Abstract
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.
Similar content being viewed by others
Data availability
The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.
References
Desai B, Maskrey A, Peduzzi P, De Bono A, Herold C. Making development sustainable: the future of disaster risk management, global assessment report on disaster risk reduction. 2015.
UNISDR U. Editor Sendai framework for disaster risk reduction 2015–2030. 3rd United Nations world conference on DRR; 2015: UNISDR Sendai, Japan.
Safarpour H, Khorasani-Zavareh D. The fourth epidemiological transition: the need for worldwide focus on reducing morbidity and mortality rates of disasters and emergencies. Shiraz E-Med J. 2019;20(9):e86746.
CRED. The human cost of natural disasters 2015: a global perspective. Centre for Research on Epidemiology of Disasters. Brussels: Université catholique de Louvain; 2015.
Ardalan A, Rajaei MH, Masoumi G, Azin A, Zonoobi V, Sarvar MJPc. 2012-2025 Roadmap of IR Iran’s Disaster Health Management2012.
Safarpour H, Fooladlou S, Safi-Keykaleh M, Mousavipour S, Pirani D, Sahebi A, Ghodsi H, Farahi-Ashtiani I, Dehghani A. Challenges and barriers of humanitarian aid management in 2017 Kermanshah earthquake: a qualitative study. BMC Public Health. 2020;20(1):563.
Farahi-Ashtiani I, Ghomian Z, Pirani D, Nejati-Zarnaqi B. Cluster approach model for promoting coordination in humanitarian aid; following the Kermanshah earthquake, Iran, 2017. Trauma Monthly. 2020;25(6):254–61.
Ardalan A, Mowafi H, Homa Yousefi K. Impacts of natural hazards on primary health care facilities of Iran: a 10-year retrospective survey. PLoS Currents. 2013;5.
Day S, Forster T, Himmelsbach J, Korte L, Mucke P, Radtke K, et al. World risk report 2019—focus: water supply. Berlin: Bündnis Entwicklung Hilft; 2019.
Murray V, Aitsi-Selmi A, Blanchard KJIJoDRS. The role of public health within the United Nations post-2015 framework for disaster risk reduction. 2015;6(1):28–37.
Chan EY, Murray VJTL. What are the health research needs for the Sendai Framework? 2017;390(10106):e35-e6.
Walt G, Shiffman J, Schneider H, Murray SF, Brugha R, Gilson LJHp, et al. Doing’health policy analysis: methodological and conceptual reflections and challenges. 2008;23(5):308–17.
Kaliszewski I. Quantitative Pareto analysis by cone separation technique: Springer Science & Business Media; 2012.
Medicare Cf, Services M. How to use the fishbone tool for root cause analysis 2014.
Takian A. Implementing family medicine in Iran identification of facilitators and obstacles: London School of Hygiene & tropical medicine; 2009.
Araújo JLC Jr, Maciel Filho R. Developing an operational framework for health policy analysis. Revista Brasileira de Saúde Materno Infantil. 2001;1(3):203–21.
Ardalan A. UNISDR Scientific and Technical Advisory Group, Case Studies – 2014, Evidence-Based Integration of Disaster Risk Management to Primary Health Care, the Case of I.R.Iran.
ISDR U, OCHA UJUN, New York, Geneva. Disaster preparedness for effective response: guidance and indicator package for implementing priority five of the Hyogo Framework 2008.
SARKER MR, AHMED F, DEB AK, CHOWDHURY M. Identifying barriers for implementing green supply chain management (GSCM) in footwear industry of Bangladesh: a Delphi study approach. Revista de Pielarie Incaltaminte. 2018;18(3):175.
Takian A, Rashidian A, Kabir MJJHp. Planning. Expediency and coincidence in re-engineering a health system: an interpretive approach to formation of family medicine in Iran. 2010;26(2):163–173.
Agide FD, Garmaroudi G, Sadeghi R, Shakibazadeh E, Yaseri M, Koricha ZB, et al. Application of Kingdon and Hall Models to Review Environmental Sanitation and Health Promotion Policy in Ethiopia: A Professional Perspective as a Review. Ethiopian journal of health sciences. 2019;29(2).
Pitayarangsarit S. The introduction of the universal coverage of health care policy in Thailand: policy responses: National Health Security Office and international health policy program. 2010.
Pillay TD, Skordis-Worrall JJHp. South African health financing reform 2000–2010: Understanding the agenda-setting process. 2013;109(3):321–31.
Joanna Mikulski FV. Building political priority for preventing violence against children, Lessons from the Shiffman-Smith Framework. 2013:1–15.
Moloughney B. The use of policy frameworks to understand public-health related public policy processes: a literature review. Peel Public Health. 2012.
Scholar WHOJCWEG. Health 21: the health for all policy framework for the WHO European region. 1999.
Collins TJPh. Health policy analysis: a simple tool for policy makers. 2005;119(3):192–6.
Buse K, Mays N, Walt GJUB, Ltd B. Making health policy (understanding public health). 2005.
Mannheimer LN, Lehto J, Östlin PJHpi. Window of opportunity for intersectoral health policy in Sweden—open, half-open or half-shut? 2007;22(4):307–15.
Acknowledgements
The author thanks all participants who helped us in this research.
Code availability
Not applicable.
Funding
The authors received no fund for this study.
Author information
Authors and Affiliations
Contributions
AA, AT and HYK conceived and designed the study. HYK conducted data collection. HYK, AA, and AT, and AO carried out data analysis and interpretation. HYK drafted the manuscript. AA and AT supervised the whole process of research and are guarantors. All authors have read and approved the final draft of the manuscript.
Corresponding authors
Ethics declarations
Ethics approval
This research received ethical approval from the Ethics Committee of the Tehran University of Medical Sciences (TUMS) (the approval code was Ir.tums.sph.rec.1396.4315).
Consent to participate
The participants were informed about the objectives and importance of the study and reassured them about anonymity, confidentiality, and the right to withdraw from the research at any time, without any explanation.
Consent for publication
(include appropriate statements)
Conflicts of interest/competing interests
The authors declare that they have no conflict of interest.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
ESM 1
(DOCX 62.2 kb)
Rights and permissions
About this article
Cite this article
Yousefi Khoshsabegheh, H., Takian, A., Ardalan, A. et al. Implementation of the Sendai framework in the health system in Iran: identification of facilitators and obstacles. J Environ Health Sci Engineer 19, 1597–1606 (2021). https://doi.org/10.1007/s40201-021-00715-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40201-021-00715-9