Exploring Key Capacities: Insights from Assessing the Resilience of the Public Health System Before and After the Kahramanmaraş Earthquakes

Abstract

AbstractThe goal of this mixed-methods study was to identify and compare the key capacity considerations regarding public health system resilience before and after the 2023 Türkiye-Syria earthquakes. Public health system resilience was assessed through online and face-to-face workshops using the United Nations Public Health System Resilience Scorecard. The pre-earthquake evaluation was conducted in Istanbul and Trabzon in 2021; the post-earthquake evaluation took place in Hatay and Kahramanmaraş in 2023, with a total of 41 participants each. The online workshops lasted approximately four days, while the face-to-face workshops lasted one day. The study found a significant decrease in the scores for most scorecard resilience indicators in the post-earthquake assessment. Qualitative analysis showed that this decline was largely due to infrastructure collapse. Additionally, defining the roles of health disciplines in disaster management and having data transmission procedures between public health system stakeholders in disasters were among the main capacity considerations in both the pre-and post-earthquake assessments. The post-earthquake evaluation revealed several capacity gaps that had not been addressed in pre-earthquake assessments in areas such as disaster preparedness of vulnerable populations and logistics. The findings highlight the critical importance of strengthening building stock and infrastructure to establish a disaster-resilient public health system.