Healthcare Workers Perspective on the Effect of War on Patient’s Safety as a Measure of Quality of Provided Healthcare Services during Armed Conflicts in Sudan (2024/2025)

Background The disruption of healthcare systems during armed conflict poses a direct threat to patient safety and overall care quality. Since April 2023, escalating violence in Sudan has damaged health infrastructure and disrupted essential services, increasing the risk of preventable patient harm; however, evidence on how war affects patient safety culture from the perspective of frontline physicians remains limited, particularly in Sudan. This study aims to assess doctors’ perspectives on the impact of armed conflict on patient safety in Sudan. Methods A cross-sectional study was conducted in 2024–2025 among frontline physicians in Sudan with at least one month of wartime service. Data were collected using an anonymous self-administered questionnaire adapted from the Surveys on Patient Safety Culture Hospital Survey version 2.0. Convenience sampling was used due to access constraints. Descriptive statistics, independent t-tests, one-way ANOVA, and multiple linear regression were performed using SPSS version 26, with significance set at p < 0.05. Results A total of 666 physicians participated, with a mean patient safety score of 59.8 ± 11.1.Frequently reported safety events were infections (58.4%), medication errors (53.2%), and communication errors (50.6%). Transparency after event reports (20.4%) and speaking up against unsafe practices (20.1%) were infrequent, and few perceived supervisory or leadership support for safety (17.1–19.2%). Over one-third (36.8%) judged patient safety systems inadequate during crises; 32% rated Ministry of Health support as poor, and 36.6% considered patient protection measures ineffective. Full-time work was associated with higher patient safety (p = 0.020) and accountability (p = 0.012). Direct patient contact increased collaboration (p = 0.003) but reduced accountability (p = 0.025). Witnessed patient safety events significantly influenced collaboration (p = 0.006), training and resources (p = 0.025), and patient safety scores (p = 0.009) Conclusion Armed conflict in Sudan has substantially compromised patient safety. Strengthening workforce stability, safety culture, and institutional support is essential to protect healthcare quality in conflict settings.