ABSTRACT:
Background. Communities are at the forefront of experiencing and responding to diverse shocks and stressors. Informal and community-based actors have been widely recognised as important contributors to health system resilience, where they enhance adaptive capacity, facilitate collective action, and support access to services (Shirleyana, 2023, Than, 2024). In many contexts, these actors operate at the interface between formal health systems and community action, often navigating both an intimate understanding of immediate local needs and the practical constraints of responding to them within broader institutional structures (Odii, 2024). While their contributions are well documented, there remains limited empirical insight into the processes and relational dynamics through which resilience is enacted in practice (Fortnam, 2024, Shirleyana, 2023, Than, 2024). Clarifying these dynamics is essential for designing health system policies that encompass the diverse range of actors involved in responding to crises and driving resilience. Methods. This study adopts a qualitative, exploratory case study design, focusing on the Community Action Networks (CANs) that emerged as self-organised groups in Cape Town, South Africa, in response to COVID-19. Semi-structured interviews will be conducted with individuals who were involved in, or engaged with, the CANs from 2020 to 2023. Interviews will explore participants' experience with the CANs, including how they perceived their roles and responsibilities, both internally and in tandem with external entities, such as health system actors. The analysis will follow an inductive approach to identify relevant thematic codes. Results and conclusions. The expected result of this study is to generate insight into the key processes, relationships, and enabling or constraining factors shaping the CAN actors. This study aims to offer insights into how to design health system policies that are inclusive of, and support of, the interface between formal and informal responses.