Official websites use. Share sensitive information only on official, secure websites. You do not have permission under this licence to share adapted material derived from this article or parts of it. In South Kivu Eastern Democratic Republic of the Congo [DRC] , health districts HDs affected by chronic armed conflicts are devising coping mechanisms to continue offering healthcare services to the population. Nonetheless, this alone does not suffice to make them fully resilient to such conflicts.
This study uses mixed methods triangulation and an extreme case study design to compare a HD with no history of armed conflict Idjwi, Case 1 and another one experiencing armed conflict Fizi, Case 2 in South Kivu. The Kruk et al. BMJ , index was employed as a theoretical framework for exploring resilience characteristics.
Qualitative data were collected through a document review using a pre-set review grid and semi-structured individual interviews with purposively sampled key stakeholders. They were subjected to deductive-inductive thematic analysis. Quantitative data were collected using a Likert scale questionnaire administered to stakeholders in the selected HDs using non-probabilistic methods β purposive and snowball sampling.
These data were subsequently analysed for comparative descriptive purposes. Recurring short-term shocks as well as chronic stress factors whether or not linked to chronic armed conflicts were identified. Common resilience mechanisms e. If this condition is fulfilled, quality of care could improve and spare capacity could be created to withstand disturbances.
Resilience, previously employed in fields such as ecology, engineering, urban planning and psychology [ 1 β 4 ], has become an increasingly prominent topic in health sector systems [ 5 ]. It has, indeed, weathered several periods, the most striking of which were the Ebola epidemic in West Africa in β The health crisis that emerged from this epidemic has been explained by several factors, including a lack of resources and the organizational challenges inherent in health systems [ 6 , 7 ].
