Description
Introduction – Objectives:
Climate change exerts various adverse effects, both direct and indirect, on health, healthcare systems, and facilities. On the other hand, Health care contributes to 4—5% of global greenhouse gas emissions, and health care facilities are directly responsible for about 17% of the emissions. Hospitals are complex organizations that play a fundamental role in the provision of health services during health emergencies. They need to strengthen their resilience and expand and adapt their readiness plans to an all-hazards approach, including climate change emergencies. The global evidence and literature on hospital resilience, employing an all-hazard approach, remain fragmented and in an early stage, with less focus on operationalizing the conceptual frameworks. The aim of the study was to develop, validate, and pilot a comprehensive conceptual framework and operational guide for strengthening hospitals' resilience using an all-hazard approach with a particular focus on low-resource settings.
Methodology:
To meet the aim of the study, a mixed-method study was employed to triangulate findings from an extensive scoping literature review, an online survey, and 46 in-depth key informant interviews with hospital managers and relevant experts from 18 countries in the Eastern Mediterranean Region. An expert consultation was convened to validate the draft framework and its operation guide. Subsequently, the operational guide was piloted in two resource-constrained countries.
Results and Discussions:
To provide practical guidance for hospital managers using an all-hazard approach, a conceptual framework for strengthening hospital resilience, along with comprehensive operational guidance embedded with specific tools, was developed and piloted. A detailed pilot guide was also developed. The operational guide interlinks the resilience of six components (6S- Space, Staff, Stuff, Systems, Strategies, and Services) across all phases of the disaster risk management cycle (PPRR- Prevention, Preparedness, Response, and Recovery phases) before, during, and after an emergency or disaster including climate change related emergencies. Operationalizing hospital resilience necessitates that hospitals have risk-informed emergency preparedness and response plans, complemented by routine measures to ensure the integrity and agility of their structural, non-structural and functional elements. Plans should include institutional arrangements for managing emergencies of prioritized hazards (including risk analysis related to climate hazards), with clear allocation of roles and responsibilities among the management, clinical and support staff. Furthermore, interviewees emphasized that continually enhancing the leadership and managerial capacities of hospital managers is a crucial strategy in disaster and emergency management. The pilot results in two low-resource settings demonstrated the practicality of the operational guide, requiring only minor adjustments. Countries are encouraged to adapt and implement this operational guide based on their specific contexts.
Conclusions:
This guide emphasizes how key actions can be integrated into routine hospital operational systems, functions, and services that will strengthen how hospitals prepare for, respond to, recover from, and build back better from the impacts of multiple hazards, including climate change. Strengthening hospital resilience ultimately helps improve access to healthcare, reduce vulnerabilities and challenge inequalities, further contributing to the advancement of Universal Health Coverage (UHC), global health security, disaster risk reduction, climate adaptation and mitigation, sustainability, and health equity.
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