Date of Award

1-9-2022

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. Uzma Rahim Khan

Second Advisor

Mr. Salman Muhammad Soomar

Third Advisor

Dr. Zia-Ul-Haq

Department

Community Health Sciences

Abstract

Background: Karachi being the largest and a coastal city prone to many disasters like cyclones, earthquakes, and urban floods. Because of climate changes these disasters are expected to increase in frequency and intensity. Their widespread impact at human, economic and environmental level makes it vital to have well developed and resilient healthcare systems. Developing countries' healthcare systems are vulnerable to disasters and mass casualty incidents. Objective: The study aims to determine the tertiary care hospitals readiness for disaster and mass casualty management in Karachi.
Methods: It was a cross sectional study. Total five tertiary care hospitals both public and private were selected in Karachi. WHO’s Hospital Emergency Response Checklist is a pretested and pre validated tool with 9 key components and 92 indicators. Each indicator has three responses to choose from, “Due for review” marked as “0”, “in progress” marked as “1”, and “completed” which is given 2 marks making a maximum score of 184. The questionnaire was filled by CEOs or Medical Superintendents of selected hospitals. Individual healthcare facility scores were calculated and categorized as unacceptably prepared (0-64), insufficiently prepared (64-129), and sufficiently prepared (130-184).
Results: Three (60%) tertiary care hospitals in Karachi were insufficiently prepared to deal with emergencies. Two (67%) of the public and one (50%) private hospital was insufficiently prepared. In Key component of command and control, Public and private hospitals achieved 9(64%) and 12 (85%) respectively. In communication, Public and private hospitals achieved 13 (72%) and 16 (89%) respectively. In safety and security, Public and private hospitals achieved 15 (68%) and 20 (91%) respectively. In key component of triage, Public and private hospitals achieved 13 (65%) and 18 (90%) respectively. In key component of surge capacity, Public and private hospitals achieved 16 (61%) and 17 (65%) respectively. In Continuity of essential services, Public and private hospitals achieved 11 (69%) and 12 (75%) respectively. In key component of human resources, Public and private hospitals achieved 18 (60%) and 20 (67%) respectively. In logistics and supply management, Public and private hospitals achieved 12 (60%) and 15 (75%) respectively. Public and private hospitals achieved 11 (61%) and 12 (67%) in the key component of post-disaster recovery. The average score obtained by public and private hospitals was 118 (64%) and 142 (77%). The average score of tertiary care hospitals was 126.8 (64%) out of the total score of 184.
Conclusion: Although Private hospitals were better prepared compared to public hospitals, both public and private hospitals need to improve their preparedness to deal with mass casualty and disaster events. Most of the hospitals in Karachi were insufficiently prepared in all key components but have unacceptable preparedness in command and control, logistics, and post disaster recovery key components. Overall preparedness of tertiary care hospitals in Karachi needs more efforts and upgradation in all key components tertiary care hospitals to reduce the health impact of MCI and disasters.

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