Publication date: May 20, 2025

During the COVID-19 pandemic, policymakers focused on improving health outcomes and safeguarding healthcare availability, which have led to negative consequences for other societal systems that persist today. The impact of these policies on health and non-healthcare systems depends on the resilience of these systems, that is, the capability of a system to maintain functioning during crises by using its adaptive capacity and transformative response. Policymaking during the COVID-19 pandemic might have benefitted from considering the resilience of non-healthcare societal systems and the impact of policy choices on these systems. However, so far, the development of resilience indicators for complex systems and their application in a pandemic context remains undervalued. Therefore, in this paper, we developed performance measures for the resilience of healthcare and education as showcases for pandemic policymaking. We applied a disaster management model (COPEWELL) to both the healthcare and educational system in the Netherlands. An initial list of performance measures for each system was established based on their national quality registries. To safeguard face and content validity actors ranked these measures for each system, resulting in five performance measures for each. The healthcare resilience measures cover healthcare performance both inside and outside hospitals, and the education resilience measures apply to primary, secondary schools, and higher education. Assessing the added value of multisystem policymaking using such resilience measures is a next step to be taken.

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Original Article