People as frontliners in the management of disasters and public health emergencies

Managing healthcare effectively during disasters and public health emergencies (DPHEs) is often challenging due to inadequate surge capacity across four key areas: Staff, stuff, space, and system. Expanding this capacity is vital when healthcare facilities are threatened or infrastructure fails. A promising approach involves utilizing community resources and latent individual capabilities, especially in resource-limited settings where community participation is critical. In this study, we utilized a scoping review methodology to investigate strategies for mobilizing individual capabilities within DPHE management. A systematic search was conducted across PubMed, Scopus, Web of Science, and grey literature sources. From an initial pool of 512 records, 50 documents met the inclusion criteria following a rigorous full-text review. Collaborative thematic analysis of included studies identified seven major themes: Communities as frontline actors and the evolution of the "frontliner" concept; effectiveness of community-based training and participatory interventions; participation, agency, and community-delivered health services in displacement and recovery contexts; institutionalization and integration of community capacity; trust, social capital, and local leadership as determinants of engagement and effectiveness; participatory tools for planning and the limits of "participation" in practice; and community engagement in public health emergencies and epidemic response. Leveraging local capacities and resources in community centric DPHE management can augment formal response systems as long as they are effective, sustained, and meaningful. However, significant gaps remain regarding implementation, sustainability, power dynamics, and equity. Future research needs to move beyond descriptive accounts and focus on strategies to overcome barriers to participation, ensuring equity and fair distribution of resources and rigorously evaluating the real-world impacts of integrated community-institutional approaches. Ultimately, these strategies can foster collective action to improve community health and well-being and shift the paradigm from institutional reliance to community-centric resilience.