Understanding the Effectiveness of Emergency Medical Teams From Members' Perspectives: A Qualitative Analysis of Sustainability and Health System Strengthening in Natural Hazard-Related Disasters.

BACKGROUND: After natural hazards, Emergency Medical Teams (EMTs) provide critical care when national systems are overwhelmed. While their short-term effectiveness is established, their contribution to long-term health system recovery remains underexplored. OBJECTIVE: From the perspective of deployed members, this study explored the barriers and facilitators influencing the long-term effectiveness and sustainability of EMT interventions post-disaster. METHODS: This qualitative study used in-depth interviews with nine purposively sampled EMT members who had deployed to natural hazards. Using thematic analysis, we identified three core themes: barriers to sustaining impact, mechanisms promoting long-term effectiveness, and challenges in measuring impact. RESULTS: Poor coordination with national staff, limited knowledge transfer, logistical and cultural barriers, and the absence of structured monitoring and evaluation strategies constrained the long-term effectiveness of EMT interventions. Strategies such as local capacity building and Risk Communication and Community Engagement (RCCE) have been identified as two mechanisms through which sustainable health care programming can be implemented. CONCLUSION: The findings highlight a persistent tension between acute response priorities and the goal of long-term health system strengthening. This study suggests that addressing this gap requires integrating structured approaches, such as MEAL and RCCE, to better support sustainable health development post-disaster.