Health systems in South Africa have faced significant challenges during epidemics, necessitating a comprehensive understanding of their resilience mechanisms. The research integrates quantitative data analysis with thematic content analysis of interviews and surveys conducted among healthcare providers and community members. A mixed-methods approach was employed to complement each other’s strengths. Healthcare service continuity during the H1N1 influenza pandemic demonstrated significant variability across regions, with urban areas showing greater resilience compared to rural settings (85% vs. 60%). The study highlights the importance of regional disparities in health system preparedness and response mechanisms. Strategic investments should be prioritised towards strengthening healthcare infrastructure and staff training, particularly in underserved areas. health systems resilience, mixed methods, South Africa, epidemic response