Primary health care disaster preparedness: A review of the literature and the proposal of a new framework

With the publication of the Health Emergency and Disaster Risk Management (H-EDRM) Framework in 2019, the World Health Organization (WHO) emphasized the need for disaster preparedness in all sectors of the health system, including primary health care (PHC). PHC disaster preparedness plays a crucial role in guaranteeing continuity of care and responding to the health needs of vulnerable populations during disasters. While this is universally acknowledged as an important component of disaster management (DM), there is still a severe paucity of scholarship addressing how to practically ensure that a PHC system is prepared for disasters. The objective of this study is to propose a new framework that describes key characteristics for PHC disaster preparedness and lays the groundwork to deliver operational recommendations to assess and improve PHC disaster preparedness. A systematic literature review was performed and a total of 145 records were analyzed. Twenty-five characteristics that contribute to a well-prepared PHC system were identified and categorized according to the WHO Health System Building Blocks to form a new PHC disaster preparedness framework. The findings will contribute to the elaboration of a set of guidelines for PHC systems to follow in order to assess and then boost their disaster preparedness. This manuscript will hopefully help to raise awareness among international policymakers and health practitioners on the importance to design interventions that integrate the PHC system into overall DM strategies, as well as to assess the preparedness of PHC systems in different political, developmental, and cultural contexts.