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The World Health Organization (WHO) has been assisting health authorities in preparing for the challenges posed by climate change for more than 20 years by implementing a risk management approach to strengthen health systems, learn from these efforts, and share information to support critical collaborations and partnerships. The Operational Framework for Building Climate Resilient Health Systems was published by WHO in 2015 to help users conduct vulnerability and adaptation (V&A) assessments, develop comprehensive medium- and long-term adaptation plans (e.g., Health National Adaptation Plans (HNAPs), and design and implement climate change and health interventions and programs. The Operational Framework outlines ten health-system functions that are required to boost climate resilience, which are organized around the six building blocks that underpin UHC delivery.

Climate action, climate-resilient health systems, and resilience in existing health systems functioning are all related ideas. Despite the fact that these phrases have a variety of definitions, they nonetheless have several fundamental characteristics in common. In the context of climate change, the Intergovernmental Panel on Climate Change (IPCC) defines resilience as "the ability of social, economic, and environmental systems to cope with a hazardous event, trend, or disturbance, responding or reconfiguring in ways that preserve their essential function, identity, and structure while also maintaining the capacity for adaptation, learning, and transformation." Independent of climate change, health system resilience can be defined as the ability of health actors, institutions, and populations to plan for and respond effectively to crises, sustain essential operations when a crisis occurs, and restructure if conditions warrant it. Climate-resilient health systems are those that can anticipate, respond to, cope with, recover from, and adapt to environment-related shocks and stresses in order to achieve long-term population health benefits despite an unstable climate. This definition emphasizes that resilience is measured at the system level. Health systems are made up of several actors, infrastructure, and activities, as well as cooperation with other sectors and entities.

This paper provides insights into the routine monitoring of climate-related shocks and stresses that will affect each of the ten health-system functions specified in the Operational Framework, in order to identify gaps that must be addressed to improve preparedness for a changing climate.

Climate resilience is needed in the four fundamental requirements for providing safe and quality health care in the context of climate change: (i) health workforce – adequate numbers of skilled human resources, with decent working conditions, empowered and informed to respond to environmental challenges; (ii) water, sanitation, hygiene, and health care waste management – the sustainable and safe management of water, sanitation, and health care waste services; (iii) energy – sustainable and resilient energy services; and (iv) infrastructure, technologies, and products – appropriate infrastructure, technologies, products and processes, including all the operations that allow for the efficient functioning of a healthcare facility.

This report aids health authorities at all levels, from local to national, in charting progress towards establishing health systems that protect communities from existing climate-related hazards while also being prepared for future climate shocks and stressors. Because many of the actions and success indicators are applicable to decisions made by decision-makers in other sectors, this report can also help them with their adaptation efforts. To that end, it proposes a paradigm and method for quantifying the climate resilience of health systems.