Evaluation of flood preparedness in government healthcare facilities in Eastern Province, Sri Lanka

Background: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. Objective: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. Design: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years. Seven in-depth interviews were conducted with randomly selected Medical Officers in Charge or their equivalent, and 3 interviews were conducted with Medical Offices of Health. Results: Two general hospitals, 3 base hospitals, 11 divisional hospitals, and 15 primary care units were included. Six respondents (19.4%) reported flooding in their facility, and 19 (61.3%) reported flooding in their catchment area. For the health workforce, 77.4% of respondents reported not enough staff to perform normal service delivery during disasters, and 25.5% reported staff absenteeism due to flooding. Several respondents expressed a desire for more disaster-specific and general clinical training opportunities for themselves and their staff. Most respondents (80.7%) reported no delays in supply procurement during weather emergencies, but 61.3% reported insufficient supplies to maintain normal service delivery during disasters. Four facilities (12.9%) had disaster preparedness plans, and 4 (12.9%) had any staff trained on disaster preparedness or management within the last year. One quarter (25.8%) of respondents had received any written guidance on disaster preparedness from the regional, provincial, or national level in the last year. Conclusions: While there is a strong health system operating in Sri Lanka, improvements are needed in localized and appropriate disaster-related training, resources for continuing clinical education, and investments in workforce to strengthen flood and other disaster resilience within the government healthcare system in the study district.