Zia Ul-Haq1,2, Basharat Hussain Shah1, Mohammad Ardakani3, Saeed Akbar Khan3, Saleem Muhammad4, Saeed Farooq5, Sardar Hayat Khan3, Qudsia Huda6. 1. Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan. 2. Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom. 3. World Health Organization, Islamabad, Pakistan. 4. Gomal Medical College, Dera Ismail Khan, Pakistan. 5. Primary Care and Health Sciences, University of Keel, Keel, United Kingdom. 6. World Health Organization, Geneva, Switzerland.
Abstract
BACKGROUND: The World Health Organization (WHO) has strongly advocated health systems' preparedness for effective management of crisis situations globally for more than two decades. Pakistan is known for its high vulnerability to hazards and lack of coping and adaptive capabilities. Health systems' preparedness for locales with such high-risk profile is essential, yet there is a dearth of studies addressing the status of such preparedness in the country. AIMS: This study aimed to assess the status of preparedness of health-system components for crisis management in the most disaster prone districts of Pakistan. METHODS: A purposive sample of 12 of the most disaster prone districts in two provinces of Pakistan was evaluated for preparedness using the WHO's toolkit for assessing health-system capacity for crisis management. Six core functions of the Health Systems Framework, with a total of 229 indicators, were evaluated at the district management as well as secondary and tertiary health care facilities level. Proportions of indicators prepared were calculated and preparedness was classified as Acceptable (≥ 66%), Partial (36-65%) or Inadequate (≤ 35%). RESULTS: Seventy-two percent, 95% Confidence Interval [46.0, 90.0] of indicators in these most vulnerable districts were evaluated as partially or inadequately prepared for appropriate management of crises. Even the highest scoring core function, Leadership and Governance was partially prepared with a score of 53.6% (52.4, 54.9). Process elements were found to be less prepared compared with structure components. CONCLUSIONS: Federal level strategic planning, implementation, management and follow-up aimed at ensuring health-systems' preparedness need to be reviewed and strengthened.
BACKGROUND: The World Health Organization (WHO) has strongly advocated health systems' preparedness for effective management of crisis situations globally for more than two decades. Pakistan is known for its high vulnerability to hazards and lack of coping and adaptive capabilities. Health systems' preparedness for locales with such high-risk profile is essential, yet there is a dearth of studies addressing the status of such preparedness in the country. AIMS: This study aimed to assess the status of preparedness of health-system components for crisis management in the most disaster prone districts of Pakistan. METHODS: A purposive sample of 12 of the most disaster prone districts in two provinces of Pakistan was evaluated for preparedness using the WHO's toolkit for assessing health-system capacity for crisis management. Six core functions of the Health Systems Framework, with a total of 229 indicators, were evaluated at the district management as well as secondary and tertiary health care facilities level. Proportions of indicators prepared were calculated and preparedness was classified as Acceptable (≥ 66%), Partial (36-65%) or Inadequate (≤ 35%). RESULTS: Seventy-two percent, 95% Confidence Interval [46.0, 90.0] of indicators in these most vulnerable districts were evaluated as partially or inadequately prepared for appropriate management of crises. Even the highest scoring core function, Leadership and Governance was partially prepared with a score of 53.6% (52.4, 54.9). Process elements were found to be less prepared compared with structure components. CONCLUSIONS: Federal level strategic planning, implementation, management and follow-up aimed at ensuring health-systems' preparedness need to be reviewed and strengthened.
Authors: Khayal Muhammad; Muhammad Saqlain; Gul Muhammad; Ataullah Hamdard; Muhammad Naveed; Muhammad Hammad Butt; Siraj Khan; Najlaa Saadi Ismael; Zakir Khan; Yusuf Karatas Journal: Disaster Med Public Health Prep Date: 2021-02-16 Impact factor: 1.385