disasters

The elderly has special needs in disasters, and their lives and health status are affected by disasters. Two countries, Iran and Germany, were selected to study and analyze the different aspects of the elderly's needs and capabilities in disasters. This study aims to identify and compare the needs and capacities of the elderly in disasters in Iran and Germany and suggest implications for healthcare systems.

The present research is a comparative study using a scoping review. Relevant keywords were searched on the Web of Sciences, PubMed, and Scopus. Two researchers selected the final references using title and abstract screening based on the inclusion and exclusion criteria.

A total of 18 references were selected for the final analysis. Earthquakes and heat waves were the most common disasters in the studies of Iran and Germany. The elderly status in disasters was explained in terms of vulnerability/needs, capacities/capabilities, assessment/measurement, and the interventional approach.

Comparing the elderly conditions in disasters in Iran and Germany can result in useful implications for policy-making and management. Hazard risk analysis and assessment, special training for nursing home staff, and improving the elderly's disaster risk perception are highly suggested.

It is important to offer reproductive and sexual healthcare services to improve the health of society. However, healthcare personnel lack sufficient knowledge and skills to provide such services in disasters. This study aims to investigate the role of healthcare service providers in delivering reproductive and sexual healthcare services during disasters.

This study is a narrative review conducted in five stages: Designing the research question, searching and extracting the related studies, selecting the relevant studies, developing the timetable, summarizing the data and information, and reporting the results. After extracting the keywords through the MeSH database, the studies done in Iran and abroad were checked by searching the databases, including Google Scholar, Scopus, the Cochrane Library, ScienceDirect, PubMed, Web of Science, and UpToDate. We used the different combinations of the following keywords: “Healthcare personnel,” “nurses,” “midwives,” “service providers,” “healthcare providers,” “reproductive healthcare,” “sexual healthcare,” “sexual and reproductive healthcare,” “calamity,” “crisis,” “disaster,” and “emergency” from 2009 to 2024. 

Using the search strategy, 403 articles were found, and 10 studies were included in this narrative review. Regarding the reproductive and sexual healthcare services in disasters, four main categories were found: Providing educational and counseling services, planning and providing reproductive healthcare services, providing emergency services in the field of gynecology, obstetrics, and newborn care; and preventing and managing the consequences of sexual violence.

Regarding the many obstacles in providing reproductive healthcare services, this study can be employed to plan, design, and implement some effective interventions for providing the due services. Healthcare service providers can benefit from this review by familiarizing themselves with their role during disasters. It is hoped that the extracted results in the present study can effectively depict the role of healthcare workers in reproductive healthcare in disasters.

This study aimed to develop an educational program to address the basic educational needs of community-based health organizations (CBHOs) or non-government organizations (NGOs) in Iran involved in disaster management.

This qualitative study was conducted in two phases: a) Identifying the basic educational needs of CBHOs/NGOs before participating in disaster management through interviews with 25 key informants from Isfahan, Iran, and b) Validating the components by conducting focus group discussions with key informants and designing the educational program.

We extracted two main themes (goals): 1) Recognizing the conceptual foundations of CBHOs/NGOs with three categories (objectives) of “role and social status”, “structures”, and “practical approaches”, and 2) Attention to social determinants of health (SDH) with nine categories of “culture of safety”, “social responsibility”, “social cohesion”, “addiction prevention plans”, “women’s needs”, “mental health”, “ethical standards”, “ morale improvement”, and “communication skills”. The educational program was elaborated by specifying the syllabuses, educational strategies/teaching methods, target groups, duration, and budget for each objective. 

The educational program can be used to increase CBHOs/NGOs’ skills and knowledge, help them coordinate their actions, and adapt their responses to the diverse needs and preferences of the community.

Volcanic eruptions pose a threat to communities and often sideline their basic needs. This study investigates the experience of evacuees and their perception of sexual needs after evacuation due to the eruption of Mount Merapi in Indonesia.

In this qualitative study, in-depth interviews were conducted with 24 evacuees from Central Java and the Special Region of Yogyakarta provinces affected by Mount Merapi’s eruptions. Thematic content analysis was used to analyze the data and extract the themes related to sexual needs and well-being in evacuation centers.    

