Exploring Grassroots Indicators for Pandemic Prevention Preparedness and Response: A Systematic Narrative Review

Abstract

Background: The COVID-19 pandemic has revealed how conventional top-down, expert-driven indicators often fail to align with local community realities, marginalising their perspectives, concerns, knowledge, and narratives. However, the limitations of pandemic-related and global health security indicators are not unique but reflect recurring patterns across major social metrics. In response, an alternative paradigm advocates for grassroots-inclusive approaches to developing indicators. This review assesses how and why grassroots-inclusive approaches complement top-down approaches to indicator development and synthesises their theoretical and practical contributions to public health.

Methods: A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Six databases—MEDLINE, Embase, CINAHL, Web of Science, Scopus, and PsycINFO—were systematically searched, along with Google Scholar, to identify relevant articles published from their inception to September 1, 2024. Peer-reviewed articles, opinion pieces, and book chapters were included, and findings were synthesised narratively.

Results: The review included 43 studies from a range of disciplines. Across these studies, communities co-produced indicators through participatory workshops, interviews, and consensus exercises in areas including environmental sustainability, disaster resilience, public health, well-being, and local development. Reported strengths included greater local relevance, community ownership, and accountability. Key challenges included sustaining participation, integrating grassroots indicators into top-down systems, and addressing data gaps. Notably, no study applied grassroots-inclusive indicators to health security or pandemic preparedness.

Conclusion: Despite retrieving and analysing literature from multiple disciplines, no study specifically applied grassroots-inclusive indicators to health security or pandemic preparedness. However, the evidence demonstrates that integrating expert and non-expert perspectives in indicator development is both feasible and practical.

Keywords: Pandemic Preparedness, Health Security, Grassroots Indicators, Community Engagement, Participatory Approaches, Bottom-up Approach

Copyright: © 2025 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Citation: Eshete MT, Shrestha P, Ang C, et al. Exploring grassroots indicators for pandemic prevention, preparedness, and response: a systematic narrative review. International Journal of Health Policy and Management. 2025;14:8886. doi: 10.34172/ijhpm.8886

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