Effectiveness of a primary health care program on urban and rural community disaster preparedness, Islamic Republic of Iran: a community intervention trial.

BACKGROUND: To evaluate the effectiveness of a capacity-building intervention administered through a primary health care (PHC) system on community disaster preparedness in Iran. METHODS: A controlled community intervention trial with pre- and postassessments was conducted in 2011 in 3 provinces of Iran. In each province, 2 areas were chosen and randomly selected as an intervention or control group. A total of 9200 households were in the intervention area and 10 010 were in the control area. In each study group in each province 250 households were sampled for pre- and postassessment surveys. Community health volunteers led by PHC staff administered an educational intervention covering elements of hazard awareness and preparedness, with a focus on earthquakes and floods. Relative changes for awareness and readiness scores were assessed to demonstrate changes in outcome variables from pre- to postassessments in intervention and control groups. An effectiveness test of significance was based on interaction between time and area. RESULTS: Households in intervention communities exhibited improved disaster awareness and readiness with respect to all outcome measures. Relative changes in awareness in intervention and control areas were 2.94 and -0.08, respectively (P < .001). Relative changes for readiness scores were 5.52 in intervention areas and 0.56 in control areas (P < .001). Relative changes for awareness and readiness were significantly correlated with a community's baseline risk perception and previous experience with natural disasters (P < .001). CONCLUSIONS: An educational intervention administered through the PHC system effectively improved disaster awareness and readiness at a community level. For sustainability, community disaster reduction programs must be integrated into routine public health service delivery.

2012-2025 Roadmap of I.R.Iran's Disaster Health Management.

OBJECTIVE: In line with Iran's Comprehensive Health Sector Road Map, the National Institute of Health Research at the Tehran University of Medical Sciences developed the 2012-2025 road map of Disaster Health Management (DHM), including goals and objectives, strategies, activities and related prerequisites. This article presents the process and results of this road mapping project. METHODS: The project started with an expanded literature review followed by stakeholder analysis to assess level of interest and impact of related organizations to DHM; STEEP.V methodology to define determinants with a potential impact on Iran's HDM for duration of 2012 to 2025; strength, weakness, opportunity and threat (SWOT) analysis and formulation of goals and objectives, strategies, activities, and prerequisites. Brainstorming, group discussion and interviews with key informants were used for data collection; nominal group technique was used whenever prioritization was necessary, and Delphi panel methodology was applied for consensus development. RESULTS: STEEP.V analysis revealed the most important Social, Technological, Environmental, Economic, Political and Value-based determinants. Iran's DHM mission and vision were defined respectively as "Mitigation from, preparedness for, response to and recovery from consequences of natural and man-made hazards at the community level as well as to the health facilities and resources of I.R.Iran" and "In 2025, Iran's DHM will be the most developed system in the region resulting in the least vulnerability, the highest readiness in health facilities and resources, and the highest and most effective contribution of the Iranian community to disaster resilience", respectively. Sixteen strategies and related activities, along with the necessary prerequisites, were developed. CONCLUSIONS: This was the first attempt at comprehensive strategic planning in the field of DHM in Iran. The current framework provides Iran's health system with a list of strategies and activities to be considered in operational planning and actions. However, a dynamic process of evaluation and revision is required to ensure that Iran's health system goals are met by 2025. Address for correspondence: Ali Ardalan, No. 78, Italia Ave, Department of Disaster and Emergency Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran. Email: aardalan@gmail.com or aardalan@tums.ac.ir CITATION: Ardalan A, Rajaei MH, Masoumi G, Azin A, Zonoobi V, Sarvar M, Vaskoei Eshkevari K, Ahmadnezhad E, Jafari G. 2012-2025 Roadmap of I.R.Iran's Disaster Health Management. PLoS Currents Disasters. 2012 Jul 16.