Facilitators and challenges of using eHealth for primary health care delivery during disasters: a qualitative study of health care providers' perceptions and experiences

Maryam Nikfard; Abbas Ali Dehghani Tafti; Ibrahim Salmani; Mohammad Reza Khajehaminian; Hamid Reza Dehghan; Mahsa Khodayarian

doi:10.1186/s12875-025-03089-1

Facilitators and challenges of using eHealth for primary health care delivery during disasters: a qualitative study of health care providers' perceptions and experiences

BMC Prim Care. 2025 Nov 24;26(1):376. doi: 10.1186/s12875-025-03089-1.

Authors

Maryam Nikfard¹, Abbas Ali Dehghani Tafti¹, Ibrahim Salmani¹, Mohammad Reza Khajehaminian², Hamid Reza Dehghan³, Mahsa Khodayarian⁴

Affiliations

¹ Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
² Department of Health in Disaster and Emergencies, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. khajehaminian@gmail.com.
³ Department of Health Technology Assessment, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
⁴ Department of Health Education and Promotion, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Background: The frequency and intensity of disasters and their impacts on global population health are on the rise. Health systems often face disruptions during disasters due to infrastructure damage and the sudden surge in patient numbers. These disruptions are exacerbated by the lack of sufficient capacity, resources, and tools needed to respond effectively to disasters. Primary Health Care (PHC), as the first point of public contact with the health system, plays a key role in providing integrated health services. Also eHealth technologies help ensure the continuity of essential health services and fill existing gaps in health care delivery. This research aims to explore the perceptions and experiences of the health care providers to understand the facilitators and challenges of using eHealth to deliver primary health care in times of disasters and health emergencies.

Methods: This qualitative study was conducted through semi-structured interviews with senior managers, experts, and health care providers, selected through purposive sampling. The data were analyzed using thematic content analysis with inductive approach in MAXQDA 2020.

Results: The facilitators were categorized into six areas: health network infrastructure, the health information system (SIB), health care providers, mobile health capabilities, community participation, and intersectoral collaborations. The associated challenges were identified in six categories: challenges related to the SIB system, technical challenges, health system challenges, health care providers, community challenges, and the inherent aspects of disasters.

Conclusions: Strengthening the health information system, improving technical infrastructure, fostering intersectoral collaborations, and increasing community engagement are essential steps. Additionally, empowering HCPs and addressing the inherent challenges of disasters can improve the resilience and responsiveness of health systems to deliver PHC in disasters and health emergencies. This understanding of facilitators and challenges provides a framework for improving PHC delivery through eHealth in future disaster scenarios, ensuring resilient, equitable, continuous, and accessible health services.

Keywords: Challenge; Disaster; EHealth; Facilitator; Health care providers; Health emergency; Primary health care.

MeSH terms

Attitude of Health Personnel*
Disasters*
Health Personnel* / psychology
Humans
Interviews as Topic
Primary Health Care* / organization & administration
Qualitative Research
Telemedicine* / organization & administration