Abstract
Background
The COVID-19 pandemic, an unprecedented event, exposed varying levels of preparedness across health systems. This study examines the resilience of primary health and community services in Aotearoa New Zealand, focusing on their response to the needs of unpaid caregivers and older care recipients during the pandemic’s first waves. The objective is to inform future disaster preparedness and enhance health system resilience.
Methods
A multidisciplinary research team conducted qualitative research involving semi-structured interviews with service providers (SPs) who provided primary or community home-based services, care, support or information to older people and/or their caregivers across Aotearoa New Zealand. Views were sought from five service provider groups: national organisations, Māori, Pacific, or rural providers and dementia services. Data were collected between July 7 and October 4, 2020. Interviews focused on innovative practices, resources, and organizational settings. Notes from interviews were revised and validated by participants. Thematic coding and analysis were performed using NVivo 14 software to identify key themes and strategies.
Results
Twenty SP staff (Chief Executive Officers and representatives) from National (4), Māori (3), Pacific (5), rural (4), and regional dementia service (4) providers) were interviewed. Participants had 0-21 years in post (Mean=7.37, SD=6.56). Telephone interviews lasted 30-45 minutes. Government support, coordination by Civil Defence Emergency Management groups, and regional communication influenced SP resilience. Challenges included access to personal protective equipment (PPE), staffing, identifying vulnerable people, digital access, and accessing residential care facilities. Innovative practices and remote communication were essential for service continuity.
Conclusions
Aotearoa New Zealand managed COVID-19 effectively, but the pandemic exposed areas for improvement in health system resilience. Examples of absorptive and adaptive resilience in SPs’ and government responses highlighted both strengths and weaknesses. Insights from these experiences can inform transformative resilience, necessitating long-term strategic changes to address vulnerabilities and enhance capacity, ensuring the health system’s robustness and sustainability for future crises.