在卫生系统中建立气候适应能力:乍得一家农村医院的气候脆弱性和能力评估。

IF 3.2 4区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Annals of Global Health Pub Date : 2025-08-19 eCollection Date: 2025-01-01 DOI:10.5334/aogh.4743
Patricia Nayna Schwerdtle, Didier Tokoumnogo Zidouemba, Alexi Reouhiri Dermbaye, Kiran Jobanputra, Melissa Mcrae, Melanie Tarabbo, Mohamed Njouonkou, Marius Madjissem, Alexandre Robert, Zia Haider
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引用次数: 0

摘要

背景:乍得极易受到气候变化的影响,对卫生系统和人口健康构成重大威胁。气温上升、降雨不规则、干旱和资源短缺加剧了粮食不安全、营养不良和疟疾等病媒传播疾病。在拉克地区的农村地区恩古里,这些气候压力因素导致健康结果恶化和卫生保健服务紧张。如果不采取适应措施,在不断加剧的气候压力下,设施将难以维持基本服务。本案例研究介绍了乍得一家农村医院适应设施的气候脆弱性和能力评估(VCA),确定了主要风险并确定了提高气候适应能力的优先解决方案。目标:本案例研究描述了在高脆弱性、低资源环境下设施适应气候VCA的开发和实施,并概述了可操作适应计划的优先解决方案。方法:本研究采用参与式混合方法设计,分为五个阶段:(1)对气候危害、暴露途径和人口脆弱性进行文献综述;(2)设施审计,评估基础设施和医疗保健服务的差距;(3)定性焦点小组细化风险识别;(4)制定解决方案矩阵,并进行成本估算和可行性分析;(5)参与式优先排序流程,以制定多年设施改进计划。研究结果:VCA确定了气候风险,包括疟疾死亡率升高和电力中断中断氧气供应。产生了一份包含35个解决方案的清单,其中选择了22个优先行动进行实施。这些措施包括前瞻性规划、社区宣传、补充喂养计划和改善废物管理。该进程强调了社区参与、多学科协作和工作人员积极性对气候适应型和可持续医疗保健的重要性。结论:调整后的VCA为评估医疗机构中与气候相关的脆弱性和能力提供了一种可复制的方法。它揭示了保健服务提供面临的重大风险,并为制定当地可行的可持续适应措施提供了信息。在Ngouri医院应用的框架显示了对同样受影响的环境的相关性,支持使卫生系统与全球可持续性目标保持一致的努力,并支持在不断变化的气候条件下确保高质量的卫生保健。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Building Climate Resilience in Health Systems: A Climate Vulnerability and Capacity Assessment in a rural hospital in Chad.

Building Climate Resilience in Health Systems: A Climate Vulnerability and Capacity Assessment in a rural hospital in Chad.

Building Climate Resilience in Health Systems: A Climate Vulnerability and Capacity Assessment in a rural hospital in Chad.

Building Climate Resilience in Health Systems: A Climate Vulnerability and Capacity Assessment in a rural hospital in Chad.

Background: Chad is highly vulnerable to climate change, posing significant threats to health systems and population health. Rising temperatures, irregular rainfall, droughts, and resource scarcity exacerbate food insecurity, malnutrition, and vector-borne diseases like malaria. In Ngouri, a rural area in the Lac Region, these climate stressors have led to worsening health outcomes and strained healthcare services. Without adaptation measures, facilities will struggle to maintain essential services amid escalating climate pressures. This case study presents a facility-adapted climate vulnerability and capacity assessment (VCA) for a rural hospital in Chad, identifying key risks and prioritizing solutions to enhance climate resilience. Objectives: This case study describes the development and implementation of a facility-adapted climate VCA in a high-vulnerability, low-resource setting and outlines prioritized solutions for an actionable adaptation plan. Methods: The study employed a participatory mixed-methods design, incorporating five stages: (1) literature review on climate hazards, exposure pathways, and population vulnerabilities; (2) facility audit assessing infrastructure and healthcare delivery gaps; (3) qualitative focus groups to refine risk identification; (4) development of a matrix of solutions with cost estimates and feasibility analysis; and (5) a participatory prioritization process to develop a multi-year facility improvement plan. Findings: The VCA identified climate risks, including elevated malarial mortality and power outages disrupting oxygen supply. A list of 35 solutions was generated, with 22 priority actions selected for implementation. These included anticipatory planning, community sensitization, supplementary feeding programs, and improved waste management. The process highlighted the importance of community engagement, multidisciplinary collaboration, and staff motivation for climate-resilient and sustainable healthcare. Conclusion: The adapted VCA offers a replicable approach to assessing climate-related vulnerabilities and capacities in healthcare facilities. It revealed significant risks to health service delivery and informed the development of locally feasible, sustainable adaptation measures. The framework applied in Ngouri hospital demonstrates relevance for similarly affected contexts, supporting efforts to align health systems with global sustainability goals and to secure quality healthcare under changing climatic conditions.

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来源期刊
Annals of Global Health
Annals of Global Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
5.30
自引率
3.40%
发文量
95
审稿时长
11 weeks
期刊介绍: ANNALS OF GLOBAL HEALTH is a peer-reviewed, open access journal focused on global health. The journal’s mission is to advance and disseminate knowledge of global health. Its goals are improve the health and well-being of all people, advance health equity and promote wise stewardship of the earth’s environment. The journal is published by the Boston College Global Public Health Program. It was founded in 1934 by the Icahn School of Medicine at Mount Sinai as the Mount Sinai Journal of Medicine. It is a partner journal of the Consortium of Universities for Global Health.
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