Developing context-specific competencies for epidemic and pandemic preparedness in the MENA region: a training needs assessment and Delphi approach

Introduction Epidemics and pandemics continue to expose persistent preparedness gaps across the Middle East and North Africa (MENA), particularly in fragile and conflict-affected settings. Strengthening workforce capacities through context-specific competencies is critical for improving preparedness and enhancing health system resilience. Methods Guided by the European Centre for Disease Prevention and Control (ECDC) preparedness framework, the study employed a two-phase mixed-methods design comprising a Training Needs Assessment (TNA) and Delphi survey. The TNA was administered to 95 professionals from 18 MENA countries. Gaps between perceived importance and ability to perform were analyzed quantitatively alongside thematic analysis of open responses. To ensure expert validation of these competencies, the Delphi survey was conducted and included 10 regional experts involved in two iterative online rounds and a consensus meeting to refine and prioritize competencies. Results The TNA identified significant training gaps across all five ECDC preparedness domains, with the highest needs observed in Policy Development, Adaptation, and Implementation, Detection and Assessment and Health Services. Qualitative findings revealed additional barriers, including resource shortages, weak governance, and limited access to training opportunities. The Delphi process refined these findings, allowing experts to prioritize competencies as basic, core, essential, or omitted. Of the 99 competencies, 71 were classified as essential, 23 as core, and 5 as basic. The results of the surveys directly informed the focus and content of the certificate in epidemic and pandemic preparedness. Conclusion This study utilized the ECDC preparedness framework to assess and refine competencies for epidemic and pandemic preparedness in the MENA region. Through a TNA and Delphi approach, it produced validated, context-specific competencies that informed the design of a contextualized regional certificate. The findings underscored the critical need for targeted training programs that address both immediate and long-term challenges in health system resilience in the MENA region.