Strengthening public health system resilience to disasters in Türkiye: Insights from a scorecard methodology

Background: Turkiye is a country that faces many disasters, especially earthquakes and floods, which have serious short- and long-term consequences for public health. The importance of disaster risk reduction activities in building resilience before a disaster strikes is increasingly recognized. Furthermore, resilience assessment is considered to be the starting point for these activities. However, there is a substantial gap in the scientific evidence on systematic assessments of the resilience of the public health system and also a serious lack of activities to strengthen the system against disasters in Turkiye. Aim: Using a Scorecard methodology, the study aimed to systematically assess the resilience of the public health system in Turkiye by examining key indicators related to disaster risk management and preparedness, and subsequently to recommend priority actions. A systematic assessment of resilience can provide the scientific evidence needed to identify weaknesses in the system. Furthermore, identifying priority actions based on this evidence allows progress to be made towards strengthening the system. Methods: This mixed-methods study was conducted in two separate regions of Turkiye with the highest earthquake (Esenler/Istanbul) and flood risk (Ortahisar/Trabzon). Based on the Scorecard methodology, two-stage workshops (online and face-to-face) were held. During the online stage, qualitative data were collected by interviewing participants about their evaluation of the situation in the counties regarding the Scorecard indicators, and quantitative data were collected through scoring. In the face-to-face stage, strategies were developed to improve the resilience of the public health system. Quantitative data were expressed with numbers and percentages, and thematic analysis was utilized for qualitative data analysis.