From traditional musicians to digital musicians: a study on talent transformation in the music industries driven by AI technology.

The COVID-19 pandemic, occurring within 5 years of the prolonged Ebola Virus Disease crisis in West Africa, ravaged health systems worldwide, including those in high-income countries (, ). These infectious disease shocks highlighted the need for health systems to be resilient beyond just their preparedness to respond to emergencies. Consequently, health system researchers began to explore the concept of resilience in the health sector. Among several framings of health system resilience, one influential view conceptualizes a resilient health system as a learning system (, ). Priority research areas include measuring and managing the dynamic system performance, and areas such as, linkages between societal and health system resilience; the impact of governance on resilience capacity; establishing legitimacy; and the influence of the private sector on health system resilience (). Preparedness tools and indices used to assess system readiness were deemed inadequate for measuring resilience due to incongruence between measurement scores and the actual impact during shocks (, ). Joint External Evaluation (JEE) and the Global Health Security Index (GHSI) findings have been used as proxy measures for resilience but COVID-19 exposed discrepancies between scores and observed performance (, ). The WHO's Health System Resilience Indicators were introduced as improved measurement strategies where the JEE and GHSI proved insufficient (, ). The Epidemic Preparedness Index (EPI) had been introduced earlier, before the COVID-19 pandemic, to counter inadequacies in the development of tools that had been used to assess health systems (). Definitional ambiguity compounds the measurement challenge. The more commonly applied definition emphasizes absorptive, adaptive, and transformative capacities (, , ). The World Health Organization (WHO) defines health system resilience as “the ability of all actors and functions related to health to collectively mitigate, prepare, respond, and recover from disruptive events with public health implications, while maintaining the provision of essential functions and services and using experiences to adapt and transform the system for improvement” (). However, such definitions may not fully capture all unique perspectives worldwide, given the heterogeneity of national and subnational perspectives (). The concept could benefit from further refinement in terms of definition, measurement, and scope (, ). Witter et al. describes it as a process shaped by relationships and power structures (). Africa CDC and the Global Health Security Agenda emphasize measurable capacities, such as workforce, surveillance or coordination (). Emerging voices call for the inclusion of equity in the definition of resilience (). The absence of a universally binding definition allows national conceptualization but complicates cross-country comparison and may misalign global standards and local practice. Empirical research on health system resilience in sub-Saharan Africa reveals context-specific challenges and capacities that differ substantially from those of high-income health systems. Recent qualitative research in East Africa has identified several tensions, including the disconnect between decentralization policies and actual fiscal capacity at the local level, weak institutional structures for capturing and formalizing lessons from outbreaks, and a reliance on donor-funded preparedness programs rather than locally-designed initiatives (, ). These patterns have been documented in qualitative research following Ebola and COVID-19 responses across the region and continent (, ). In 2022, Uganda responded to an outbreak of the Ebola Virus Disease, which was first confirmed in a patient in the central district of Mubende (). Although this was the country's seventh Ebola outbreak since the first in 2000, it was the first since the last in 2012 (). The response to the outbreak was plagued by similar challenges, as documented in other low- and middle-income countries (, ). Following the 2022 outbreak, Uganda has responded to two other Ebola outbreaks, in 2025 and a current outbreak in 2026 (, ). Moreover, very few empirical studies have examined how national-level stakeholders in East Africa conceptualize and operationalize health system resilience in response to infectious disease shocks. Understanding local stakeholder definitions is critical for translating global frameworks into context-specific policies and initiatives. To contribute to this evidence base, we explored how Uganda's national-level health system stakeholders define resilience to infectious disease shocks and its attributes, with the aim of proposing a contextualized definition relevant to Uganda and comparable settings. This study was conducted within Uganda's healthcare system, structured into 16 health regions and operating under devolved governance, in which authority is transferred from the central Ministry of Health (MoH) to districts. Governance of n