• The provision of uninterrupted emergency medical service at primary care but also at municipal hospitals is under-funded, inadequately staffed and under equipped. 
• Inadequate and insufficient training for doctors and nurses for the management of emergencies. Medical emergency guidelines/ protocols and/or algorithms do not exist. 
• Community engagement initiatives regarding health emergencies preparedness and response, are almost completely absent. 
• The earthquake in 2019 and the COVID-19 pandemic have sparked increased awareness and sensitivity on disasters and health emergencies. 
• Both the National Strategy for Development and Integration 2021 – 2030 and the National health strategy 2021 – 2030 set for the first time as a priority the strengthening of the system response to emergencies at local and central level. 

Risultati principali attesi:  

• The regulatory framework, standards, and guidelines for health emergencies are updated/revised.
• Roles and responsibilities of primary health care services in the health emergency system are defined. 
• The national training system for management of public health emergencies is strengthened. 
• The epidemiological surveillance system is strengthened 
• The network of 24/7 health centers, municipality hospitals is strengthened in delivering emergency services. Clinical guidelines and protocols for health emergencies at primary health care level are implemented 
• Institutional development and capacities of “Together for Life” and other CSOs are strengthened to advocate for a community participatory approach in emergency preparedness and evidence-based health policy development. 

Risultati fasi precedenti:  

• Communities and institutions rely on central government for support when emergencies occur. 
• Need of an after-action review that focuses on bringing together key stakeholders for collective learning, documenting lessons learned and institutionalizing best practices seen during the COVID 19 response 
• Emergency services at the level of primary health care and municipality hospitals is disregarded by the health insurance and is not properly reported and financed. 
• Communities need better education on health emergencies.