title: Impacts of natural hazards on primary health care facilities of iran: a 10-year retrospective survey.
abstract: Public health facilities in Iran are exposed to a wide range of natural hazards. This article presents the first survey of the impacts of such natural hazards on primary health care (PHC) centers in Iran from 2001 to 2011. A retrospective survey was conducted in 25 out of 30 provinces of Iran. Archival reports at provincial public health departments were cross-referenced with key informant interviews. During a 10-year period, 119 natural hazard events were recorded that led to physical damage and/or functional failure in 1,401 health centers, 127 deaths and injury or illness in 644 health staff. Earthquakes accounted for the most physical damage and all health-worker deaths. However, there was an increasing trend of impacts due to hydro-meteorological hazards. Iran's health system needs to establish a registry to track the impact of natural hazards on health facilities, conduct regular hazard and vulnerability assessments and increase mitigation and preparedness measures.
  
  
  BACKGROUND
  Disaster, primary health care, facility, Iran, natural hazard Corresponding author: Ali Ardalan MD, PhD. Iran's National Institute of Health Research, Tehran University of Medical Sciences. Harvard Humanitarian Initiative. Email: aardalan@tums.ac.ir.
authors.affiliation: Department of Disaster & Emergency Health, National Institute of Health Research, Tehran University of Medical Sciences, Tehran, Iran; Department of Disaster Public Health, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Ardalan
authors.forename: Hani
authors.initials: H
authors.lastname: Mowafi
authors.forename: Homa Yousefi
authors.initials: HY
authors.lastname: Khoshsabeghe