We identified four themes of “sexual needs”, “privacy/well-being”, “psychosocial well-being”, and “role of government and associations”. The results revealed that evacuees’ sexual needs persist after volcanic eruptions but face challenges such as lack of privacy, inadequate facilities, and a non-conducive environment. The participants were aware of the role of these needs in psychosocial health but were influenced by individual and situational factors. 

The results highlight the persistence of sexual needs among evacuees after volcanic eruptions and the need for paying attention to these needs in evacuation planning to enhance their psychosocial health.

Disasters affect men and women unequally. While both male and female populations have their own needs, capacities and vulnerabilities, little is known about the men’s health status in disasters. Thus, the present review is aimed to identify and explain the impacts of disasters on men’s health status in the world.

The current scoping review was conducted using PRISMA protocol 2020. Web of Sciences, PubMed, Scopus databases were searched using related keywords. Inclusion and exclusion criteria were used to select the relevant references. EndNote software, version 17, was applied to manage the citations. The data were analyzed using thematic analysis.

A number of 13 references was selected for final analysis after screening process. Physical and sexual health were the most frequent aspects of men’s health which was studied by the gender and disaster researchers (23.1%). Men’s health aspects in disasters were categorized as physical health, mental health, social health and sexual health.

Men are visible as the capable group in disasters and their health needs (physical, mental, social, sexual and spiritual health) may likely not be considered post-disasters. Developing gender analysis tools for assessing the vulnerabilities, needs and health status of male population in disasters as well as establishing a sex-disaggregated database for effective decision-making regarding men’s health during disasters are highly suggested.

Social trust in relief organizations is one of the prerequisites for community preparedness for disasters. This study aims to explore the challenges of social trust in disaster management in Iran with a focus on the COVID-19 pandemic, and provide recommendations for building social trust.

This is a qualitative study using a conventional content analysis method. Participants were 27 lay people and managers of emergency and relief organizations in Tehran who were selected purposefully with maximum diversity. We used in-depth semi-structured interviews to explore their experiences and perceptions. Data analysis was performed using MAXQDA software, version 2018 and Graneheim and Lundman’s content analysis method. 

In this study, two main themes emerged, “challenges to building social trust” and “recommendations for building social trust.” The challenges had four categories: Managerial issues, misunderstanding of the situation, lack of transparency, and lack of coordination. The recommendations had three categories: Management improvement, efficient risk communication, and experience-based interventions. 

Social trust during disasters in Iran can be improved by transparency in the performance and tasks of relief organizations, timely and accurate provision of information (risk communication), and emphasis on social participation and solving managerial issues.

Disasters, both natural or manmade, have been a serious threat to human life and property for many years. The shortest response time is certainly the most important factor in increasing the survival of victims in disasters. Considering the vital importance of time in relief operations, the aim of this study is to investigate the response time in various incidents and disasters by the aid workers of the RCS by the provinces of the country during the years 2012 to 2020.

This descriptive-quantitative study is cross-sectional and data was collected by the Rescue and Relief Organization of IRCS during the years 2012 to 2020 in all Emergency Operation Centers (EOC) of the country. The variables contain the year, the province, the time interval between the occurrence of the disasters and the notification by the RCS aid workers, the time interval between their notification and presence at the scene of the disaster. The median (first and third quartile) after removing the outliers was used to report these times by year and province in the three years of 2012, 2016 and 2020. A line chart was applied to examine the trend changes during the study period.

The results show that the maximum minutes between the occurrence of road accidents and the notification of RCS aid worker was not reported in any province in 2012, and in many provinces, this time are equal to 5 minute. The highest mean minutes were seen 7 in Gilan province and 6 in Zanjan, East Azerbaijan, Fars, Khuzestan and Yazd provinces in 2020. Also, this figure has decreased from 5 in 2012 to 4 minute in 2020 in the country. The highest mean of minutes in 2012 and 2020 belongs to Qom province with 11.5 and 13 minute. The median of these minute has increased from 5 in 2012 to 9 in 2020. In urban accidents, the median time of notification and presence of aid workers at the scene has decreased from 5 to 4 and increased from 5 to 7 minute, respectively. On the other hand, in mountain incidents, a decrease of one minute (from 10 to 9) and an increase from 20 to 36 minute can be seen in the mean of the times of notification of the accident and presence at the scene, respectively.

