Assessment of Health System Functions in Earthquake-stricken Regions in Kermanshah, Iran

Abstract

Background: The occurrence of an earthquake in Kermanshah province in 2017 leads to death and injury of its inhabitants. Assessment of the health system functions can lead to the provision of the necessary healthcare services for the affected population post-disasters. The present study is aimed to assess the health system functions after the Kermanshah earthquake. Objectives: Assessment of health system functions in the reproductive, pediatric, and environmental health dimensions in the affected regions of Kermanshah were the research objectives. Methods: This mixed methods study was conducted in the two phases of developing a tool and assessment of the main health system functions. Content validity and reliability were measured by CVR and CVI, and Cronbach's alpha, respectively. Assessment of health system functions was conducted by the participation of 100 affected households. Results: Firstly, the primary tool was designed using 31 primary items extracted from literature review and a qualitative study. CVR and CVI of the tool were 100%, and Cronbach's alpha was 0.97. The coverage of the reproductive, environmental, and children’s health services ranged from 90 to 100% since the first day to one year after the earthquake and between 30 and 60% from one year to two years post-earthquake. Conclusions: The assessment of health system performance can provide the necessary data for effective decision making and promoting health system functions. Further research is needed to assess the functions of the health system after other natural disasters rather than earthquakes.