Given the important role of climate resilient health systems in the Pacific countries where the health impact of climate change is inevitable, this presentation discusses how to contextualize the concept of climate resilience in assessing and strengthening health care facilities in the Pacific.

1. What does “climate-resilient health
systems” and “GREEN and SMART
healthcare facilities” mean to the
context of Pacific?
20 March 2019
Changgyo Yoon, technical officer
Pacific Health Systems and Policy
WHO Division of Pacific Technical Support

2. Climate resilient health systems
 WHO’s definition
– is one that is capable to anticipate, respond to, cope with, recover from and
adapt to climate-related shocks and stress, so as to bring sustained
improvements in population health, despite an unstable climate (WHO,
Operational Framework for Building Climate Resilient Health Systems, 2015)
– US DHHS’s definition: Climate Resilience or Climate Change Resilience: The
capacity of an individual, community, or institution to dynamically and
effectively respond to shifting climate impact circumstances while
continuing to function at an acceptable level (Primary Protection: Enhancing Health Care
Resilience for a Changing Climate)
Adopted from WHO, Operational Framework for Building Climate Resilient Health Systems, 2015

3. A framework for climate resilient health systems
 Building climate resilient health systems is the
key steps in achieving UHC and health related
SDGs
– To ensure access to essential health services
 Given the Healthy Islands vision, it needs to
encompass the key concept of health systems
envisioned by Healthy Islands
– Children are nurtured in body and mind; and People
work and age with dignity (health service related pillars)
 Develop through integration of actions in the
core policy areas of health system strengthening:
– social determinants of health; risk reduction; public
health surveillance and disease outbreak management;
implemented within the framework of national
sustainable development objectives

4. Can “climate resilience” be measured?
 A number of countries have developed toolkits to
assess climate resilience of health facilities: Canada,
US, PAHO
 Develop and contextualize a toolkit by mapping
identified elements to existing toolkits for service
availability and utilization such as SARA, HeRAMS
and existing data
– WPRO/DPS has been conducting HeRAMS in assessing health
service availability and utilization
 However, there is no single toolkit to quantitatively
measure climate resilience of health systems

6. Toolkits to assess climate resilience of health facility

7. Can “climate resilience” be measured?
- an example of HeRAMS applied to Pacific countries

8. GREEN and SMART health care facilities
 Green health care facilities
– a facility that has the ability to mitigate its impact on the
environment and reduce pollution; save costs; reduce
greenhouse gas emissions; and achieve adaptation, risk
reduction and development benefits (PAHO, 2017)
 SMART health care facilities
– Combines key concepts of safe and green hospital to make
facilities to be climate resilient and ensure health services
provided at all times (including acute phase of disasters)

10. GREEN and SMART health care facilities
(in the Caribbean)
 Given the key concepts of SMART HCF, the project
aims to:
– Ensure health care facilities are environmentally friendly and
disaster resilient
– Reduce impact of Climate Change
– Reduce operational costs
– Enhance user comfort and performance
– Empower decision makers to select the most cost effective
green improvements to undertake at a facility, thereby allowing
them to make Smart decisions.

11. How to Smart Health Care Facilities?
 Details of SMART project by DFID/PAHO in the Caribbean,
SMART2 (PHASE II)
– 5-year Project
– 7 countries: Grenada, St. Lucia, St. Vincent and the Grenadines,
Dominica, Guyana, Belize and Jamaica
– Over 400 Health facilities assessed (safe & green)
– Over 600 people (49% female) trained
– Smart App created with database
– “SMARTing” of at least 4 facilities in each country
– Improved Technical material/ Tools
– Develop National & Regional Capacity
– Integration of USAID Caribbean Clean Energy Program tool

12. SMART hospital/HCF tool kit available
 Hospital Safety Index: existing tool developed
by PAHO
 Green Checklist: evaluates water, energy,
atmosphere, IAQ, hazardous materials, etc
 Baseline Assessment Tool: Capture of
essential baseline information for design
specifications, SoW, and CBA
 Cost Benefit Analysis Tool by Florida
International University
 Knowledge, Aptitude and Practices (KAP)
Survey
 Preventive maintenance manual

13. Coming back to the Pacific
 Caribbean has implemented SMART project with
toolkits available and with context of the region
 Progress in the Pacific
– A guideline/tool developed by Fiji MHMS and WHO could be a
reference for other countries to consider
– KOICA project for TUV/KIR has components to train health
workers on climate change and health (resilience), but little
attention to enhancing infrastructure
– KOICA/MHMS Fiji to rennovate Tavua hospital / Japan
embassy’s support on grass root projects
 However, gaps are in:
– How to contextualize the concept into the Pacific’s situation
– How to use data from the tool for establishment of new HCF
or retrofit existing HCF (health centres / clinic)
– How to translate the concepts and data into engineering /
construction
– How to put monitoring and evaluation framework on projects