According to the type of accident disasters and the climatic and geographical conditions of the provinces, the duration of disaster relief is different and determining the standard criteria for it depends on various factors. It seems that the time between the occurrence of a natural disaster and the notification and the time between the notification and the presence at the scene in road, urban and mountain incidents are at a favorable level in the RCS. Hence, it is recommended to conduct detailed analytical studies to determine the standard measure of relief time and prepare special provincial guidelines to reduce rescue duration.

Given the demanding nature of their work, military personnel are frequently exposed to stressful events and disasters, necessitating exceptional physical and mental resilience. Resilience within the military context is pivotal for effectively managing emergency situations. This study aims to identify factors affecting military resilience in emergencies and disasters.  

A qualitative systematic review was conducted using databases such as PubMed, Scopus, Web of Science, Google Scholar, and ScienceDirect, covering the period from January 2000 to August 2023. To identify additional records, the reference lists of the included studies were examined. The quality assessment of the included studies was conducted using the JBI tool.  

The review identified and incorporated 37 pertinent articles. The qualities of studies were acceptable. Through analysis, six primary themes emerged: self-efficacy, stress management, resilience, social-spiritual support networks, Adaptation processes, and Desirable activities. Notably, not all articles addressed each identified theme.  

This research highlights the crucial role of factors like self-efficacy, stress management, Resilience infrastructure, social-spiritual support networks, Adaptation processes, and Desirable activities in boosting the resilience of military personnel in emergencies and disasters. It also emphasizes the significance of interventions and support networks in helping individuals effectively overcome challenges and achieve positive outcomes in their lives. Moreover, Identifying and understanding other potential factors that affect military resilience is crucial for developing effective training programs to improve it.

Resilience is related to self-management and optimal use of energy resources in four areas: physical, mental, emotional and spiritual. The existence of different components of spirituality can have a positive effect on the resilience process of people in disasters. This study was conducted to explore the concept of spiritual resilience in disasters and identify its properties in the Iranian society.  

For this study, semi-structured interviews were held in 2022-2023. The interviewees were selected from Iranian subjects with sufficient knowledge and experience in spiritual resilience through purposive sampling. Data were collected and analyzed based on a qualitative approach using inductive content analysis.  

After categorizing the codes obtained from 27 interviews, three categories, i.e., “the concept”, “the properties”, and “the consequences” of spiritual resilience in disasters and emergencies, were identified. Five subcategories, namely patience, preserving of one's existence, flexibility, recovery, and faith in a supernatural source, collectively formed the concept of resilience. According to the experts’ opinions, spiritual resilience in disasters could be explored from three properties, including self-awareness, awareness of others, and theology.  

The originality of this paper can be valuable for decision-makers and managers in relevant organizations, as they can utilize the results to plan and implement essential intervention measures. By understanding the factors that contribute to spiritual resilience, these interventions can be designed to improve the overall spiritual resilience of society and mitigate the adverse impacts of disasters.

Hospitals are the first centers affected by accidents and disasters. Formulating a preparedness plan that takes into account the training of all employees, regular exercises, and the forecasting of required resources is essential for effective disaster management response. The present study was conducted to investigate the effectiveness of disaster management training based on the tabletop exercises approach on the ability of members of the hospital incident command system to manage mass casualties in one of the selected military hospitals in Tehran.

This semi-experimental research employed a pre-test and post-test design. The statistical population consisted of the members of the hospital incident command system, of whom 20 individuals were selected based on the entry criteria. A researcher-made questionnaire was used to measure the hospital’s readiness regarding the incident command system, excess capacity, and early warning system.

The average total score of preparedness before the intervention was 6.47±0.87. The average total scores of the members’ ability and attitude in dealing with disasters before the intervention were 3.19±0.72 and 3.28±0.41, respectively. The average scores of overall readiness and competence among nurses immediately after the intervention and one month later showed significant improvement compared to the scores before the intervention. After completing the course in the simulated environment during the workshop, 100% of the students achieved scores at a good level. Additionally, in the area of acquiring pre-hospital skills, 100% of the students scored at the proficient level. Furthermore, after the training workshop concluded, 100% of the students rated themselves as completely proficient.

