Healthy peopleHealthy environments
WHO Framework for Climate-Resilientand Environmentally Sustainable HealthCare Facilities — An Assessment Tool
In 2019, the 72nd WHA approved a GlobalStrategy on Health, Environment and ClimateChange, a broad strategy covering all aspects ofhealth and environment with importantemphasis on climate change, and responding tohealth risks and challenges up to 2030. TheStrategy has 12 Goals to be achieved, under thebroad headings of: People and better health andwell-being; Universal health coverage; Airpollution; Climate change; Water sanitation andhygiene; Chemical safety; Radiation safety;Health care settings; Workplaces; Global andregional settings; Emergencies; and Governance.Under health care settings, the Strategyidentifies as its goal that “all health carefacilities and services are environmentallysustainable: using safely managed water andsanitation services and clean energy;sustainably managing their waste andprocuring goods in a sustainable manner; areresilient to extreme weather events; andcapable of protecting the health, safety andsecurity of the health workforce”. Moreover,achieving all the other Goals will have an impacton improving the performance of the healthsystem and of health care facilities in particular.
Why focus on health care facilities
Health care facilities are setting which providedirect health treatment procedures for patientsand vary in size from small health care clinics tolarge hospitals. In many countries and settings,health care facilities are vulnerable to climatechange and other environmental stresses. Theyoften lack a proper infrastructure, a sufficienthealth workforce, and suffer from inadequatewater and sanitation services, and energysupply. These four areas also impactednegatively by climate related shocks andstresses. In their functioning, health carefacilities can also have a negative impact onhealth and the environment, through emissionsof greenhouse gases, which contribute toclimate change, and through discharges ofinsufficiently treated wastes, of different kinds,to the environment.
It is therefore the aim of this work to assisthealth care facilities identify and implementinterventions that provide protection fromexternal climate-related shocks (build climate-resilience), and that protect the healthworkforce and their serving communities fromenvironmental threats (see figure).
Conceptual framework: Building climate-resilient and environmentally sustainable health care facilities
The Framework report will be completed in May 2020, including detailed checklists for health carefacilities to monitor and assess their climate resilience and their environmental sustainability. Thesechecklists will be tested in countries between May and July, before producing a final report.
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Increasing Health Care Facilities Resilience
Climate threats to health systems areparticularly visible when it comes to health carefacilities. Often, health care facilities are notbuilt to cope with increasing climate-relatedrisks, such as extreme climate events includingstorms, floods and droughts; extremetemperatures, fires, sea-level rise; and changedpatterns of climate sensitive diseases. Althoughit is recognized that health care facilities,through their operations, are an importantsource of greenhouse gases, and thereforecontributing to climate change, often smallerfacilities in less developed countries do notcontribute to the problem. And yet, they are theones most likely to be affected, directly orindirectly, by climate change impacts. It istherefore key to build climate-resilience, toaddress the main four environmentalfundamentals to deliver safe and quality care: Awell informed health workforce, adequateaccess to WASH (and wastes) services, minimumstandards for energy, and a strategically located,and solid health infrastructure. Interventions tobuild resilience may include risk assessments(hazards, vulnerabilities and exposures), trainingand capacity building in the health workforce,awareness and communication, service delivery,and funding.
Addressing environmental sustainability
Health care facilities, when not well managed,produce adverse environmental impacts,affecting the very same people it aims toprotect. A minimum requirement for safe andquality care are access to reliable sources ofwater and energy, and yet, many health carefacilities lack even these basic resources.Environmental sustainability, from thisperspective, means implementing interventionsthat optimize the consumption of resources (e.g.water, energy, food), and reduces emissions ofgreenhouse gases, and discharges of wastes(including biological, chemical and radiological).It also includes procuring goods and servicesthat follow the principles of environmentalsustainability.
In less developed settings, health care facilitiesmay be unable to implement all required actionsfor resilience and environmental sustainability.The framework proposes minimum standardsthat all health care facilities must have, followedby an incremental approach for interventionsdepending on each facility’s feasibility, capacityand resources. Building climate-resilience andenvironmental sustainability are best addressedtogether, thus achieving synergies and resourceefficiency.
WHO Framework for Climate-Resilient and Environmentally Sustainable Health Care Facilities
Climate-resilient and environmentally sustainable health care facilities – are facilities that arecapable to anticipate, respond to, cope with, recover from and adapt to climate-related shocks andstress, so as to bring ongoing and sustained health care to their target populations, despite an unstableclimate, with access to minimum standards of WASH (and wastes) and energy services, an informedhealth workforce, and solid infrastructure, and which protects its environment for the benefit of itsworkers, patients and surrounding communities.