Table 3

Summary of key qualitative themes from key informant interviews on emergency medical supply chain performance during the February 2023 earthquake response in Northwest Syria (n = 8)

Qualitative finding categoryKey insights and themes
Crisis communicationParticipants reported major communication barriers and complete blackouts, especially between teams in Syria and Türkiye
Responders relied on informal tools like WhatsApp, which proved flexible and effective for rapid decision-making but lacked features for structured message tracking or integration with logistics systems
CoordinationHeavy reliance on intra-coordination (between local actors/NGOs)
Significant gaps in external coordination (with international organizations) led to unclear roles, duplication of efforts, and overstocking of certain items
Coordination with Türkiye was hindered by border closures and shifts in Turkish policy prioritizing domestic needs, restricting exports of medical supplies into NWS
Information management systemsChallenges in obtaining timely and accurate data from health facilities hindered the ability to effectively address medical needs
Functioning systems often had data on central warehouse stock but lacked real-time data at the facility level (warehouses or pharmacies)
Funding and donor relationsThe earthquake response saw faster and more flexible funding than typical protracted Syrian crisis responses, including expedited disbursements and relaxation of procurement regulations
Organizational flexibility (e.g. rapid implementation of emergency waivers) was key to enabling faster life-saving activities
Despite announced appeals, the amount of allocated funding that reached affected areas in the initial weeks was significantly less
Existing disaster preparednessMany facilities were unprepared for the scale of the earthquake, despite previous experience with crises like COVID-19 or cholera outbreaks
Facilities had to rely heavily on existing stockpiles of emergency supplies, demonstrating the crucial role of prepositioned stock

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