Beyond scoring on public health system resilience: A qualitative study of the scorecard application

Societal complexity can cause cascading events during disasters. A multisectoral approach is essential to minimize this effect. The Public Health System Resilience Scorecard (Scorecard), developed by the United Nations Office for Disaster Risk Reduction, World Health Organization, and partners, helps assess public health systems and identify challenges through a multisectoral approach. Although the Scorecard was used in previous studies, the learning experiences of individual participants remained unknown. This study used a qualitative approach to capture the workshop participants' understanding and experience using the Scorecard. Participants were interviewed before and after the workshop using semi-structured guidelines. The researchers analyzed the data using thematic analysis. To capture an overview, keywords such as disaster scenario/plan and preparedness of vulnerable population were utilized to gain a better understanding and explain the findings from the data. Seven themes emerged from interviews with 12 participants from both pre- and post-workshop. While participants were from earthquake-affected areas, this study indicated that the Scorecard not only provided opportunities to reflect on the strengths and weaknesses of public healthcare systems to prepare better, but also allowed participants to reflect and articulate actions needed, with an understanding of resilience, especially in the post-disaster phase. • The study demonstrated that the Public Health System Resilience Scorecard serves not only as a measurement tool but also as an educational resource. • Participants' understanding of disaster resilience evolved from a focus on psychological recovery to a broader systematic view. • The Scorecard facilitated multisectoral collaboration by uniting diverse Public Health System stakeholders. • Key areas for main improvement identified included expanding mental health services, better preparedness for vulnerable groups. • Additionally, the workshop helped participants develop structured planning for workforce capacity and logistics.