Objective  To describe current situation of the development of public health emergency response framework at provincial, municipal and county level in China and to provide evidences for promoting the development of the framework.

  Methods  A questionnaire-based cross-sectional survey was conducted in 2013 to collect the information on the development of public health emergency response framework (policy, preparedness planning, legislation, organizational structure, mechanism and decision making system) in health related facilities at provincial, municipal, and county levels in China.

  Results  The average scoring percentage in the evaluation on overall development of health emergency response framework was 83.1 %, 72.0 %, and 65.8 % for health related facilities at provincial, municipal, and county level; the average scoring percentages for evaluating the overall development in eastern, central, and western region of China were as following: 84.8 %, 84.8 %, and 80.1 % for the health related facilities at provincial level; 77.1 %, 73.0 %, and 66.9 % for the facilities at municipal level; and 68.6 %, 65.4 %, and 60.5 % for the facilities at county level.

  Conclusion  The development of health emergency response framework at the provincial, municipal and county level in China has been improved in recent years but the development differs obviously by administration level and geographical region. Special concern should be paid to the development in grass roots health related facilities and the facilities in western China.