GLC4HSR’s Health Systems Assessment & Monitoring aims to measure resilience across any shock by combining rigorous evidence review with expert-driven framework design. We began with a systematic review of 38 HSR frameworks - ultimately selecting six that spanned facility (micro), provincial (meso), and national/international (macro) levels.

Using a modified Delphi method, experts iteratively refined draft indicators, which were then organized into a 4×6 matrix mapping the four stages of a shock (prevention, preparedness, response, recovery) against the WHO’s six health-system building blocks. Ten additional domains surfaced during this mapping and were incorporated.

In-depth interviews with academicians and practitioners further sharpened our definition of HSR, clarified governance’s role, and established priorities, leading to a measurement framework structured around four core themes, three cross-cutting themes, and one overarching outcome domain. Eight thematic working groups then populated this framework with specific indicators and collected baseline data in India, producing the bespoke Health Systems Resilience Assessment (HSRA) tool now being piloted with WHO and government partners.