Strengthening Community-Centered Approaches for Health Emergencies in Crisis-Affected Regions: A Call for Regional & International Actions
Year: 2025
Type: article
Abstract: The COVID-19 pandemic exposed the vulnerabilities of the healthcare systems across the globe, and the Eastern Mediterranean Region (EMR) was not an exempt.1 One of the most crucial lessons learnt was the importance of an adequate and equitably distributed health workforce.2 However, the ongoing conflicts in the region and resource constraints make it challenging to achieve this goal. In response to emergencies, community-centred approaches have proven to be both effective and efficient, providing essential support to the overstretched formal healthcare systems.3 These approaches are especially important in low- and middle- income countries where the burden of health emergencies, compounded by conflict and instability, continues to increase.4 Community-centred organisations are crucial for strengthening preparedness, response, and resilience. In crisis-affected and resource-limited settings, community-centred organisations and networks offer surge capacities and technical expertise tailored to the specific needs of the communities they serve.5,6 The recent World Health Summit highlighted the growing global recognition of community-centred approaches in managing public health emergencies. Experts discussed the need for robust local capacities to prepare for and respond to health crises. The role of international and regional organisations in enhancing community protection was emphasised, particularly in light of the complex conditions driving health emergencies, including climate change, geopolitical instability, and migration patterns.7 Community engagement is now a core element in the World Health Organization’s approach to Health Emergency Preparedness, Response, and Resilience, with community protection identified as one of the “5Cs” in its framework.8 The involvement of local communities in health surveillance, outbreak detection, and emergency response is crucial, especially in regions like the EMR, where crises are often prolonged and external aid may be unavailable or restricted. The ongoing unrest in Gaza, Sudan, Lebanon, and other parts of the EMR continues to exacerbate the health challenges faced by vulnerable populations. Conflicts in Syria, Yemen, and Libya have created long-standing humanitarian crises, with the health impacts of climate change adding further strain. Rising temperatures and changing ecosystems fuel the resurgence of vector-borne diseases, while food and water insecurity are becoming more pronounced.9 The "One Health" approach, which links human, animal, and environmental health, must be integrated into community-based responses to address these interconnected challenges effectively. Programs like Field Epidemiology Training Programs can significantly strengthen community-based initiatives by establishing community-based emergency management systems, building community health workers' capacity, adapting suitable tools, and enhancing surveillance systems. Training and mentorship for community health workers are essential components of a resilient community-based response. Health workers can be equipped to contribute to preparedness, outbreak response, and Risk Communication and Community Engagement.10 These networks foster a collaborative approach that strengthens overall health emergency management by linking local efforts with governmental and non-governmental actors. EMPHNET has employed models of successful community-centred initiatives in the EMR. For example, in Gaza, the EMPHNET-Community Health Champions Program was launched to address the shortage of healthcare providers and the significant barriers to access. Community health champions in Gaza were trained to carry out essential health services, such as vaccination, nutritional surveys, provision of nutritional supplements, and health education, thus filling critical gaps in service provision. This programme was instrumental in overcoming language, culture, and trust challenges, vital for effective health interventions in conflict-affected areas. Similarly, the "Volunteers for Vector Control" initiative in Sudan focuses on controlling vector-borne diseases like malaria and dengue fever. By engaging local communities in activities such as breeding site management and disease reporting, this programme aims to sustainably control the spread of these diseases. It is currently in its pilot phase, with plans for expansion based on initial evaluations. One effective intervention is Community-Based Surveillance Systems, which engage communities to monitor health risks and detect potential outbreaks in real-time.11 Simple, adaptable digital tools can help local volunteers collect and share data quickly with higher-level response mechanisms. These systems ensure timely reporting of health threats and enable communities to respond rapidly to emerging infectious diseases, as demonstrated during the COVID-19 pandemic.12 Another example of the value of community engagement is the successful integration of Event-Based Surveillance into national health systems across several EMR countries, including Sudan, Libya, Afghanistan, and Iraq.13,14 Communities were involved in identifying and reporting unusual health events, facilitating early detection and response to outbreaks. These efforts have contributed significantly to managing COVID-19 and other respiratory diseases, illustrating the effectiveness of community-driven public health interventions.7 International and regional organisations must advocate for increased investment in community-centred health systems, ensuring communities have the tools and resources to withstand the health threats they face. They can provide the technical expertise, training, and support required to build resilient local health systems. The COVID-19 pandemic demonstrated the critical role of communities in early detection and outbreak response, and these lessons must now be applied to other public health threats driven by conflict, instability, and climate change. Our joint efforts are vital to ensuring that communities can protect their health and well-being, even in the most difficult situations.
Authors: Mohannad Al Nsour, Haitham Bashier, Rawan Araj
Institution: Eastern Mediterranean Public Health Network
Language: English
Subfield: Emergency Medical Services
Field: Health Professions
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4415472010