Health Consequences Management in a Multi-Hazard Context: A Systematic Review of the Coincidence of Flood and the COVID-19 Pandemic.

OBJECTIVES: The co-occurring flood and coronavirus disease (COVID-19) increase the consequences for health and life. This study examined the strategies to manage the health consequences of the co-occurring flood and COVID-19, with a specific focus on these 2 challenges. METHODS: This review included all the studies published in peer-reviewed journals between January 1980 and June 2021. Several electronic databases were searched, including Scopus, Web of Science, and PubMed. Mixed Methods Appraisal Tools (MMT), version 2018, assessed the articles retrieved through a comprehensive and systematic literature search. Descriptive and thematic analyses were carried out to derive strategies for managing the health consequences of the simultaneous flood and COVID-19. RESULTS: Among 4271 identified articles, 10 were eligible for inclusion. In total, 199 strategies were identified in this review for managing the multi-hazard health consequences of flooding and COVID-19, which were classified into 9 categories and 25 subcategories. The categories included policy making and decision making, coordination, risk communication, logistics, planning, preparedness measures, response measures, social and humanitarian support, and actions of local communities and non-governmental organizations. CONCLUSIONS: Managing a multi-hazard and reducing its health consequences requires various actions. Flood management must be needed, and flood-affected people and their health should be protected.

Iranian primary healthcare system's response to the COVID-19 pandemic using the healthcare incident command system.

The present study aimed to evaluate the effects of the healthcare incident command system (HICS) on the district health networks (DHNs) covered by provincial Medical Universities (PMU) in terms of the management and commanding of the COVID-19 pandemic in Iran. This study was a cross-sectional survey. The study was performed in Iran in June 2020 in 60 DHNs, 41 of which had an active HICS. Data were collected on eight HCIS dimensions from all 60 DHNs by trained crisis management experts to evaluate the effects of HICS use on management of the COVID-19 pandemic. For all the 60 DHNs, the mean score of the COVID-19 incident command and management was 78.79 ± 11.90 (range 20-100); with mean scores highest for organizational support and coordination and lowest for logistic and planning. Significant differences were observed between the DHNs with active HICS and DHNs with inactive or no HICS in terms of the mean scores of incident management and command and their associated dimensions. According to the results, the HICS use had a positive impact on the improvement of incident management and command and all the related dimensions. Therefore, the HICS could be conducted and implemented in primary healthcare for the systematic and proper management of crises caused by infectious diseases and increasing primary healthcare system efficiency in response to these crises.

Social Network Analysis for Implementation of the Sendai Framework for Disaster Risk Reduction in Iran.

BACKGROUND: Stakeholders are responsible for managing the risks of disasters. Hence, appropriate, collaborative, timely interactions of involved organizations, and having a collective view of these interactions, have an important influence on the operation of the whole system. This study was aimed at social network analysis (SNA) for the implementation of the Sendai framework for disaster risk reduction in Iran. METHODS: SNA was used in this study. A review of literature on disaster risk management (DRM) plus snowball sampling technique identified a list of 85 stakeholders. Delphi method among purposefully selected experts was used to score the relationship between the stakeholders. Louvain method, along with the modularity optimization method, was applied to identify groups of stakeholders with greater interactions. Centrality measurements were used to define organizations with key-roles in the network. RESULTS: The density of this network was 0.75, which showed that not all the stakeholders were connected. The National Disaster Management Organization and Civil Defense Organization showed higher influences considering their responsibilities. A total of 3 clusters of stakeholders with specific duties that mostly interact with each other and have some interaction with other groups were recognized. CONCLUSION: Understanding the pre-disaster interaction of the network and the strengths and weaknesses of the interactions among stakeholders could help improve DRM.

Behavioral, health- related and demographic risk factors of death in floods: A case-control study.

During the first half of 2019, many provinces of Iran were affected by floods, which claimed the lives of 82 people. The present study aimed to investigate the behavioral, health related and demographic risk factors associated with deaths due to floods. We measured the odds ratio and investigated the contribution and significance of the factors in relation to mortality. This case-control study was conducted in the cities affected by flood in Iran. Data were collected on the flood victims using a questionnaire. Survivors, a member of the flood victim's family, were interviewed. In total, 77 subjects completed the survey in the case group, and 310 subjects completed the survey in the control group. The findings indicated that factors such as the age of less than 18 years, low literacy, being trapped in buildings/cars, and risky behaviors increased the risk of flood deaths. Regarding the behavioral factors, perceived/real swimming skills increased the risk of flood deaths although it may seem paradoxical. This increment is due to increased self confidence in time of flood. On the other hand, skills and abilities such as evacuation, requesting help, and escape decreased the risk of flood deaths. According to the results, the adoption of support strategies, protecting vulnerable groups, and improving the socioeconomic status of flood-prone areas could prevent and reduce the risk of flood deaths.

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

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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40201-021-00715-9.