Determining the Factors Affecting the Retrofitting of Health-Care Facilities: A Qualitative Study

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.

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.

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.

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.