Transforming community disaster preparedness: PHEDM model evaluation in Uttarakhand, India

In rural India, disaster and health emergency management typically follows a top-down approach. This study compared Nausar (intervention) and Salmata (control) panchayats in the Udham Singh Nagar district of Uttarakhand. The initial two tiers of the PHEDM five-tiered model were executed over seven phases, beginning with structured risk assessments and followed by capacity enhancement in Tiers I and II. Nausar exhibited notable advancements, such as an increase in the composite preparedness index from 14.5 to 36.5 (Cohen’s d = 1.12, p < 0.001), a rise in adaptive capacity by +9.4 (p = 0.04), an expansion of Community Emergency Response Team (CERT) members from 6 to 48, an improvement in WASH coverage from 73% to 95%, and an increase in drill participation from 12% to 68%. The control panchayat showed no significant changes, and the Difference-in-Differences analysis confirmed the causal effect. These results indicate that the PHEDM’s community Tier I and II model effectively enhances scalable village preparedness.