Health System Disruption at the Primary Health Center Level Affected by Earthquake, Tsunami, and Liquefaction in 3 Districts of Central Sulawesi, Indonesia.

Abstract

An earthquake followed by tsunami and liquefaction on September 28, 2018, in Central Sulawesi caused health system disruptions. This study aimed to know health system disruption at the primary health center (PHC) level due to the disaster in 3 districts (Palu, Sigi, Donggala) of Central Sulawesi. This was a qualitative study conducted in March 2019 involving 36 PHCs. Data were collected through interview of PHC officers using a structured questionnaire. Variables included disruption of management, budget, human resources, drug supply, Early Warning Alert and Response System (EWARS) of epidemic prone disease (EPD), human resource migration, health facility damage, and health facility access. Descriptive analysis was conducted to define disruption for a 1-y projection. Health system disruptions in Palu affected management, budget, human resources, EWARS, health facility damage, and health access; occurred within 1-2 mo; and were projected to become better after 6 mo. Problems in Sigi were management, human resources, drug supply, EPD, and EWARS for 1 mo after disaster and were projected to be better after 2 mo. The problems in Donggala were health services access, management, human resources for 1 mo after the disaster and were projected to be normal after 2 mo. Health system disruptions occurred in Central Sulawesi Province at the PHC level within 1-2 mo and were projected to become better after 3 mo in most PHCs.