War Shelter Preparedness as a Public Health and Governance Challenge: A Scoping Review

Articles in Press

Document Type : Review

Authors

1 Department of Health in Disasters and Emergencies, School of Health Management and Medical Information science, Shiraz University of Medical Sciences, Shiraz, Iran.

2 School of Health Management and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran

3 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran

10.30476/jhmi.2026.110564.1361

Abstract

Introduction:
The evolving nature of armed conflicts—particularly their increasing concentration in urban areas—has heightened the need to reassess systems designed to protect civilian populations. War shelters represent a core component of civil defense and are expected to support not only physical safety but also public health and psychosocial well-being. However, in many countries, preparedness remains limited and fragmented, especially in relation to governance structures and health-oriented planning. This scoping review aimed to synthesize existing evidence on strategies, challenges, and health-related outcomes of war-shelter preparedness in settings with insufficient or uneven levels of readiness.

Method:
This scoping review followed the PRISMA‑ScR guidelines. A systematic search was conducted in PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar for studies published between 2005 and 2025. Nineteen studies met the inclusion criteria. Data were extracted using a structured form and analyzed through thematic synthesis.

Results:
Five overarching themes were identified: governance and policy; structural and technical design; public health and mental health; community engagement and education; and coordination and operations. Additional emerging themes included spatial equity in access, emerging technologies (including digital and sensor‑based tools), and social adaptive capacity. Major gaps across the literature involved inadequate integration of public‑health standards, limited provision of mental‑health and medical services within shelters, and unequal spatial distribution of shelter infrastructure.

Conclusion:
War‑shelter preparedness should be conceptualized as a multidimensional, health‑oriented system rather than a purely technical intervention. Strengthening shelter systems requires integrated governance, public‑health planning, community participation, and institutional coordination to enhance civilian protection and public‑health resilience.

Keywords

Main Subjects

Health Management & Information Science

Articles in Press, Accepted Manuscript
Available Online from 24 May 2026

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