The tabletop exercises have a significant effect on enhancing the capabilities of the members of the incident command system and the hospital in managing disasters.

Volcanic eruptions can harm pregnant women in the absence of disaster risk management. Health personnel have not adequately prepared pregnant women for disaster-prone eruptions.

This research aimed to evaluate the effectiveness of a disaster risk management model in enhancing the preparedness of pregnant women in anticipation of the eruption of Mount Agung.

The research employed a quasi-experimental design, utilizing a pre-test-post-test control group method. Conducted in Bali, Indonesia, in 2022, the study involved a sample of 200 participants, divided equally into two groups of 100 each. Participants were selected using quota sampling. Preparedness questionnaires were administered before the educational intervention (pre-test) and again after two weeks of education (post-test). The data were analyzed using the Wilcoxon Signed Rank Test and the Mann-Whitney U test.

It was found that in the intervention group, the preparedness of most pregnant women was categorized as fair (55%) before the intervention and high (65%) after the intervention (p < 0.001). In the control group, most pregnant women's preparedness remained in the fair category both before (66%) and after (65%) the intervention (P = 0.085). Additionally, there was a significant difference in the preparedness levels between the groups after the intervention (P = 0.015).

Health workers can enhance the eruption emergency preparedness of pregnant women through educational classes specifically designed for them.

Due to its geographical location, Iran has frequently faced natural disasters, especially earthquakes, which highlight the need to use the disaster management process. The aim of this study was to structural equation modeling of disaster preparedness in relation to personality traits, mediation of fate and behavioral consequences of citizens.

This descriptive research is one of the structural equation correlational one. All people aged 18 to 60 living in Tehran city were studied and finally 384 people were selected as a sample based on Morgan table by multi-stage cluster sampling using these questionnaires including: a) NEO 5-Factor Inventory (Costa & McCrae, 1985); b) Fatalism (Shamsoddini & Maghsoodi, 2021); c) Behavioral consequences (researcher-made); and d) Household preparedness index for disasters (Nouri, 2016). Cronbach's alpha coefficient (0.79) was used to assess the reliability of the questionnaires and data were analyzed using SPSS-24, Amos and Lisrel 8.8.

The results showed that personality traits (p<0.01) has a positive and significant effect on disaster preparedness. Also, the indirect effects of fatalism (p<0.01) have a negative effect and behavioral consequences (p<0.01) have a positive and significant effect on people's preparedness against disasters.

According to the research findings, the components of personality traits, fatalism and behavioral consequences have a great impact on people's tendency to prepare for natural disasters.

Hospitals play a vital role in disaster management and their function must be maintained during crises. Isfahan province is susceptible to major crises and disasters at any time of the year. The study aimed to investigate the hospital safety index (HSI) in hospitals in Isfahan province. 

This cross-sectional study was conducted using the HSI questionnaire of the world health organization. The safety of all 55 hospitals in Isfahan province was evaluated with the Persian version of the questionnaire from 2017 to 2022. In this study, all hospitals were evaluated by a group of experts from the emergency operations center (EOC) of Isfahan University of Medical Sciences, and the checklists were completed with the cooperation of the hospital disaster committee, visiting the hospitals, and interviewing the personnel. 

The safety level of hospitals has improved from 2017 to 2022 so in 2022, 38 hospitals (69.09%) had a high safety level, and 17 hospitals (30.91%) had a medium safety level. This increase in safety has happened in all three components of safety (functional, non-structural, and structural safety). There was no significant difference in the overall hospital safety score between academic-educational, non-academic governmental, social security and military, and private and charity hospitals (P<0.05). 

Although the safety in the hospitals of Isfahan province has improved due to the continuous disaster prevention and preparedness activities, hospitals still need to improve to achieve higher levels of safety. The HSI shows how well a hospital can maintain its organization and performance during disasters. This index will be useful for decision-making and policy-making to prioritize administrative and civil interventions.

Reproductive health services have remained a top priority in humanitarianemergencies. As more people are displaced, and their mobility areas become more diverse,emergency response efforts must ensure access to standard RH care services. This systematicreview aimed to evaluate and interpret the research on reproductive health in disastersconducted in 2022.

