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Implementation of the Sendai framework in the health system in Iran: identification of facilitators and obstacles

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Abstract

Purpose

Sendai Framework is an international disaster risk reduction strategy that helps prioritization of disaster risk governance in all policies, strategies, and programs. Considering its geographical location and topographic characteristics, Iran experiences numerous hazards. Natural disasters adversely affect the health of population directly through injury and death, increased physical and mental illness, displacement and disruption of social networks. In addition, Iran’s public health facilities have been increasingly impacted by such events during the last decade. This study aimed to investigate the implementation of Sendai framework in health system in Iran.

Methods

In this mixed method study, first, throughout a literature review, all documents related to Disaster Risk Management (DRM) in Iran’s health system were extracted. Then the obstacles and facilitators of DRM were found out based on the literature review and, a two-round Delphi, followed by an expert panel was performed. According to the results of the Delphi and expert panel Pareto analysis, and Fishbone model were used.

Results

85 obstacles and 33 facilitators were extracted in total, which were divided into ten groups include Coordination, Actors, Intervention, Monitoring & Evaluation, Accountability, Attitude, Context, Budget, Idea, and Content. The most important obstacles were attributable to the intervention group, the Context, and the attitudes. The most important facilitators were the intervention group, monitoring and evaluation, and then Actors, policy content and Idea.

Conclusion

Despite the existing facilitators for the implementation of the Sendai framework in Iran, there are far more obstacles along the pathway. These factors are relevant to all aspects of policy which would require long-term and continuous cultural change and educational planning.

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Data availability

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

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Acknowledgements

The author thanks all participants who helped us in this research.

Code availability

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Funding

The authors received no fund for this study.

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Authors and Affiliations

  1. Department of Health in Emergencies and Disasters, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Homa Yousefi Khoshsabegheh, Ali Ardalan & Abbas Ostadtaghizadeh

  2. Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Amirhossein Takian

  3. Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Amirhossein Takian

  4. Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran

    Amirhossein Takian

  5. National Disaster Management Organization, Tehran, Iran

    Behnam Saeedi

Authors
  1. Homa Yousefi Khoshsabegheh
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  2. Amirhossein Takian
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  3. Ali Ardalan
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  4. Abbas Ostadtaghizadeh
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Contributions

AA, AT and HYK conceived and designed the study. HYK conducted data collection. HYK, AA, and AT, and AO carried out data analysis and interpretation. HYK drafted the manuscript. AA and AT supervised the whole process of research and are guarantors. All authors have read and approved the final draft of the manuscript.

Corresponding authors

Correspondence to Amirhossein Takian or Ali Ardalan.

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Ethics approval

This research received ethical approval from the Ethics Committee of the Tehran University of Medical Sciences (TUMS) (the approval code was Ir.tums.sph.rec.1396.4315).

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The participants were informed about the objectives and importance of the study and reassured them about anonymity, confidentiality, and the right to withdraw from the research at any time, without any explanation.

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The authors declare that they have no conflict of interest.

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Yousefi Khoshsabegheh, H., Takian, A., Ardalan, A. et al. Implementation of the Sendai framework in the health system in Iran: identification of facilitators and obstacles. J Environ Health Sci Engineer 19, 1597–1606 (2021). https://doi.org/10.1007/s40201-021-00715-9

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  • DOI: https://doi.org/10.1007/s40201-021-00715-9

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