Has the COVID-19 pandemic enhanced the capacity of rural public health emergency management? Evidence from Jiangsu Province of China

Public health emergencies pose both challenges and opportunities for improving rural public health emergency management capacity. This study develops a comprehensive evaluation framework comprising 22 indicators across four dimensions: emergency infrastructure, emergency preparedness, emergency response, and emergency recovery. Using expert scoring, the analytic hierarchy process (AHP), and the entropy weight method, the rural public health emergency management capacity of Jiangsu Province was quantitatively assessed for the period 2016-2023 to compare changes before and after the COVID-19 pandemic. The results show that the outbreak of COVID-19 significantly enhanced the overall capacity of rural public health emergency management in Jiangsu Province, with the composite score increasing from 4.97 to 6.84. Among the four dimensions, emergency infrastructure capacity experienced the most pronounced improvement, rising from 4.02 to 9.66, whereas gains in emergency preparedness, response, and recovery capacities were relatively limited. These findings indicate that major public health emergencies can accelerate infrastructure development but do not automatically strengthen institutional preparedness or recovery mechanisms in rural areas. Accordingly, this study suggests increasing financial investment, promoting multi-actor collaborative governance, and improving public health emergency management mechanisms to further enhance rural public health emergency capacity in China.