Hospital Hazard Management Practices in Nepal and India: A Narrative Systematic Literature Review

Abstract

Background: Hospitals have the responsibility to continue with their services despite disasters, outbreak, fire, earthquakes, mass casualty event or any other emergency situations that may occur. Nepal and India face many forms of natural, technological, biological, and human made hazards, yet hospitals in both the nations operate in a different resource and preparedness scenario.

Objectives: The study highlights the key practices for hospital hazard management in Nepal and India and identify common preparedness issues, gaps, and areas which require improvement.

Methods: A narrative systematic literature review has been carried out based on research articles and health emergency related literature. The studies which focus on hospital disaster preparedness, emergency planning, hospital resilience, fire safety, hospital waste management, infectious disease emergencies, surge capacity and response systems in Nepal and India have been considered. Preference has been given to research articles which have DOI numbers but some old literature and WHO guidelines have also been taken into consideration.

Results: The literature discussed above clearly shows that disaster plans, emergency response systems, triage, training, infection control, and waste management are present in the hospitals of both countries. While the implementation of those plans and systems is inconsistent, the hospitals of Nepal are suffering from specific issues related to earthquake vulnerability, resources, capacity of staff and beds, planning, and implementation of disaster plans, while the inconsistency in Indian hospitals is observed in the areas of preparedness, fire safety, surge capacity, emergency department planning, pandemic preparedness, and biomedical waste management.

Conclusion: Hazard management is not only about disaster plan having. Risk assessment, implementation of emergency plan, trained staff, drills, safe infrastructure, supplies, communications, waste management, and monitoring are necessary.

Novelty: This review unites information about hazard management in Nepal and India and shows the hazard management as a comprehensive hospital management process not limited by natural hazards.