Disaster preparedness and service continuity in primary healthcare centers: a systematic review and structured contextual evidence synthesis
4 affiliations
- 1Doctoral Study Program in Medical Science, Faculty of Medicine, Universitas Padjadjaran
- 2Department of Public Health, Faculty of Medicine, Universitas Islam Bandung
- 3Department of Public Health, Faculty of Medicine, Universitas Padjadjaran
- 4Faculty of Health Sciences, Curtin University Malaysia
Abstract
Background: 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.
Objective: 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.
Methods: 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.
Results: 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.
Conclusion: 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.
Systematic review registration: Open Science Framework, https://doi.org/10.17605/OSF.IO/H8JU7 , Identifier: 10.17605/OSF.IO/H8JU7 .
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BibTeX
@article{irasanti2026disaster,
title = {{Disaster preparedness and service continuity in primary healthcare centers: a systematic review and structured contextual evidence synthesis}},
author = {Siska Nia Irasanti and Deni Kurniadi Sunjaya and Guswan Wiwaha and Titik Respati and Roy Rillera Marzo},
journal = {Frontiers in Public Health},
year = {2026},
month = oct,
doi = {10.3389/fpubh.2026.1961009},
url = {https://www.frontiersin.org/articles/10.3389/fpubh.2026.1961009/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Disaster preparedness and service continuity in primary healthcare centers: a systematic review and structured contextual evidence synthesis
AU - Siska Nia Irasanti
AU - Deni Kurniadi Sunjaya
AU - Guswan Wiwaha
AU - Titik Respati
AU - Roy Rillera Marzo
PY - 2026
DA - 2026/10/28
JO - Frontiers in Public Health
DO - 10.3389/fpubh.2026.1961009
UR - https://www.frontiersin.org/articles/10.3389/fpubh.2026.1961009/full
AB - Background: 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. Objective: 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. Methods: 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. Results: 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. Conclusion: 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. Systematic review registration: Open Science Framework, https://doi.org/10.17605/OSF.IO/H8JU7 , Identifier: 10.17605/OSF.IO/H8JU7 .
SN - 2296-2565
ER -