Hospital Disaster Preparedness in Lagos State: Lessons from COVID-19 and a Six-Pillar Framework for Resilience

Illustrative Image: Hospital Disaster Preparedness in Lagos State: Lessons from COVID-19 and a Six-Pillar Framework for Resilience
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A study by Bukar et al. (2025) titled “Disaster preparedness and resilience for hospitals: lessons learned from the COVID-19 pandemic“, published in the American Journal of Multidisciplinary Research and Innovation, reveals that hospitals in Lagos State lack sufficient disaster preparedness across staff, supplies, infrastructure, and governance.

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Hospitals in Lagos lack adequate disaster preparedness, but resilience can improve through a six-pillar framework addressing governance, workforce, infrastructure, and community.
– Bukar et al. 2025

The COVID-19 pandemic exposed critical weaknesses in hospital disaster preparedness, particularly in Lagos State, Nigeria, while also offering valuable lessons for future resilience. This study explores these shortcomings and proposes a comprehensive framework to strengthen hospital systems against future crises. Findings revealed that hospitals in Lagos struggled across four key areas: staff lacked specialized training for disaster response; essential medical supplies were often insufficient; hospitals faced limited surge capacity and inadequate isolation facilities; and governance structures were fragmented, resulting in poor coordination. These gaps underscore the urgent need for hospitals to transition from reactive responses to proactive resilience-building strategies.

To address these challenges, the study proposes a six-pillar framework: strong and transparent governance and leadership; sustainable financial support for health infrastructure; continuous workforce training and capacity building; adaptable healthcare delivery models that allow flexible use of space and services; locally driven preparedness tools, including community engagement and effective communication systems; and continuous learning through drills and simulation exercises to refine strategies. However, implementing this framework faces obstacles such as limited resources aggravated by inflation and insecurity, infrastructure constraints in Lagos’ densely populated environment, governance challenges linked to corruption, and the complexities of training diverse cultural communities at scale. Despite these barriers, the study stresses that hospital resilience must become a cornerstone of disaster risk management. By embedding the lessons of COVID-19 into governance, financing, workforce development, and community engagement, hospitals in Lagos—and across other regions—can be better equipped to withstand and adapt to future disasters.

How the Study was Conducted

The study adopted a comprehensive literature review methodology. The authors systematically examined existing studies, reports, and policy documents to build their insights. Sources were drawn from reputable databases such as ScienceDirect, PubMed, and official government publications, with a specific focus on research related to hospital disaster preparedness, resilience, and lessons from the COVID-19 pandemic. To guide the analysis, the authors applied the 4S Framework, a widely recognized model in disaster preparedness that evaluates four key areas: Staff (human resources and training), Stuff (equipment and supplies), Space (physical infrastructure and surge capacity), and Systems (governance, coordination, and communication).

The review also engaged in a comparative analysis of leading global frameworks, including the WHO’s Health Emergency and Disaster Risk Management (H-EDRM), the Sendai Framework for Disaster Risk Reduction, and the Sustainable Development Goals (SDGs). While these international models provided a broad foundation, the study placed its contextual emphasis on Lagos State, Nigeria, examining how local hospitals performed during COVID-19 and identifying critical gaps in preparedness.

What the Authors Found

The authors found that hospitals in Lagos State lack sufficient disaster preparedness across staff, supplies, infrastructure, and governance, but resilience can be significantly strengthened by adopting a six-pillar framework focused on governance, financial stability, workforce competency, flexible healthcare delivery, local preparedness tools, and continuous learning.

Why is this important

Real-World Urgency – COVID-19 revealed major weaknesses in healthcare systems, with Lagos hospitals struggling from shortages, overcrowding, and poor coordination. This study offers a practical blueprint for strengthening resilience against future pandemics, natural disasters, and conflicts.

Saving Lives – Hospitals are the backbone of disaster response. Strengthening their systems ensures quicker response, improved patient outcomes, and reduced mortality during crises.

Policy and Planning Value – The six-pillar framework provides actionable guidance for policymakers and hospital leaders, enabling smarter resource allocation, workforce training, and adaptable infrastructure development.

Turning Lessons into Action – By transforming hard lessons from COVID-19 into a roadmap for improvement, the study promotes continuous learning so hospitals don’t just recover but evolve to meet future challenges.

What the Authors Recommended

• The authors suggested that the Lagos State government establish transparent, accountable governance structures and secure sustainable funding to support long-term preparedness, infrastructure upgrades, and coordinated response efforts.
• The study emphasises that the Lagos State government invest in continuous disaster-response training, develop specialized emergency teams, and design culturally sensitive communication and training strategies.
• In addition, the Lagos State government should create adaptable hospital spaces with surge capacity, implement modular healthcare systems, and involve communities through strong local preparedness tools and communication networks.
• Furthermore, institutionalise regular drills, simulations, and feedback mechanisms while addressing systemic challenges such as corruption, fragmented governance, and urban infrastructure gaps.

In conclusion, the study highlights that strengthening hospital disaster preparedness in Lagos requires more than reactive measures—it demands a proactive, systemic approach rooted in governance, financing, workforce development, and community engagement. By adopting the proposed six-pillar framework and addressing structural challenges, hospitals can transform the hard lessons of COVID-19 into lasting resilience, ensuring they are better equipped to protect lives and sustain healthcare delivery during future crises.