From January 2010 to December 2022, a systematic search was conducted in thePubMed, Cochran Library, Scopus, and EMBASE databases, as well as Science Direct, Web ofScience, and ProQuest databases. The author chose the articles based on keywords. Inclusionand exclusion criteria were also considered for the selection of articles, and the quality ofthe articles was checked with the relevant checklists. Finally, the articles were mined forinformation on Reproductive health (RH) in disasters.

213 articles were extracted after searching the databases. 7 articles were completelyin line with the study objective after their titles, abstracts, and texts were evaluated. A crosssectionalarticle, a combined article, two qualitative articles, an experimental article, and acase report were among the chosen articles. These 6 studies uncovered a diverse range of RHissues. Most women’s problems in disasters are caused by lack of awareness and knowledge,lack of support and protection equipment, lack of support from organizations in charge, andignorance of cultural factors.

The most vulnerable individuals in society are women and girls. Women’s livingconditions are worsened, and they experience mental, psychological, and physical stress dueto emergencies and disasters. Therefore, the issue of RH among women should be givenspecial consideration by health policymakers. Creating RH programs for women affected bydisasters is essential to disaster management. Therefore, to lessen their suffering and issuesduring disasters, countries should develop thorough guidelines and programs to improve theRH of women and girls of childbearing age.

 Hospitals are primary centers providing services during unexpected events and should maintain their operational capabilities during and after disasters. Therefore, continuous evaluation of the safety status of these centers is vital.

 This study investigated the functional, non-structural, and structural safety status in selected hospitals in Ahvaz and determined the most significant safety challenges across three dimensions.

 This descriptive-cross-sectional study was conducted in three hospitals in Ahvaz. The World Health Organization's (WHO) “Hospital Safety Index” checklist was used to collect data across three dimensions: Functional, non-structural, and structural safety. Descriptive statistics, such as mean percentages and frequency distribution tables, were utilized to investigate the quantitative objectives.

 The safety level of the studied hospitals was estimated at 30.81% in the functional dimension, 59.17% in the non-structural dimension, and 71.69% in the structural dimension. According to the WHO classification, they were categorized in levels C, B, and A, respectively. The overall safety was 52.48% and was placed in category B. In the functional safety dimension, the highest score was related to hospital 2 at 35.24%, and the lowest score was related to hospital 3 at 24.59%. In the non-structural safety dimension, the highest score was related to hospital 3 at 66.66%, and the lowest was related to hospital 1 at 48.55%. In the structural safety dimension, the highest score was related to hospital 2 at 84.61%, and the lowest was to hospital 1 at 50%. Regarding overall safety, hospital 2 obtained the highest score at 57.61%, and hospital 1 obtained the lowest at 43.90%.

 The results revealed a moderate safety status in the three investigated hospitals. Although the safety status of these hospitals is not critical regarding disaster preparedness, there is a need for better planning and implementation to improve their safety levels.

Preparing to deal with natural disasters, is important for the health of the society, and a valid clinical guideline which fits the country's conditions can lead to a reduction in complications caused by the aforementioned disasters. Therefore, the present study was conducted to develop and validate the clinical guidelines for reproductive health in natural disasters.

This mixed methods study was carried out in three phases. The first phase was a structured review of literature which systematically reviewed the articles and clinical guidelines related to the reproductive health in disasters. In the second phase, a qualitative study was conducted with the content analysis approach in order to identify the needs related to women's reproductive health in disasters, and a draft clinical guide was prepared. In the third phase, the validation of the prepared draft was carried out by a group of experts using the (RAND) Research and Development technique.

The themes obtained included the consequences of facing a disaster and the need to provide comprehensive services. The clinical guideline  consists of 5 chapters including an introduction on the importance of reproductive health in natural disasters, general clinical guidelines, prevention of physical and mental injuries in a crisis, access to reliable sources of information and the availability of the health services provider team. 

Correct management of crisis, empowering information skills and access to service providers in crises are of particular importance. Therefore, support of health care providers and training of service providers to learn about evidence-based performance in crises and their use is a necessary step to implement the clinical guidelines prepared in the country.