Factors Influencing Public Health Preparedness Open Access

Choplin, Parker (Spring 2021)

Permanent URL: https://etd.library.emory.edu/concern/etds/s7526d80h?locale=en



Climate change, land encroachment, and world travel exacerbate the probability and frequency of emerging pathogens and extreme weather events. Public health preparedness is a country’s first line of defense to prevent, detect, and respond to protect its people from catastrophic events and mass casualties. Unfortunately, many countries are not well equipped to protect their citizens from these events, as illustrated by the current COVID-19 pandemic.


This project determined the global preparedness strategies that currently exists, identified gaps in preparedness domains and strategies, and proposed new, innovative capacity building activities.


PubMed™, EMBASE™, CAB Direct™, and Cambridge Core™ were searched. After excluding duplicates and applying inclusion and exclusion criteria, 63 studies were selected for data extraction and inclusion in the review.


Five themes in emergency preparedness emerged from data extraction: community resilience; healthcare workforce; health system’s preparedness; governance and funding; and health security. Gaps were identified in healthcare worker training, laboratory capacity, and mental and psychological/psychosocial health preparedness.


This review was limited by most studies occurring in the United States (50%), with Latin American and South America not represented. Additionally, this systematic review was performed by one person, whereas most reviews were performed by at least two people to reduce bias. Future recommendations consisted of more funding and resources allocated towards building infrastructure and capacity among mental health, simulation exercises, and laboratory services. Additional reviews and research should examine gaps in preparedness systems that COVID-19 exploited. Overall, countries should invest resources into building preparedness capacity across all domains. It is no longer a question of if but when the next pandemic or natural or manmade disaster will occur; nations should be prepared to efficiently protect their populations.

Table of Contents

Chapter 1: Introduction 1

1.1 Statement of the Problem 5

1.2 Statement of Purpose 6

1.3 Project Significance 7

1.4 Research Questions 7

Chapter 2: Methods 8

Figure 1. PRISMA Screening and Article Inclusion Processes for Public Health Preparedness, 2021 11

Chapter 3: Results 12

Table 1. Countries and Regions in the Systematic Literature Review of Public Health Preparedness, 2021 12

Chapter 4: Discussion, Recommendations, and Conclusions 24

4.1 Discussion 24

4.2 Recommendations 30

4.3 Conclusions 31

References 32

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