ABSTRACT:
Public health emergencies disproportionately affect low- and middle-income countries (LMICs), where health systems face recurring shocks, constrained resources, and elevated occupational risks for frontline responders. Preventable safety incidents reduce workforce availability, disrupt operations, and undermine emergency response effectiveness, particularly in humanitarian contexts. While Health, Safety, and Environmental (HSE) systems are well established in occupational settings, they are rarely integrated into public health emergency preparedness and response. This study explores how systematic HSE integration enhances responder protection, response continuity, and overall health system resilience in low-resource settings. The study adopted a mixed research and practice-based approach, combining a desk review of international frameworks on public health emergencies, occupational health, and humanitarian response with a retrospective qualitative analysis of emergency medical and public health responses in low-resource and humanitarian environments. Data sources included field observations, safety assessments, incident reports, and after-action reviews. Thematic analysis focused on preparedness, responder safety, coordination, and continuity of operations, with indicative quantification of operational outcomes where data permitted. Findings indicate that integrating HSE systems is associated with a 20–35% reduction in responder safety incidents and a 25–40% improvement in hazard identification and mitigation. These gains supported sustained workforce availability and reduced operational disruptions during emergency responses. Programs that applied routine risk assessments and targeted safety training showed improved coordination, clearer command structures, and faster stabilization of response activities. However, limited training coverage, often reaching less than half of responders, and weak monitoring and evaluation mechanisms constrained consistent implementation and scalability, particularly within decentralized health systems common in East Africa. Overall, embedding HSE systems within public health emergency frameworks represents a practical and scalable enhancement beyond traditional models focused mainly on logistics and clinical capacity. Institutionalizing HSE in national policies, expanding frontline training, and strengthening monitoring systems are critical to improving response continuity and resilience across LMICs.