Blom Iris Martine, Asfura Javier Shafick, Eissa Mohamed, Mattijsen Juliette Claudine, Sana Hamaiyal, Haines Andrew, Whitmee Sarah
Population Health, London School of Hygiene & Tropical Medicine, London, UK.
National Autonomous University of Honduras, Tegucigalpa, Honduras.
Wellcome Open Res. 2023 Jun 12;7:202. doi: 10.12688/wellcomeopenres.18005.2. eCollection 2022.
: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs). Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. : This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. : This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.
预计气候变化将成为本世纪对健康的最大威胁。2021年，46个国家致力于建立环境可持续的低碳医疗保健系统。其中，34个国家来自低收入和中等收入国家（LMICs）。目前，医疗保健系统占全球温室气体（GHG）排放量的4.4%，高收入国家（HICs）的医疗保健系统在该部门的温室气体排放中占比最大。然而，在没有强有力的温室气体减排措施的情况下，预计低收入和中等收入国家的排放量未来会增加。本系统综述旨在确定基于证据的温室气体减排干预措施，以指导医疗保健系统向净零排放转型，特别是在低收入和中等收入国家。此外，还将研究有助于适应气候变化和减少温室气体排放的干预措施之间的潜在协同效应。 本方案将遵循“系统评价与Meta分析方案的首选报告项目（PRISMA-P）”清单中推荐的项目，这些项目将在系统评价方案中涉及。将对确定为相关的电子数据库进行全面搜索。确定了检索词，以获取1990年至2022年期间发表的所有相关同行评审的原始研究。将评估偏倚风险，并对证据质量进行分级。最终的叙述性综合分析将纳入低收入和中等收入国家医疗保健系统温室气体减排的变革理论框架。 本系统综述将综合现有关于所有排放范围的温室气体减排干预措施的证据，包括范围1（医疗保健运营）、范围2（能源）和范围3（供应链）。它可用于为低收入和中等收入国家的医疗保健系统如何在优先考虑采取哪些行动以实现温室气体排放量最大幅度减少（同时考虑实施的难易程度、范围和成本）的情况下减少排放提供建议。最后，这可以促进该领域迫切需要的进一步研究。
