Health Systems Resilience and Emergency Preparedness: A Study of Primary Healthcare Facilities’ Capacity to Respond to Disease Outbreaks in Selected Wards in AMAC

Abstract

Background: Primary Healthcare Centres (PHCs) are Nigeria’s frontline defence against infectious disease outbreaks, but their resilience remains uncertain. This study assessed the emergency preparedness and resilience of PHCs in the Abuja Municipal Area Council (AMAC) to respond to such threats.

Methodology: A cross-sectional, mixed-methods study was conducted across 11 purposively selected PHCs. Quantitative data were collected via a structured checklist aligned with the WHO health systems building blocks. Qualitative data were gathered through in-depth interviews with health workers. Data analysis employed descriptive statistics and thematic analysis.

Results: Significant preparedness gaps were identified. A critical infrastructure deficit was found, with only one facility (9.1%) possessing a functional isolation area. All facilities reported insufficient staffing, cited as the primary constraint to surge capacity. Less than half (45.5%) had an up-to-date emergency plan, and no facility had conducted simulation drills. Surveillance relied entirely on paper-based systems, and only 54.5% of facilities reported always submitting timely returns. While vaccine supply chains were robust, over half of the facilities (54.5%) reported limited emergency medication stocks. Qualitative findings highlighted overwhelming staff burnout, unreliable utilities, and systemic financial constraints.

Conclusion: PHCs in AMAC exhibit low resilience and are critically underprepared for disease outbreaks. Vulnerabilities span all core health system components, especially infrastructure, human resources, and information systems. Comprehensive measures including infrastructure investment, staff recruitment, digital surveillance, and strengthened supply chains are essential to transform these facilities into a resilient frontline for health security.