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Evaluating Factors Influencing Disaster Preparedness and Service Continuity in Primary Healthcare CentersKey factors shape disaster preparedness in local healthcare centers

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Key Takeaway
Human resources and planning are key to PHC disaster preparedness, but community capacity remains under-reported.

This systematic review and contextual evidence synthesis analyzed 74 publications to evaluate disaster preparedness within primary healthcare centers (PHCs). The analysis focused on identifying specific barriers, facilitators, and operational capacities that influence service continuity during emergencies.

Findings indicate that human resources are a critical component, appearing in nearly all primary studies. Planning and coordination also showed high prevalence, while information management and infrastructure were identified in the majority of reviewed cases. These elements form the core of the Health Emergency Disaster Risk Management (EDRM) framework.

However, the review highlights a significant gap in reporting community capacities for health EDRM, which were only noted in 40% of primary studies. This suggests that local community involvement is under-documented in current literature.

To address these gaps, the authors propose a layered model for center-level assessment. This framework aims to guide the development of standardized instruments to better evaluate and improve the resilience of primary healthcare systems during and after catastrophic events.

When a disaster strikes, local clinics are often the first line of defense for patients. However, keeping these centers running during a crisis is difficult. A review of 74 publications looked at what makes a primary healthcare center ready to handle emergencies. The researchers found that having enough staff and clear plans are the most common factors in successful preparation.

The study looked at 15 primary reports from these centers. It found that human resources were a major focus in nearly all cases. Planning and coordination were also highly present. While information management and infrastructure were important, they appeared less frequently in the data. These findings help experts understand what a clinic needs to stay functional when things go wrong.

One important gap found was that community capacity is often under-reported. While the study provides a roadmap for assessing how clinics prepare, it is important to note that this was a review of existing reports rather than a new clinical trial. The results offer a way to build better tools for evaluating local healthcare readiness.

What this means for you:
Staffing and clear planning are the most common factors in preparing local clinics for disasters.

Common questions

What are the most important parts of disaster preparedness for a clinic?

The review found that human resources were the most common factor, appearing in 14 out of 15 primary studies. Planning and coordination were also very common, appearing in 13 out of 15 studies. These elements are key to ensuring a clinic can continue to function during an emergency.

What other factors help clinics stay open during a disaster?

Information and knowledge management were identified in 11 out of 15 studies. Additionally, health infrastructure and logistics were found in 10 out of 15 studies, while monitoring and evaluation were also found in 10 out of 15 studies.

Is community involvement part of the plan?

Community capacities for health emergency management were reported in 40% of the primary studies. However, the researchers noted that these community capacities are often under-reported in current data.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
Primary healthcare centers (PHCs) are a key health-system contact for disaster-affected populations, yet direct PHC evidence remains thin and is frequently conflated with hospital, workforce, policy, and secondary-review literature. To identify factors, barriers, facilitators, capacities, and operational gaps shaping PHC disaster preparedness; contrast component profiles against a structured contextual synthesis; characterize what is operationally distinctive about PHCs; and propose a PHC-derived layered model. A systematic review, supplemented by a structured contextual evidence synthesis, was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement and Synthesis Without Meta-analysis (SWiM) principles. The primary Scopus search plus preserved supplementary retrieval from PubMed, ProQuest, and OpenAlex, followed by a pre-submission full-text update, duplicate reconciliation, and independent confirmation by two reviewers, yielded 74 unique publications: 15 primary empirical PHC studies and 59 contextual publications. Evidence was mapped descriptively to the 10 World Health Organization Health Emergency and Disaster Risk Management (Health EDRM) components; all 15 primary PHC studies were independently appraised by two reviewers using design-specific Joanna Briggs Institute (JBI) tools or the Mixed Methods Appraisal Tool (MMAT) 2018. All 10 Health EDRM components were assessed across the 15 primary PHC studies. The most frequently identified were human resources (14/15, 93.3%), planning and coordination (13/15, 86.7%), information and knowledge management (11/15, 73.3%), followed by health infrastructure and logistics and monitoring and evaluation (each 10/15, 66.7%). Distinctive PHC characteristics included small generalist teams, staff and family-readiness barriers, executable plans, referral dependence, continuity of basic utilities and water, sanitation, and hygiene (WASH) services, limited local stocks, community outreach, and regular facility-level monitoring. PHC preparedness emerges as an interdependent capacity, with several distinctive PHC characteristics arising from specific Health EDRM components. Community capacities for Health EDRM were reported in only 40% of primary PHC studies, highlighting an under-reported area warranting further exploration. A layered model is proposed for center-level assessment and future instrument development, organizing system support, core preparedness capacity, service and community response, and cross-cutting information, communication, and monitoring as interacting domains linked to continuity of essential services. Open Science Framework, https://doi.org/10.17605/OSF.IO/H8JU7, Identifier: 10.17605/OSF.IO/H8JU7.
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