Table 2 Strategies for strengthening a climate-resilient health system

Governance and leadership

Developing a national health and climate change adaptation plan (10);

Engaging government in health and climate change (2);

Refining the regulations of the health sector to manage the health risks of climate change (2);

Developing and implementing a comprehensive policy on climate change and health (1);

Increasing awareness of healthcare leaders of the changing hazards (1);

Designing a crisis leadership model underpinned by values and ethics (1);

Using climate vulnerability indices for health planning (1);

Putting pressure on governments to divest themselves of fossil fuels (1);

Cooperating PHC with institutions that deal with climate change (1);

Empowering key stakeholders across sectors to work at the local levels (1);

Enhancing inter-sectoral and international collaboration (1);

Decentralizing management through devolution of authority(1);

Establishing an iterative process for managing and monitoring the health risks of climate change (1);

Providing mandatory reporting on health, social, financial, and environmental performance (1);

Joining an organization such as the Climate and Health Alliance (1);

Designing a framework for climate change (1);

Financing

Providing adequate funding (3);

Increasing research funding (2);

Improving access to long-term international financing (2);

Estimating the costs of action and inaction to protect health (1);

Increasing funding for climate change programs in local communities (1);

Increasing reliance on “cost recovery” for public sector services (1);

Health workforce

Using a sustainable and trained workforce (3);

Recruiting and training of health personnel in biostatistics and epidemiology (1);

Involving nursing staff in community microbiological water testing (1);

Strengthening the capacity of health staff at different levels through training (1);

Improving training provisions to raise awareness among professionals (1);

Integrating climate change education into university training curricula (1);

Engaging diverse stakeholders (1);

Leading physician on climate action in everyday practice (1);

Designing health educational content for residents (1);

Identifying vulnerable professional groups (1);

Increasing workplace awareness of infectious disease risks (1);

Developing suitable protective clothing and gear (1);

Spreading the knowledge and skills of health protection facing climate change (1);

Ensuring access to healthcare and financial resources to support healthcare personnel working through emergencies (1);

Medical products and technologies

Planning and backup systems for essential services, i.e. electricity, air conditioner, ventilation, and water supply (9);

Designing a low-carbon or net zero healthcare facility (2);

Implementing infrastructure adaptations such as sustainable land use, building design, and emergency power generation (2);

Allocating resources (2);

Better utilization of resources (1);

Improving laboratory infrastructure and testing capabilities (1);

Strengthen infrastructure and equipment capacity to increase health facility resilience to natural disasters (1);

Health information systems

Forecasting climate impacts and assessing the vulnerabilities and capacities of the health system (6);

Enhancing surveillance targeting climate-sensitive diseases and their risk sources (5);

Research in climate change’s impact on health, and improve adaptive capacities of health services (4);

Developing early warning systems on environmental risks (3);

Keeping updated, centralized, easily accessible global databases on climate plans (2);

Analyzing long-term multi-disciplinary climate, health, and socio-economic parameters (2);

Establishing backup data systems (1);

Integrating environmental, ecological, veterinary, and epidemiological data (1);

Ensuring adequate data collection and data quality (1);

Developing the use of proxy measures and interpolation when data may be unavailable (1);

Developing spatial analysis technologies with greater integrative analysis capabilities than current GIS software (1);

Increasing the ability to share data and information across jurisdictions (1);

Improving the timeliness of access to laboratory testing and its results (1);

Integrating health into loss and damage assessments related to climate change (1);

Collating and disseminating best practices from successful countries (1);

Improving communication pathways between the health sector, meteorology services, and other stakeholders (1);

Capacity building for project formulation, management, and evaluation specific to climate change (1);

Developing and proposing health adaptation plans (1);

Service delivery

Designing primary healthcare-based approaches to address both the immediate and long-term effects of climate change (3);

Improving access to mental health services (3);

Strengthening of capacity and quality for health services and facilities (2);

Providing normative guidance on primary health care (2);

Prioritizing vulnerable populations and geographies (2);

Promoting health programs with households on efficient use of energy (2);

Providing Health advisory platforms in order to improve services and education (2);

Improving access to pharmaceuticals for increased health risks (2);

Designing a municipal heat-wave preparedness plan (1);

Accessing essential equipment, e.g., power generators and water pumps (1);

Adopting energy and water efficiency programs in order to change staff behavior (1);

Providing incentives to reduce energy use in buildings and transport (1);

performing waste disposal under safe conditions (1);

Providing information to patients about climate change and its links to human health (1);

Investing in renewable energy and energy-efficient technologies (1);

Minimizing unnecessary care and limiting consumables (1);

Developing toolkits to reduce environmental harms from operating-room practices (1);

Engaging in active relocation of vulnerable health facilities (1);

Delivering an “essential services package” to the whole population (1);

Strengthening chronic disease self-management programs (1);

Monitoring clients in the community (1);

Changing diet, e.g., eating less meat and eating from food gardens (1);

Revising existing health plans to include a robust situation analysis of the climate landscape (1);

Increasing resources for health emergency risk management (1);

Enhancing health system capacity for rapid disease-specific emergency response (1);

Updating and improving emergency risk communication strategies (1);