Barriers faced by primary healthcare providers in addressing emergency situations in the Northern region of Palestine before and during the Gaza war

Abstract Introduction: Physicians working in primary health care (PHC) centers are the first contact for patients and expected to deal with emergencies. Emergency care training in PHC settings has been neglected globally, especially in low to middle income countries. Adequate preparation becomes especially important during periods of conflict. The study objectives are to identify the barriers facing PHC physicians when dealing with emergency cases in the northern region of Palestine. Methods: A cross-sectional study was conducted with 179 physicians working in the 10 PHC centers distributed among 5 northern governances in Palestine. The study period was from July through December 2023. Data was collected electronically through a self-administered questionnaire adapted from literature review that was internally valid based on the measurement of Cronbach's alpha coefficient. Results: The physicians’ ages ranged between 25 and 60 years with a mean ± SD of (35.3 ± 8.15) years. Most were not boarded in a specialty (91.6%). The majority attended BLS courses (85.5%), whereas 45.2% and 72% had never attended ACLS or ATLS, respectively. Physicians who reported having work experience in emergency departments (P value = 0.002) and reported attending ACLS courses (P value < 0.001) had a significantly higher perceived level of competence in dealing with emergency cases than others. Conclusion: Emergency services at PHC in northern Palestine are functioning but have room for improvement. Efforts and resources are needed to increase availability of equipment, supplies, and drugs. Training in emergency management courses like ACLS would enhance the level of competence of physicians to perform emergency skills.