Health workforce management under shocks: evidence from the 2023 Türkiye earthquake

The 2023 Türkiye earthquakes, among the largest multi-centred disasters of recent decades, placed extraordinary pressure on the health workforce. Drawing on multi-level qualitative data from national, provincial, organisational, and frontline responders, this study examines how the workforce was mobilised, managed, supported, and coordinated during the emergency response, and what these reveal about health system preparedness in large-scale emergencies. The study used a qualitative exploratory design, based on 32 interviews with governmental officials at the national and provincial levels, emergency teams, international organisations and NGO staff, and frontline health workers, supported by two focus group discussions with key informants, health workers and volunteer teams. Data was analysed thematically guided by the WHO Human Resources for Health Action Framework. Despite the existence of national disaster plans, findings show that early workforce mobilisation relied heavily on informal communication and individual initiative due to formal systems being disrupted by the scale of the event, reflecting a strong professional ethos. However, structured rotations, inter-provincial deployments, and the sister-city model later stabilised emergency services. Task shifting occurred mainly in administrative and logistical roles, supported by rapid organisational adaptations such as pillar-based teams and accelerated recruitment processes. Volunteers and Emergency Medical Teams provided critical surge capacity, but early integration was hindered by communication failures, unclear roles, and limited institutional support. During the 2023 earthquakes, health workers in Türkiye experienced severe physical and emotional strain as both responders and victims, with inconsistent access to psychological support across organisations. The study underscores that effective health workforce response in disasters depends on strong governance, equitable staffing, adaptable organisational processes, and consistent support for wellbeing. Türkiye’s experience provides actionable recommendations for strengthening health workforce preparedness to build more resilient health systems that are able to respond in increasingly complex disaster settings.