Healthcare workforce resilience amidst civil unrest: a cross-sectional study on personal coping and health system resilience knowledge in a low-and-middle-income-country setting

Abstract

In healthcare, resilience is a necessity, and the perceived health system resilience among healthcare providers is critical in their ability to cope with challenges. Assess the healthcare workforce resilience status against their perception of the health system’s resilience in Tibebe-Ghion Teaching Referral Hospital, Northwest Ethiopia. A hospital-based cross-sectional study was conducted between September 1 and December 15, 2025, including 501 participants selected via simple random sampling technique. We analyzed our data—covering demographics, the 25-item Connor-Davidson Resilience Scale, and Kruk’s health system resilience index—using SPSS version 27. Categorical data were summarized as frequencies and percentages, and discrete data as means. Binary logistic regression was performed with 95% confidence intervals, and significance was set at P < 0.05. Compared to the reference short-cycle tertiary education (ISCED level 5), healthcare providers with a second and third-degree education were more likely to perceive the health system as resilient (adjusted odds ratio of 4.753 (1.237, 18.263) and 8.968 (1.990, 40.418), respectively). Healthcare providers with higher perceived health system resilience reported higher personal resilience (adjusted odds ratio of 2.165 (1.506, 3.113)). Better-educated healthcare providers tend to view the health system as supportive. Recovery from adversity is related to how robust a provider perceives the health system to be, highlighting that adaptive coping is deeply tied to workplace trust than expecting individual employees to single-handedly “bounce back” from stress.