Assessing primary health care network preparedness for future pandemics in Lebanon

Abstract Background The COVID-19 pandemic exposed critical gaps in health system preparedness worldwide, particularly within primary health care (PHC). In Lebanon, disparities between rural and urban and INGO-supported and non-INGO-supported primary health care centers (PHCCs) may affect the ability of PHCCs to respond to future pandemics. The Health Emergency Preparedness, Response and Resilience (HEPR) framework provides a structured approach to assess facility-level preparedness. Aim To assess PHC preparedness for future pandemics in Lebanon and identify gaps requiring improvement. Methods A health facility survey was administered to 185 eligible PHCCs nationwide, with 169 responses (91.4%). Findings were mapped across the 5 HEPR domains and analyzed using descriptive and unadjusted bivariate statistics, with statistical significance set at p < 0.05. Results Preparedness varied across HEPR domains. Timely reporting of priority communicable diseases through the national surveillance system was reported by 99.4% of PHCCs, whereas no PHCC reported a formal feedback mechanism to systematically address community concerns. Only 53.8% of PHCCs reported having an emergency plan, indicating an important gap in facility-level emergency preparedness. Countermeasures were readily available, although availability varied across vaccines, medicines, laboratory networks, and essential supplies. Conclusion PHC pandemic preparedness in Lebanon showed strengths in surveillance and access to countermeasures but persistent gaps in emergency coordination, workforce preparedness, risk communication, and sustainable financing. This study demonstrates how a national HEPR framework can be operationalized at the PHC facility level, offering a practical approach for strengthening preparedness in fragile and crisis-affected settings.