Seyedin, S.H.; (2008) Health systems effectiveness and efficiency for disasters and conflicts. Doctoral thesis , UCL (University College London).

Abstract

The study of disaster management has been one of the main concerns of medical doctors, managers, policy makers and scientists since the mid twentieth century. There is an urgent need to improve our understanding of disaster management systems and principals especially within health services. This will maximise the efficiency of organisations dealing with disasters. This thesis studies the disaster management system used by health organisations within the health ministry of Iran in order to look at productivity, weaknesses and strengths of the system among subordinate organisations and teams working within the health ministry. The study also looks at effects of previous disasters on preparedness of the organisations and the differences between hospitals and health centers in disaster management activities. Moreover the study uses the findings of the research as evidences to design an appropriate model and suggest reforms in the current system for the health ministry. The work is a mixed-method study that uses both qualitative and quantitative approaches. The population of the study included health managers in the three levels of local, regional and national organisations. For the qualitative part, some other stakeholders such as Red Crescent Organisation and WHO were included and interviewed. Seventy-eight face-to face semi-structured interviews in two phases (65 interviews for the first stage and the remainder of 13 for the model test) and an online and post questionnaire survey of 114 respondents (out of 214) sample at local (53% response rate) and 20 (out of 40) sample at regional (50% response rate) were conducted. The findings of the study showed that there are variations among subordinate organisations within the health ministry with regard to different aspects of disaster management and outcomes. These variations were evident in planning; training; policy; organisational issues and resources. The conclusion is that the current system is not sufficiently robust or productive. Further, previous disaster experiences did not have any systematic effect on the future efficiency of the system despite of a better performance in the short term. Moreover, some reforms were suggested as a model to increase efficiency and performance of the system in the health organisations.

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