Establishing a public health emergency operation center to strengthen local health system resilience in Kadoma city, Zimbabwe, 2024

Following the 2014–2016 Ebola outbreak in West Africa, the World Health Organization Regional Office for Africa, the Africa Centres for Disease Control and Prevention and the West African Health Organization prioritized establishment and operationalization of Public Health Emergency Operations Centers (PHEOCs) across Member States as strategy for strengthening emergency preparedness and response. Public Health Emergency Operations Centers serve as important platforms for coordinating timely, multisectoral and effective responses to health emergencies. In 2024, Kadoma City in Zimbabwe, established a subnational PHEOC to institutionalize emergency preparedness, strengthen coordination and enhance local health system resilience. This case study documents the establishment process, governance arrangements, early achievements and operational challenges of the PHEOC in Kadoma. Data were derived from institutional document review and key informant interviews.

The PHEOC was established through collaboration between Kadoma City Council, the Ministry of Health and Child Care and World Vision Zimbabwe. It is embedded within the Department of Health and Environmental Services, operating in alignment with the national Incident Management System framework. Early achievements included: upgrading infrastructure, equipping the center with core Information Communication and Technology systems and providing capacity-building programs. Despite these advances, the PHEOC faced key constraints including, dependence on external funding, fragmented and largely paper-based information systems and weak digital interoperability with provincial and national PHEOCs. These challenges pose risks to long-term sustainability and operational effectiveness. The experience from Kadoma demonstrates the feasibility of establishing functional subnational PHEOCs in resource-constrained settings through strategic partnerships and institutional integration. It also highlights critical system-level requirements for sustainability, including stable financing, dedicated human resources and interoperable digital infrastructure. As Zimbabwe expands its national PHEOC network, the Kadoma case provides transferable lessons for strengthening decentralized emergency preparedness and transitioning from ad hoc responses to institutionalized public health emergency management.