Document Type : Original Article


1 Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran. Iran

2 PhD in Health in Emergency and Disaster, Sirjan School of Medical Sciences, Sirjan, Iran


INTRODUCTION: The state of health‑care disaster preparedness in Iran prior to the possible
earthquakes is not well documented. This study identified the challenges of the Iranian health system
before possible earthquakes in Tehran based on the World Health Organization (WHO) framework.
MATERIALS AND METHODS: In this qualitative study, in‑depth and semi‑structured interviews were
conducted for 17 health experts and authorities, who were selected based on purposive sampling
method. The questions were designed based on the proposed framework of the WHO in six areas
including policies and planning, communication, collaboration and coordination, training, volunteers
and the public, and surge capability. The data were analyzed by using framework analysis.
RESULTS: The main themes included weak communication infrastructures, inappropriate assessment
of specialized training courses and lack of a clear scenario, integrated urban commanding,
extra‑sectorial coordination, and data banks for public volunteers.
CONCLUSION: Iran health‑care disaster preparedness was tested by many earthquakes. This
research showed that disaster preparedness in Iran faces several challenges.


1. Moosazadeh  M, Zolala F, Sheikhzadeh K, Safiri S, Amiresmaili M.
Response to the Bam earthquake: A qualitative study on the
experiences of the top and middle level health managers in
Kerman, Iran. Prehosp Disaster Med 2014;29:388‑91.
2. Ardalan A, Masoumi GR, Gouya MM, Ghafari M, Miadfar J,
Sarvar MR, et al. Disaster health management: Iran’s progress
and challenges. Iran J Pub Health 2009;38:93‑7.
3. Aghapour AH, Yazdani M, Jolai F, Mojtahedi M. Capacity
planning and reconfiguration for disaster‑resilient health
infrastructure. J Build Eng 2019;26:100853.
4. Amuli AJ. Efficacy of fire disaster management policies in
managing fire outbreaks in Tanzania’s secondary schools. Euro
J Edu Stud 2019;6(5):350‑366.
5. Khankeh H. Hospital Preparedness. 1st ed. Tehran: USWRS
Publisher; 2012.
6. UNISDR. Sendai Framework for Disaster Risk Reduction
2015‑2030. Available from:
sendai‑framework. [Last accessed on 2017 May 07].
7. Tang P, Xia Q, Wang Y. Addressing cascading effects of
earthquakes in urban areas from network perspective to improve
disaster mitigation. Int J Dis Risk Reduct 2019;35:101065.
8. Hashjin AA, Kringos DS, Manoochehri J, Aryankhesal A,
Klazinga NS. Development and impact of the Iranian hospital
performance measurement program. BMC Health Serv Res
9. Ostadtaghizadeh A, Ardalan A, Paton D, Khankeh H, Jabbari H.
Community disaster resilience: A qualitative study on Iranian
concepts and indicators. Natur Hazards 2016;83:1843‑61.
10. Tanner A, Doberstein B. Emergency preparedness amongst
university students. Int J Dis Risk Reduct 2015;13:409‑13.
11. Coppola DP. Introduction To International Disaster Management.
Oxford, UK: Elsevier; 2006.
12. Robinson J, Billington J, Gray E, Chapple M. Qualitative
Methodologies I: Using Established Qualitative Methods in
Research on Reading and Health. In: Billington J. (eds) Reading
and Mental Health. Palgrave Macmillan, Cham. 2019.
13. Mays N, Pope C. Synthesising qualitative research. Qualitat Res
Health Care 2020:151‑68.
14. Khankeh  HR, Khorasani‑Zavareh D, Johanson E, Mohammadi R,
Ahmadi F, Mohammadi R. Disaster health‑related challenges and
requirements: A grounded theory study in Iran. Prehosp Disaster
Med 2011;26:151‑8.
15. Kominski GF, Simon PA, Ho A, Luck J, Lim YW, Fielding JE.
Assessing the burden of disease and injury in Los Angeles
County using disability‑adjusted life years. Public Health Rep
16. Ardalan A,Rajaei MH, Masoumi G, Azin A,Zonoobi V, Sarvar M,
et al. 2012‑2025 roadmap ofI.R.Iran’s disaster health management.
PLoS Curr 2012;4:e4f93005fbcb34.
17. Jahangiri K, Izadkhah YO, Jamaledin Tabibi S. A comparative
study on community‑based disaster management in selected
countries and designing a model for Iran. Disaster Prev Manag
An Int J 2011;20:82‑94.
18. Bissell RA, Pinet L, Nelson M, Levy M. Evidence of the
effectiveness of health sector preparedness in disaster response:
The example of four earthquakes. Fam Community Health
19. Mohammadinia L, Ebadi A, Malekafzali H, Allen KA,
Sharif Nia H. The design and psychometric evaluation of the
Adolescents’ Resilience in Disaster Tool (ARDT‑Q37): A mixed
method study. Heliyon 2019;5:e02019.
20. Mulyasari F, Inoue S, Prashar S, Isayama K, Basu M, Srivastava N,
et al. Disaster preparedness: Looking through the lens of hospitals
in Japan. Int J Dis Risk Sci 2013;4:89‑100.
21. Merchant RM, Leigh JE, Lurie N. Health care volunteers
and disaster response‑first, be prepared. N  Engl J Med
22. Williams J, Nocera M, Casteel C. The effectiveness of disaster
training for health care workers: A systematic review. Ann Emerg
Med 2008;52(3):211‑22.
23. Kaji AH, Lewis RJ. Hospital disaster preparedness in Los Angeles
County. Acad Emerg Med 2006;13:1198‑203.
24. Simon R, Teperman S. The World Trade Center attack. Lessons
for disaster management. Crit Care 2001;5:318‑20.
25. Glik DC. Risk communication for public health emergencies.
Annu Rev Public Health 2007;28:33‑54.