Crisis management of COVID-19 at the primary healthcare level: challenges and solutions – a qualitative study

BACKGROUND: The COVID-19 outbreak, which began in December 2019, has become a global challenge, highlighting the need for effective crisis management solutions. This study aims to identify the challenges and crisis management Solutions related to COVID-19 at the primary healthcare level in Lorestan Province. METHODS: This qualitative study adopted a phenomenological approach. Twenty-five healthcare managers (senior, middle, and operational) from the Public Health Deputy of Lorestan University of Medical Sciences and its affiliated health networks were selected through purposive and snowball sampling. Data were collected via semi-structured face-to-face interviews and analyzed using directed content analysis in MAXQDA software (version 10). A total of 375 initial codes were generated and organized into themes and subthemes. The trustworthiness of the findings was ensured using Guba and Lincoln's criteria, including credibility (triangulation, member checking), dependability, confirmability, and transferability. RESULTS: The main challenges identified at different stages of crisis management include: in the prevention stage, " awareness and understanding of the disease"; in the preparedness stage, " planning"; and in the response stage, "cultural-social, economic-political, governance challenges, and intersectoral cooperation. "Effective strategies and interventions proposed include: in the prevention stage, "strengthening the health and prevention sector"; in the preparedness stage, "managing human and informational resources, organization, and planning"; and in the response stage, " Strengthening human resource management, decision-making, and coordination." CONCLUSION: Primary healthcare faced major challenges in managing COVID-19, including poor coordination, unclear guidelines, and low public trust. To strengthen future responses, clear national protocols, transparent communication, improved inter-sectoral cooperation, and targeted support for vulnerable groups are essential. These measures can enhance preparedness and resilience in future health crises.