Assessing Digital Resilience in Primary Health Care: A Structural Framework

Digital transformation has significantly changed healthcare delivery, particularly in primary care settings such as Puskesmas (Community Health Centers) in Indonesia. Although digital technologies offer opportunities to improve accessibility, efficiency, and service quality, the capacity of healthcare institutions to adapt to digital disruptions remains insufficiently understood. This study aims to examine digital resilience in primary healthcare through a systematic literature review, focusing on research trends, key influencing factors, thematic developments, and knowledge gaps relevant to Puskesmas. The review analyzes scholarly articles, conference papers, and other academic publications retrieved from Scopus, PubMed, and Google Scholar. The analysis considers publication trends, influential authors, geographical distribution, and major research themes concerning digital resilience in healthcare. The findings indicate growing research interest in digital resilience, particularly regarding the challenges faced by healthcare systems operating under resource constraints. Four major factors emerge as relevant to digital adaptation: technological infrastructure, digital literacy, policy support, and community engagement. However, existing research predominantly emphasizes the technical dimensions of digital technologies, while organizational capacity and sociocultural factors receive comparatively limited attention. Research addressing digital resilience in Southeast Asia, particularly in Indonesian primary healthcare settings, also remains underrepresented. These gaps limit the contextual understanding of how digital resilience develops within community-based healthcare institutions. The review concludes that strengthening digital resilience in Puskesmas requires an integrated approach that combines technological readiness, organizational preparedness, workforce development, and community participation. Future research should investigate the organizational and sociocultural dimensions of digital adaptation and develop context-specific strategies for improving digital literacy among healthcare workers and communities. Policymakers should also prioritize sustainable digital infrastructure and continuous training to support resilient, accessible, and effective primary healthcare services in Indonesia