Evaluating disaster risk management in Saudi Arabian public hospitals: perceptions and practices

Abstract

This thesis examines disaster risk management (DRM) within public hospitals in Saudi Arabia through the perceptions of healthcare workers (HCWs) and the public. Public hospitals face major DRM challenges, including mass religious gatherings, industrial risks, and regional disparities. While global developmental frameworks (e.g., Sendai Framework, WHO Health Emergency & DRM Framework) emphasise preparedness, resilience, and trust, it remains unclear how stakeholder perceptions can inform effective DRM in Saudi Arabia. To address this issue, a multi-method design was employed across three studies to assess perceptions of DRM, and their implications for healthcare resilience. In Study One, 542 HCWs from 22 public hospitals across four regions were surveyed to assess their perceptions of DRM effectiveness across the four phases. Overall, HCWs rated mitigation as the most effective function and preparedness as the weakest. Significant regional disparities were identified: HCWs in the Central and Eastern regions reported greater confidence across all four phases compared with those in the Southern region. In Study Two, semi-structured interviews were conducted with 24 HCWs to examine how individual experiences, and organisational, geographical, and systemic factors shaped perceptions. Thematic analysis of the interviews indicated that strong leadership, effective communication, and ongoing training enhanced confidence in DRM, whereas poor infrastructure, weak departmental collaboration, and lack of psychological support reduced confidence. In Study Three, 436 members of the public were surveyed to examine trust in hospital DRM, focusing on four areas: perceived preparedness, knowledge of initiatives, quality of communication, and perceived satisfaction with hospital DRM. Perceived satisfaction and preparedness were strongest predictors of trust, followed by knowledge of initiatives, though communication alone had less significance. Collectively, these studies indicate that DRM practices in Saudi public hospitals can be shaped substantially by organisational, systemic, and perceptual factors. The findings suggest that key factors for the effective improvement of hospital resilience include inclusive leadership, equitable resource distribution, transparent risk communication, and proactive public engagement. These are all critical factors for preparing healthcare systems to respond to future crises.

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Identifiers

ORCID for Shahad Ali S Alshehri: orcid.org/0009-0007-4468-2807

ORCID for Ian Dawson: orcid.org/0000-0003-0555-9682

ORCID for Konstantinos Katsikopoulos: orcid.org/0000-0002-9572-1980

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