📖 ABSTRACT/OVERVIEW
Background: Nigeria has faced multiple epidemic challenges including COVID-19 and endemic Lassa fever, with nursing contributions to health system resilience inadequately documented and theorised in the existing literature. Aim: This study examined the role of nursing in shaping health system resilience during epidemic outbreaks, drawing on comparative analysis of COVID-19 and Lassa fever responses in Nigeria. Methods: A multiple case study comparative design employed document analysis of epidemic response reports, 48 in-depth interviews with nurses, public health officers, and policymakers, and secondary analysis of health system performance data across eight states. The Barasa framework of health system resilience was used as the analytical lens. Results: Nursing contributed to resilience across absorption, adaptation, and transformation resilience dimensions. Key nursing roles included triage surge management, community risk communication, contact tracing, and infection prevention enforcement. Critical vulnerabilities were identified in personal protective equipment access, nurse mental health support, and nursing inclusion in outbreak command structures. Conclusion: Nursing is a central but under-recognised pillar of epidemic resilience in Nigeria. Formal nursing roles in epidemic command structures, mental health preparedness for nurses, and pandemic-specific nursing training are necessary investments in health system resilience. Keywords: nursing, health system resilience, epidemic, COVID-19, Lassa fever.
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