing states: A reappraisal from data envelopment analysis," Economic Modelling, Elsevier, vol. 30(C), pages 623-635.
    4. Valérie ANGEON & Samuel BATES, 2015. "L'Agriculture, Facteur De Vulnérabilité Des Petites Économies Insulaires ?," Region et Developpement, Region et Developpement, LEAD, Universite du Sud - Toulon Var, vol. 42, pages 105-131.
    5. Angeon, Valérie & Bates, Samuel, 2015. "Reviewing Composite Vulnerability and Resilience Indexes: A Sustainable Approach and Application," World Development, Elsevier, vol. 72(C), pages 140-162.
    6. Lino P. Briguglio & Melchior Vella, 2015. "Labour demand in the EU and returns to scale: A production function approach," The Journal of International Trade & Economic Development, Taylor & Francis Journals, vol. 24(8), pages 1103-1116, December.
    7. Ambra Altimari & Simona Balzano & Gennaro Zezza, 2018. "Measuring economic vulnerability: a Structural Equation Modeling approach," Working Papers 2018-01, Universita' di Cassino, Dipartimento di Economia e Giurisprudenza.
    8. Patrick Guillaumont, 2009. "An Economic Vulnerability Index: Its Design and Use for International Development Policy," Oxford Development Studies, Taylor & Francis Journals, vol. 37(3), pages 193-228.
    9. Edwina E. Pereira & Albert E. Steenge, 2022. "Vulnerability and Resilience in the Caribbean Island States; the Role of Connectivity," Networks and Spatial Economics, Springer, vol. 22(3), pages 515-540, September.
    10. Patrick Guillaumont, 2010. "Assessing the Economic Vulnerability of Small Island Developing States and the Least Developed Countries," Journal of Development Studies, Taylor & Francis Journals, vol. 46(5), pages 828-854.
    11. Satish Chand, 2006. "Economic Growth in Forum Island Countries : Lessons of the Past Decade and Challenges and Opportunities Ahead," Development Economics Working Papers 21812, East Asian Bureau of Economic Research.
    12. Gnangnon, Sèna Kimm, 2013. "Structural vulnerability and excessive public indebtedness in CFA Franc Zone countries," Economic Modelling, Elsevier, vol. 35(C), pages 816-832.
    13. Gnangnon, Sèna Kimm, 2017. "Structural economic vulnerability, openness and bilateral development aid flows," Economic Analysis and Policy, Elsevier, vol. 53(C), pages 77-95.
    14. S. Balica & N. Wright & F. Meulen, 2012. "A flood vulnerability index for coastal cities and its use in assessing climate change impacts," Natural Hazards: Journal of the International Society for the Prevention and Mitigation of Natural Hazards, Springer;International Society for the Prevention and Mitigation of Natural Hazards, vol. 64(1), pages 73-105, October.
    15. Sèna Kimm Gnangnon, 2012. "Structural Vulnerability and Excessive Public Indebtedness in CFA Franc Zone Countries," CERDI Working papers halshs-00749470, HAL.
    16. Luis Hernando Portillo-Riascos & Edinson Ortiz-Benavides, 2021. "The External Vulnerability of the Colombian Economy 1990-2015: A Comparative Analysis," Lecturas de Economía, Universidad de Antioquia, Departamento de Economía, issue 94, pages 11-46, Enero-Jun.
    17. Jean-Fran ois Hoarau & Nicolas Lucic, 2022. "Are real merchandise imports per capita a good predictor for the standard of living for the small island world: Testing for the imports-led growth and the growth-led imports hypotheses in panels over the period 1970-2019," TEPP Working Paper 2022-16, TEPP.
    18. Sèna Kimm Gnangnon, 2012. "Structural Vulnerability and Excessive Public Indebtedness in CFA Franc Zone Countries," Working Papers halshs-00749470, HAL.
    19. Boräng, Frida & Jagers, Sverker C. & Povitkina, Marina, 2016. "Political determinants of electricity provision in small island developing states," Energy Policy, Elsevier, vol. 98(C), pages 725-734.
    20. Valérie ANGEON & Jean-François HOARAU, 2015. "Introduction - Les Petites Économies Insulaires : Un Monde À Part Entière ?," Region et Developpement, Region et Developpement, LEAD, Universite du Sud - Toulon Var, vol. 42, pages 5-13.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:162:y:2025:i:c:s0168851025001861. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.