Development and validation of an assessment tool for public health emergency management program

Abstract Background Effective public health emergency management (PHEM) is crucial for safeguarding population health and societal resilience in the face of escalating global threats. However, standardized tools for comprehensively assessing emergency readiness across diverse contexts are lacking, particularly in resource-constrained settings like Ethiopia. Existing assessment approaches have demonstrated limitations, including narrow scope focused on specific hazards or sectors, over-emphasis on implementation processes rather than programmatic outcomes, and lack of empirical grounding in tool development and validation. This study aimed to develop and validate a standardized tool to assess PHEM programs. Methods This study employed a sequential exploratory mixed methods design. Relevant assessment domains were identified through a literature review, stakeholder consultations, and expert consultations conducted at a workshop. This study utilizes Donabedian's structure-process-outcome framework to guide the assessment of public health emergency management . A questionnaire containing 60 items was then generated and underwent translation, face validation, and content validity assessment. Construct validity was evaluated using exploratory factor analysis with responses from 260 professionals. Internal consistency reliability was assessed utilizing Cronbach's alpha. Results A 45-item tool for assessing PHEM programs in diverse contexts in Ethiopia was developed and validated. The tool demonstrated high content validity (CVIs > 0.83), good construct validity (15-factor structure explaining 74.8% variance), and excellent reliability (overall α = 0.863, subscales > 0.70). The final tool covers domains such as multi-sectoral coordination, resource allocation, transparency/accountability, workforce capacity, and provision of essential supplies. Conclusions This study developed a comprehensive tool to assess emergency management programs across diverse contexts. The validation revealed critical preparedness factors like multi-sector coordination, funding transparency and workforce strength. The mixed-methods approach proved effective for crafting contextually appropriate evaluation methods in low-resource settings with infrastructure barriers. By standardizing measurement of capacities and gaps, this validated tool can guide strategic policy planning to bolster resilience nationwide. Ongoing monitoring of progress using this model can help prioritize investments and direct coordinated responses to future crises.