Background and objectiveContinuous services provision of a hospital before and after a disaster is one of the most prominent issues that all people, especially the authorities must take into huge consideration. Concerning the experiences of previous earthquakes, the role and importance of nonstructural components becomes increasingly clear in the uninterrupted services of hospitals. In this study, non-structural retrofitting status of Kerman teaching hospitals was evaluated against natural disasters.MethodsThis cross-sectional study was carried out in the second half of 2014 on the teaching hospitals in Kerman (Iran). The study population consisted of all Kerman teaching hospitals. The research instrument was World Health Organization/Pan American Health Organization (WHO/PAHO) standard checklist. Data analysis was carried out using descriptive statistics through SPSS 19.ResultsOne hospital had a low retrofitting level, two hospitals had an average level and one had a high level. In the examined hospitals in this study, the medical gas section had the lowest preparedness against natural disasters, while the office, warehouse and furniture section had the highest resistance. Generally, the non-structural retrofitting status was 50% in one hospital and was between 65% and 85% in other hospitals.ConclusionsGenerally, the retrofitting status of hospitals was not at the ideal condition, most hospitals were in average condition. Concerning the high risk of hospitals in disasters, it is necessary that senior executives and managers of Kerman Province and Kerman University of Medical Sciences take some measures to retrofit these buildings and to reduce the risk of vulnerability.

Objective: Health services are the first and most important demand for the affected people after disasters. Hospitals and staff of health centers are directly affected by disasters, and this issue is more critical due to the hospital conditions, such as the presence of patients, medical facilities, and equipment. Therefore, it is necessary to make hospitals retrofit against disasters. Methods: This study was conducted qualitatively to extract experts’ opinions about the factors affecting the retrofitting of health-care facilities in 2021. Semi-structured interviews were the basis of the data. In addition, to obtain data from different sources (triangulation), a focus group discussion (FGD) was held after the interviews. Results: The findings of this study were extracted from interviewees and FGD in the form of 2 categories, 6 subcategories, and 23 codes. Main categories included external and internal factors. The subcategories of external factors were General government policies to reduce risk, The Programs of the Ministry of Health, and medical universities for retrofitting and Uncontrollable external factors. The subcategories of internal factors were Exposure of managers and staff of health-care organizations to various disasters, determining the types of vulnerabilities in health-care facilities, and Factors related to managerial actions. Conclusions: Retrofitting health-care facilities is one of the requirements for designing and constructing these facilities. The role of governments in this issue is more than other stakeholders because governments are the trustee of the health system and are responsible for the people’s health. Therefore, governments must plan for the retrofitting of health facilities according to the disaster risk analysis and prioritization and their resources. Although, external factors play a very important role in influencing retrofitting policies, the role of internal factors should not be neglected. None of the internal and external factors alone can have a significant effect on retrofitting activities. For this purpose, a suitable combination of factors should be determined and the goal of the system should be to achieve resistant and resilient facilities against disasters.

Introduction Infrastructures guarantee the continuity of services and society’s life, and any damage to them can have disastrous consequences for the affected society. Healthcare facilities, and hospitals in particular, are the most important infrastructures in a society. Considering the role of hospitals in disaster management, the present study was designed and implemented to investigate the safety and vulnerability status of teaching hospitals as critical infrastructures.Material and Method The current cross-sectional and descriptive research was conducted in 2022 in Kerman, Iran. In this study, the 2015 version of the Hospital Safety Index (HSI) prepared by WHO/PAHO was used. The HSI calculator designed by the World Health Organization was used to calculate the safety and vulnerability index.Findings Hospital A was in average safety status (B) with a safety score of 0.57. In hospital B, The final safety score was 0.71, which is generally classified as safe (A). The final hospital safety score in hospital C was 0.50, which places it in a generally average safety status (B). Hospital D was in an unsafe condition (C) with a safety score of 0.33.Conclusion Disruption of the performance of any infrastructure can affect the performance of others. Therefore, paying special attention to infrastructure safety in any society, whether developed or developing, is one of the most important governance issues. Important point in infrastructure safety is the necessity of designing decentralized retrofitting and safety programs. If retrofitting programs are designed in a centralized manner, the result will be a waste of resources.

Both natural and man-made disasters are increasing in occurrence at the world. Hospitals and health-care centers are very complex and have a high potential for vulnerability depending on external and internal factors. Unfortunately, past experiences show that health-care centers and the health system are vulnerable to disasters. Therefore, risk analysis and safety assessment studies of hospitals and other health-care centers are absolutely necessary. This systematic review study was conducted on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. English language international databases (Pub Med, Scopus, Embase, Web of Science, and Google Scholar) were searched through January 1, 2000 up to June 20, 2019. The quality of the studies was assessed using the International Narrative Systematic Assessment tool. From 3630 titles identified in this search, 24 studies were selected. The important findings of this study were grouped into five main categories: risk analysis method, type of disaster, hospital safety methods, hospital components and key outcomes of risk analysis, and hospital safety assessments. The nature of disasters is a threat to the lives and property of the people, and therefore hospitals must be available at the incidents and disasters and they must be able to respond to the needs of the disaster-affected community. The probability of an incident and its consequences can never be reduced to zero; because the severity of many natural and even man-made disasters is unpredictable and the probability of their occurrence is different; however, it is possible to identify weaknesses and strengths through risk analysis studies as well as hospital safety assessments and implement retrofitting programs based on the type of risks and safety status and reduce the level of risk to an acceptable level.

Accidents and disasters impose enormous costs on governments and nations each year, as well as causing great suffering to people affected by various disasters around the world. Today, accidents and disasters account for a large portion of government resources and programs. Iran is no exception to this rule. It is one of the ten most populated countries globally and the fourth most troubled country in Asia in terms of natural disasters. Therefore, understanding the risks as a basis for future planning is vital. Reducing disaster risk as a global priority requires the collective efforts of policymakers, managers, professionals, and all stakeholders in this field. The Sendai Framework is the most critical UN disaster risk reduction strategy (2015-2030). Considering the importance of the mentioned cases, a group of experts came together and discussed the solutions for implementing the Sendai Framework in Iran using the focus group discussion method. Finally, they prepared the present policy brief. One of the most important strategies is to study the history of risk in different parts of the world and Iran and prepare a risk zoning map, form a transnational and national organization. This map should delegate each authority to a particular organization for risk management, emphasize the correct understanding and upgrade the scientific level of people towards risk awareness. It must pay particular attention to create a culture in the field of risk awareness, analyzing stakeholders to attract support, and create a national information network. The map ought to develop a comprehensive risk management program, expanding education at the level of managers and society, creating and upgrading a quick alert system, and comprehensive preparedness plans. Finally, it can be said that the Sendai Framework is one of the most important documents published to plan for disasters. This planning is not just in the response phase but must be applied at all the crisis management cycle levels.