School of Public Health, Climate change and health research center, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran.
School of Nursing and Midwifery, Saveh University of Medical Sciences, Saveh, Iran.
BMC Health Serv Res. 2024 Sep 30;24(1):1149. doi: 10.1186/s12913-024-11621-9.
Climate change is a long-term systematic climate variability caused by human activities that alters the composition of the global atmosphere. Health systems should be adaptive and resilient to climate change. Hence, this research aimed to strategically analyze the resilience of Iran's health system to climate change.
This study utilized a multiple methods approach. First, in-depth semi-structured interviews were conducted with 32 key climate change and health experts to identify the strengths, weaknesses, opportunities and threats of the Iranian health system's resilience to climate change. Purposeful and snowball sampling techniques were used to ensure maximum diversity among the participants. Then, a questionnaire was developed based on the findings of the first stage and was completed by 33 climate change and health experts. Finally, the strategic position of Iran's health system's resilience to climate change was determined using the internal - external factors matrix.
A total of 84 internal factors and 101 external factors were identified that affect the resilience of Iran's health system against climate change. The internal factors were categorized into seven dimensions (i.e., governance and leadership; health financing; health workforce; facilities, equipment and medicines; health information system; health services delivery, and key results). The external factors were categorized into six dimensions (i.e., political, economic, social, technological, environmental, and legal factors). The average score of internal and external factors were 2.47 and 2.12, out of 4 respectively. Iran's health system was found to be in the strategic position of V in terms of resilience to climate change. Therefore, precautionary strategies such as strengthening the climate resilience of healthcare facilities, promoting healthcare facilities' adaptation to climate change, public-private partnership, strengthening the health service delivery system, quality management and cost management, should be implemented to strengthen the resilience of Iran's health system to climate change.
Iran's health system is facing significant weaknesses and challenges that have hindered its resilience to climate change. Iran's health system can better prepare and respond to the health impacts of climate change, and safeguarding the health and well-being of its population by addressing these challenges and implementing adaptive and resilience strategies.
气候变化是由人类活动引起的长期系统性气候变异性，它改变了全球大气的组成。卫生系统应适应和抵御气候变化。因此，本研究旨在战略性分析伊朗卫生系统对气候变化的适应能力。
本研究采用了多种方法。首先，对 32 名气候变化和健康方面的专家进行了深入的半结构化访谈，以确定伊朗卫生系统对气候变化的适应能力的优势、劣势、机会和威胁。采用目的性和滚雪球抽样技术，以确保参与者之间的最大多样性。然后，根据第一阶段的研究结果，开发了一份问卷，并由 33 名气候变化和健康专家填写。最后，使用内部-外部因素矩阵确定伊朗卫生系统对气候变化的适应能力的战略地位。
共确定了 84 个内部因素和 101 个外部因素，这些因素影响了伊朗卫生系统对气候变化的适应能力。内部因素分为七个维度（即治理和领导、卫生筹资、卫生人力、设施、设备和药品、卫生信息系统、卫生服务提供和主要成果）。外部因素分为六个维度（即政治、经济、社会、技术、环境和法律因素）。内部和外部因素的平均得分分别为 4 分中的 2.47 分和 2.12 分。伊朗的卫生系统在适应气候变化方面处于战略地位 V。因此，应采取预防策略，如加强医疗设施的气候适应能力、促进医疗设施适应气候变化、公私伙伴关系、加强卫生服务提供系统、质量管理和成本管理，以加强伊朗卫生系统对气候变化的适应能力。
伊朗卫生系统面临着重大的弱点和挑战，这些弱点和挑战阻碍了其对气候变化的适应能力。伊朗卫生系统可以通过应对这些挑战和实施适应性和恢复力战略，更好地为气候变化对健康的影响做好准备并做出响应，保障其人口的健康和福祉。
