Abstract



Background and Objective: Natural and man‑made disasters have irreversible consequences for human life. Healthcare centers, as frontline providers of essential health services, play a vital role in disaster response. Structural, non‑structural, and functional safety are the main pillars of this resilience. This study aimed to evaluate the safety status of urban and rural health centers in Bandar Abbas County, southern Iran.



Methods: A descriptive cross‑sectional study was conducted in 2022 using a complete census of all 168 healthcare centers (39 urban, 129 rural). Data were collected through on‑site inspection, direct observation, document review, and structured interviews using the official Ministry of Health checklist, covering structural safety (5 items), non‑structural safety (155 items), and functional safety (34 domains). Raw scores were standardized into a percentage index (0–100) and categorized as poor (<33%), moderate (33%–66%), or good (>66%).



Results: Overall mean safety scores were critically low across all domains. Structural safety was poor in both urban (18.00±11.96) and rural (12.10±11.23) settings. Non‑structural safety was moderate in urban centers (42.27±22.42) but poor in rural centers (27.50±16.49). The overall functional safety score was 38.16±16.76. The highest functional score was for fire preparedness, while the lowest were for water/food storage and financial management.



Conclusion: The observed safety levels indicate critically low resilience, particularly in rural centers and logistic domains. Immediate targeted actions—strengthening non‑structural safety, ensuring minimum 72‑hour reserves of water, food, and PPE, integrating safety criteria into accreditation, and continuous staff training especially in rural areas—are necessary to prevent service disruption during future disasters