Hospital preparedness for disaster and mass casualty management in Pakistan: A cross-sectional evaluation study

Zia Ul-Haq, Basharat Hussain Shah, Maria Ishaq Khattak, Sheraz Fazid, Sarah Basharat, Sardar Hayat Khan, Fawad Khan, Hamid Shahzad, Junaid Razzak, Saeed Farooq, Qudsia Huda

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


BACKGROUND: World Health Organization has advocated preemptive readiness of health systems to manage disas-trous events. Pakistan is known to be highly susceptible to disasters on the one hand and significantly lacking in coping ability on the other. Preparedness of health facilities in such locales is especially important, despite which there is little published evidence regarding hospitals' response capacity in Pakistan. METHODS: From 12 most disaster prone districts of the country, a purposive sample of 20 hospitals was assessed us-ing 51 indicators, scored as fully (2), partially (1), or not prepared (0). Two domains, disaster preparedness and mass casualty management, and five subdomains, networking, planning, staff-readiness, materials, and safety, were evalu-ated. Proportions of maximum possible scores achieved by an entity were categorized as acceptable (≥66 percent), par-tial (35-65 percent), or inadequate (<35 percent). RESULTS: Out of the 20 hospitals, 14 (70 percent) were secondary and 3 tertiary level facilities (30 percent). Overall, hospitals were partially prepared with a score of 54.0 percent, 95 percent confidence interval [52.3 percent, 54.7 percent]. Disaster preparedness, 55.2 percent [54.0, 57.0], was significantly better prepared than mass casualty management, 49.2 percent [46.8, 51.6], p < 0.001. Overall, facility safety was the least prepared among the subdomains, 38.3 per-cent [31.8, 44.8], while materials were the best, 75.9 percent [72.6, 79.3]. The least prepared subdomains were staff-readiness in Punjab, 52.1 percent [47.5, 56.8], and facility safety in KP, 29.2 percent [22.1, 36.4]. CONCLUSIONS: Hospitals' preparedness for disaster and mass casualty management is deficient in these most vulner-able districts of Pakistan. Improvement initiatives commensurate with locale vulnerabilities should be instituted.

Original languageEnglish
Pages (from-to)181-192
Number of pages12
JournalAmerican journal of disaster medicine
Issue number3
Publication statusPublished - 1 Jun 2019
Externally publishedYes


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