Naser Kamar, Haq Zaeem, Naughton Bernard D
School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, D02PN40 Dublin, Ireland.
Save the Children St Vincent House, 30 Orange Street, London WC2H 7HH, UK.
Int J Environ Res Public Health. 2024 Apr 3;21(4):434. doi: 10.3390/ijerph21040434.
: The aim of this study was to assess the impact of climate change on health services as categorized by the WHO's Building Blocks for creating Climate-Resilient Health Systems. : The objective was to conduct a systematized review of the published literature concerning the impact of climate change, using a thematic analysis approach to address our aim and identify areas for further research. : A search was conducted on 8 February 2022 using the Embase and PubMed research databases. Peer-reviewed scientific studies that were published in English from 2012 to 2022, which described at least one report concerning the impact of climate change on health services in LMICs, were included. Studies were organized based on their key characteristics, which included the date of publication, objective, method, limitations, participants, and geographical focus. The Mixed-Methods Appraisal Tool (MMAT) was used to assess the risk of bias in the included studies. : Twenty-three studies were included in this review. Five areas of health services which align with the WHO building blocks framework were impacted by climate change. These health service areas included: (1) Service Delivery, (2) Human Resources, (3) Health Finance, (4) Healthcare Products and Technology, and (5) Leadership and Governance. However, research concerning the impact of climate change on health information systems, which is part of the WHO building blocks framework, did not feature in our study. The climatic effects were divided into three themes: meteorological effects, extreme weather events, and general. The research in this study found that climate change had a detrimental impact on a variety of health services, with service delivery being the most frequently reported. The risk of bias varied greatly between studies. : Climate change has negatively impacted health services in a variety of different ways, and without further actions, this problem is likely to worsen. The WHO building blocks have provided a useful lens through which to review health services. We built an aligned framework to describe our findings and to support future climate change impact assessments in this area. We propose that further research concerning the impact of climate change on health information systems would be valuable, as well as further education and responsible policy changes to help build resilience in health services affected by climate change.
本研究的目的是评估气候变化对卫生服务的影响，这些卫生服务按照世界卫生组织创建气候适应型卫生系统的“构件”进行分类。目标是对已发表的有关气候变化影响的文献进行系统综述，采用主题分析方法来实现我们的目标并确定进一步研究的领域。2022年2月8日，我们使用Embase和PubMed研究数据库进行了检索。纳入了2012年至2022年以英文发表的、描述了至少一份关于气候变化对低收入和中等收入国家卫生服务影响报告的同行评审科学研究。研究根据其关键特征进行组织，这些特征包括发表日期、目标、方法、局限性、参与者和地理重点。使用混合方法评估工具（MMAT）来评估纳入研究中的偏倚风险。本综述纳入了23项研究。与世界卫生组织构件框架一致的五个卫生服务领域受到了气候变化的影响。这些卫生服务领域包括：（1）服务提供，（2）人力资源，（3）卫生筹资，（4）医疗产品和技术，以及（5）领导与治理。然而，作为世界卫生组织构件框架一部分的关于气候变化对卫生信息系统影响的研究在我们的研究中并未出现。气候影响分为三个主题：气象影响、极端天气事件和一般影响。本研究中的研究发现，气候变化对各种卫生服务产生了不利影响，其中服务提供是最常被报道受到影响的方面。不同研究之间的偏倚风险差异很大。气候变化以多种不同方式对卫生服务产生了负面影响，而且如果不采取进一步行动，这个问题可能会恶化。世界卫生组织的构件提供了一个有用的视角来审视卫生服务。我们构建了一个与之相符的框架来描述我们的研究结果，并支持该领域未来的气候变化影响评估。我们建议，关于气候变化对卫生信息系统影响的进一步研究将很有价值，同时还需要进一步开展教育并进行负责任的政策变革，以帮助增强受气候变化影响的卫生服务的适应能力。
