title: Disaster health-related challenges and requirements: a grounded theory study in Iran.
abstract: BACKGROUND
  Despite frequent disasters caused by natural hazards, concern has been raised regarding the effectiveness of disaster health services in disaster-prone countries such as Iran. The purpose of this study was to explore, in relation to health disaster management, the experiences and perceptions of individuals who responded or were affected by a recent Iranian earthquake disaster.
  
  
  METHODS
  This study was conducted using grounded theory. Study participants included members of a multidisciplinary disaster response team as well as residents of the community affected by the earthquake (n = 29). Data collection included semi-structured interviews, field notes, and reviews of narratives.
  
  
  RESULTS
  The findings of this study indicate that the lack of planning, inadequate organizational management of resources, insufficient coordination in the provision of health services during the disaster, and the manner of participation of international relief efforts were the most important barriers to adequate disaster healthcare services delivery during the 2003 Bam Iranian earthquake.
  
  
  CONCLUSIONS
  This study supports the value of health service managers coordinating the appropriate use of international aid in advance. It is suggested that this can be done by better communication with local and foreign constituents. Further, this study indicates that public education and proper pre-event planning help to bring about an effective response to providing healthcare services during a disaster.
authors.affiliation: Department of Nursing, University of Social Welfare and Rehabilitation, Tehran, Islamic Republic of Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Khankeh
authors.forename: Davoud
authors.initials: D
authors.lastname: Khorasani-Zavareh
authors.forename: Eva
authors.initials: E
authors.lastname: Johanson
authors.forename: Rakhshandeh
authors.initials: R
authors.lastname: Mohammadi
authors.forename: Fazlollah
authors.initials: F
authors.lastname: Ahmadi
authors.forename: Reza
authors.initials: R
authors.lastname: Mohammadi
mesh_terms: D001291:Attitude of Health Personnel; D003256:Community Participation; D054597:Disaster Medicine / Q000379:methods / Q000458:organization & administration*; D004189:Disaster Planning / Q000458:organization & administration* / Q000592:standards; D055866:Earthquakes; D006801:Humans; D007391:International Cooperation; D007407:Interviews as Topic; D007492:Iran; D033262:Narration; D019370:Observation; D036301:Qualitative Research; D012066:Relief Work / Q000458:organization & administration; D018635:Rescue Work / Q000379:methods / Q000458:organization & administration; D000078329:Workforce