Resilience in public health: operationalization and approaches

depending on the choices of political stakeholders, the established social protection models, and the mobilization of society in defense of health.Regarding everyday resilience in health emergencies and the potential of the concept for planning, evaluating, and managing health systems, the development of references for this new paradigm is built in alignment with contextualizing SUS historical trajectory, building a new care and healthcare model based on universality, comprehensiveness, equity, and the PHC organization and centrality strategy arranged in a regionalized and decentralized architecture that guides the SUS.Thus, the foundations are laid for an interconnected and complementary system structure to develop and promote resilience in the work processes and organization of care and SUS management.Succinctly, this foundation was developed by the authors in another work, Resilience in Public Health: Precepts, Concepts, Challenges and Perspectives.From this perspective, some structural components are revisited based on the concept and analysis tools of human factors and resilience, highlighting work and the health work process as categories, valuing the strategic role of the interaction between the health professional and the user, in healthcare, a fundamental and essential condition for effective services and systems and resilience itself.Analyzing planning, monitoring, and evaluation develops a pertinent and innovative analysis of the potential of appropriate tools used in resilience assessment, which can assist in what is called "potential variability analysis", scaling resources, or the elaboration of SUS contingency plans.We should also underscore the critical discussion that the text brings regarding the current oversized trend of quantitative parameterization of the results of services and systems to achieve resilience.Valuing the importance of the concept's formative dimension, we reflect on the outcome of care, which is more complex, involving not only what refers to the care provided but also focusing on the special appreciation of the changes produced in the health status of the individuals served, as well as changes in behavior, knowledge, and satisfaction of the users of the services.By valuing the functioning process of the services and not only their results, evaluating resilient performance adds a new dimension to evaluating health systems.Thus, resilience in health systems remains vague because several different conceptions exist, although they share some aspects.This plurality of meanings