Exploring attitudes towards health preparedness in the Middle East and North Africa against chemical, biological, radiological, and nuclear threats: A qualitative study

Hassan Farhat*, Guillaume Alinier, Mariana Helou, Ioannis Galatas, Denis Josse, Craig Campbell, Nelson Olim, Ayşe Handan Dökmeci, Mohammed Heriza, Henda Chebbi, Kawther El-Aifa, Amira Jaafar, Sami Souissi, Asma Ben Amor, Nicholas Castle, Loua Al-Shaikh, Walid Abougalala, Mohamed Ben Dhiab, James Laughton

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Since 1970, Middle East and North African (MENA) countries have witnessed evolutionary industrial development and long-running terrorist and inter-country conflicts. Additionally, the risk of accidental, deliberate or natural chemical, biological, radiological, and nuclear (CBRN) threats has also increased, requiring a collaborative review of the health sectors’ preparedness for potential CBRN risks within the region. This study aimed to explore the opinion of multidisciplinary experts interested in disaster management research in MENA about perspectives and challenges on readiness for potential CBRN incidents. A modified interview online link was sent to the participants. A qualitative thematic analysis was performed on the responses using Nvivo®12 software, following semi-structured modified interviews using the Phonic® application. A total of 29 participants were sufficient to reach the data saturation. Through an inductive coding approach, five themes were identified: ‘CBRN-Related Incidents are a Threat’, ‘Inadequate National Practice and Policy’, ‘Need for International Cooperation’, ‘Importance of Better Mass Gathering Management’, and ‘Ineffective Hospital Preparedness’. With the assistance of the World Health Organization, there is a consensus on the need for cooperation between the MENA countries to ensure adequate healthcare preparedness for CBRN threats. Suggested measures should be considered, such as creating a unified database and liaison officer designation.

Original languageEnglish
Article numbere12509
Number of pages17
JournalJournal of Contingencies and Crisis Management
Issue number1
Early online date10 Oct 2023
Publication statusPublished - 1 Mar 2024
Externally publishedYes

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