The Policy Gap and Inefficiency in Public Volunteers’ Response to Assist the Hospitals After Natural Disasters in Iran: A Grounded Theory Methodology

Abstract

Objective: This study aims to explore a public volunteer’s hospital response model in natural disasters in Iran. Methods: This study employed grounded theory using the Strauss and Corbin 2008 method and data analysis was carried out in three steps, namely open, axial, and selective coding. The present qualitative study was done using semi-structured interviews with 36 participants who were on two levels and with different experiences in responding to emergencies and disasters as “public volunteers” and “experts”. National and local experts were comprised of professors in the field of disaster management, hospital managers, Red Crescent experts, staff and managers of Iran Ministry of Health and Medical Education. Results: The main concept of the paradigm model was “policy gap and inefficiency” in the management of public volunteers, which was rooted in political factions, ethnicity, regulations, and elites. The policy gap and inefficiency led to chaos and “crises over crises.” Overcoming the policy gap will result in hospital disaster resilience. Meanwhile, the model covered the causal, contextual, and intervening conditions, strategies, and consequences in relation to the public volunteers’ hospital response phase. Conclusions: The current public volunteers’ hospital in Iran suffered from the lack of a coherent, comprehensive, and forward-looking plan for their response. The most important beneficiaries of this paradigm model will be for health policy-makers, to clarify the main culprits of creating policy gap and inefficiency in Iran and other countries with a similar context. It can guide the decision-makings in upstream documents on the public volunteers. Further research should carried out to improve the understanding of the supportive legal framework, building the culture of volunteering, and enhancing volunteers’ retention rate.

Research Trends in Resilience and Vulnerability Studies

“…In a case study examining the experience of Iranian hospitals [80], it was observed that disaster management is not treated seriously to the level necessary; further, crises are exacerbated by well-intended volunteers who are nevertheless mismanaged or illprepared to deal with an emergency scenario, leaving the situation ripe for chaos. Lack of preparation for emergencies does not serve the hospital and its employees, the injured or sick, or would-be volunteers.…”