The Invisible Infrastructure of Resilience: Testing Collaboration Awareness in Strategic Civil-Military Collaboration on Resilient Care

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ID: 320394
2026
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Abstract
Abstract Introduction The number and complexity of cross-border threats have increased significantly in recent years, as evidenced recently by the COVID-19 pandemic and the Russian invasion of Ukraine. These developments demonstrate the need for more preparedness and resilience. Yet, there are 2 gaps in existing scientific knowledge. First, new civil-military collaborations are built in the preparation phase, which researchers rarely examine. Second, current civil-military collaborations take place at a strategic level, but scholars have largely focused on operational and tactical partnerships. This study addresses both gaps by examining collaboration awareness as a critical condition for civil-military collaboration in the crisis preparation phase on the strategic level. Collaboration awareness refers to the mutual understanding of organizational roles, responsibilities, cultures, interests, and language. It ensures predictability, mutual understanding, and accountability. Materials and Methods This exploratory study relies on various qualitative data sources to analyze interdepartmental collaboration between the Dutch Ministry of Health, Welfare and Sport (MoH) and the Ministry of Defence (MoD). It examines the role and relevance of collaboration awareness in the emerging partnership between MoH and MoD. Results The findings indicate that collaboration awareness positively affects interdepartmental collaboration, even in the face of obstacles, such as limited strategic governance, resource constraints, and time pressure. Specifically, it increases accountability by clarifying joint responsibilities across crisis preparation and response phases, reducing ambiguity. It improves predictability by enhancing open communication and shared situational awareness. And more mutual understanding, rooted in shared narratives and regular interaction, builds trust and cohesion. Conclusions This article provides a comprehensive view of how collaboration awareness can strengthen civil-military collaboration in the preparation phase at the highest organizational levels. These insights emphasize the importance of investing in joint planning, liaison structures, and shared narratives well before a crisis emerges. Ultimately, fostering collaboration awareness at all levels of government will enhance national resilience in an increasingly complex and uncertain geopolitical landscape.
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Authors Bernice den Bak, Diane Zandee, Jori Pascal Kalkman
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Journal Military Medicine
Year 2026
DOI
10.1093/milmed/usag317
URL
https://doi.org/10.1093/milmed/usag317
Keywords Keywords not found

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