Strategic Emergency Management for Health System Recovery in Complex Emergency: A Case Study from Gaza Governorate
Abstract
Background: Health systems operating in fragile and conflict-affected settings, such as the Gaza Strip, require effective strategic emergency management to strengthen resilience and support post-crisis recovery. This need is particularly critical in Gaza, where protracted conflict and a long-standing blockade have progressively weakened healthcare infrastructure, institutional capacity, and service delivery. Methods: A descriptive-analytical mixed-methods study was conducted. A structured questionnaire was administered to all senior members of health emergency management committees in Gaza’s governmental hospitals and the Ministry of Health (N=77). Quantitative data were analyzed using descriptive statistics, while qualitative data obtained from open-ended questions were examined using thematic analysis. The reliability of the questionnaire was confirmed, with a Cronbach’s Alpha of α=0.89. Results: The perceived impact of strategic management on enhancing health system recovery was high (mean=4.017, relative weight=80.34%). Quantitative findings identified strengths in integrating recovery considerations into strategic plans and promoting international partnerships, while important weaknesses were observed in stakeholder participation and the development of plans aligned with the local context. Qualitative findings indicated that strategic priorities centered on saving lives and maintaining continuity of essential health services through institutional flexibility and adaptive capacity. Administrative recovery approaches included restoration of healthcare infrastructure, support for health personnel, policy review, and multi-sectoral coordination. Conclusion: Strategic emergency management plays an important role in strengthening health system resilience and supporting recovery in Gaza. However, its effectiveness may be constrained by centralized decision-making and limited stakeholder participation. Strengthening inclusive strategic planning, institutional learning, adaptive capacity, and multi-sectoral coordination is essential for developing a more resilient health system capable of responding to and recovering from Gaza’s protracted and complex crisis.