{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T19:43:28Z","timestamp":1790106208902,"version":"4.0.1"},"reference-count":52,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>With the rise in climate emergencies come complex challenges for the field of health systems that require equally complex strategies. Acknowledgement of the pressures experienced by health systems in relation to CC is increasing, but it remains understudied. This article aims to strengthen the link between climate and health systems by examining how health systems can incorporate resilience strategies to better respond to extreme weather events. Framed by an explorative literature search, the policy analysis dives into the content of the Health National Adaptation plans of both Fiji and Tanzania in relation to the WHO Operational Framework for building a climate-resilient health system. Our findings suggest updating the WHO Framework by adding additional elements under each component and by adding new components, namely human mobility and humanitarian aid. We recommend following a step-by-step \u2018system approach\u2019 to facilitate the integration of resilience building within health systems and to acknowledge the iterative aspect of this process.<\/jats:p>","DOI":"10.3390\/ijerph22081258","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T11:02:09Z","timestamp":1754910129000},"page":"1258","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Bridging the Gap Between Climate and Health Systems: The Value of Resilience in Facing Extreme Weather Events"],"prefix":"10.3390","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5758-4607","authenticated-orcid":false,"given":"Elo\u00efse","family":"Dagneau","sequence":"first","affiliation":[{"name":"Access-To-Medicines Research Center, KU Leuven University, Vlamingenstraat 83, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6536-2772","authenticated-orcid":false,"given":"Sophie Marie","family":"Ehgartner","sequence":"additional","affiliation":[{"name":"Independent Researcher, 2000 Frederiksberg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-4591","authenticated-orcid":false,"given":"Gabriel","family":"Gulis","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Mpandeli, S., Naidoo, D., Mabhaudhi, T., Nhemachena, C., Nhamo, L., Liphadzi, S., Hlahla, S., and Modi, A.T. (2018). Climate Change Adaptation through the Water-Energy-Food Nexus in Southern Africa. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15102306"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1866","DOI":"10.1098\/rsta.2011.0007","article-title":"Global Health and Climate Change: Moving from Denial and Catastrophic Fatalism to Positive Action","volume":"369","author":"Costello","year":"2011","journal-title":"Philos. Trans. R. Soc. A Math. Phys. Eng. Sci."},{"key":"ref_3","unstructured":"Nielsen, N. (2023, January 10). EU Commission Takes Stand Against Danish Asylum Law. Available online: https:\/\/euobserver.com\/migration\/152193."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1146\/annurev-publhealth-012420-105026","article-title":"Extreme Weather and Climate Change: Population Health and Health System Implications","volume":"42","author":"Ebi","year":"2021","journal-title":"Annu. Rev. Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/2224-3151.213789","article-title":"Health Risks of Climate Change in the World Health Organization South-East Asia Region","volume":"6","author":"Bowen","year":"2017","journal-title":"WHO South-East Asia J. Public Health"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e2100796","DOI":"10.9745\/GHSP-D-21-00796","article-title":"Maternal and Child Health Care Service Disruptions and Recovery in Mozambique After Cyclone Idai: An Uncontrolled Interrupted Time Series Analysis","volume":"10","author":"Fernandes","year":"2022","journal-title":"Glob. Health Sci. Pract."},{"key":"ref_7","unstructured":"World Health Organization, International Institute for Sustainable Development (2021). Health in National Adaptation Plans: Review, World Health Organization."},{"key":"ref_8","unstructured":"Anderson, I. (2021). Rich-Country Health Care Systems: Global Lessons, Devpolicy Blog."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"113072","DOI":"10.1016\/j.socscimed.2020.113072","article-title":"Impact of Extreme Weather Conditions on Healthcare Provision in Urban Ghana","volume":"258","author":"Codjoe","year":"2020","journal-title":"Soc. Sci. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1093\/heapol\/czaa032","article-title":"Health System Resilience: A Literature Review of Empirical Research","volume":"35","author":"Biddle","year":"2020","journal-title":"Health Policy Plan."},{"key":"ref_11","unstructured":"World Health Organization (2015). Operational Framework for Building Climate Resilient Health Systems, World Health Organization."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2","DOI":"10.2471\/BLT.15.165050","article-title":"Health Systems Strengthening, Universal Health Coverage, Health Security and Resilience","volume":"94","author":"Kutzin","year":"2016","journal-title":"Bull. World Health Organ."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1080\/17565529.2020.1870425","article-title":"Health System Resilience to Extreme Weather Events in Asia-Pacific: A Scoping Review","volume":"13","author":"Rameshshanker","year":"2021","journal-title":"Clim. Dev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Bikomeye, J.C., Rublee, C.S., and Beyer, K.M.M. (2021). Positive Externalities of Climate Change Mitigation and Adaptation for Human Health: A Review and Conceptual Framework for Public Health Research. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18052481"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"20816","DOI":"10.3402\/gha.v6i0.20816","article-title":"Climate Change Threats to Population Health and Well-Being: The Imperative of Protective Solutions That Will Last","volume":"6","author":"Kjellstrom","year":"2013","journal-title":"Glob. Health Action"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.healthpol.2014.01.007","article-title":"A Review of Health Governance: Definitions, Dimensions and Tools to Govern","volume":"116","author":"Barbazza","year":"2014","journal-title":"Health Policy"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"431","DOI":"10.15171\/ijhpm.2017.36","article-title":"Governance and Capacity to Manage Resilience of Health Systems: Towards a New Conceptual Framework","volume":"6","author":"Blanchet","year":"2017","journal-title":"Int. J. Health Policy Manag."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"14001","DOI":"10.7189\/jogh.12.14001","article-title":"The Contribution of Community Health Systems to Resilience: Case Study of the Response to the Drought in Ethiopia","volume":"12","author":"Rawat","year":"2022","journal-title":"J. Glob. Health"},{"key":"ref_19","unstructured":"World Health Organization (2024). Safe, Climate-Resilient and Environmentally Sustainable Health Care Facilities: An Overview, World Health Organization."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/heapol\/czx183","article-title":"Towards an Understanding of Resilience: Responding to Health Systems Shocks","volume":"33","author":"Hanefeld","year":"2018","journal-title":"Health Policy Plan."},{"key":"ref_21","unstructured":"Kovats, S. (2015). Health Climate Change Impacts Summary Report Card. Living Environ. Change, UK Research and Innovation."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s12940-017-0324-3","article-title":"Impact of Extreme Weather Events and Climate Change for Health and Social Care Systems","volume":"16","author":"Curtis","year":"2017","journal-title":"Environ. Health"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1177\/1355819619840672","article-title":"Coastal Flooding and Frontline Health Care Services: Challenges for Flood Risk Resilience in the English Health Care System","volume":"24","author":"Landeg","year":"2019","journal-title":"J. Health Serv. Res. Policy"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7083","DOI":"10.3390\/ijerph10127083","article-title":"A Review of National-Level Adaptation Planning with Regards to the Risks Posed by Climate Change on Infectious Diseases in 14 OECD Nations","volume":"10","author":"Panic","year":"2013","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"M\u00fccke, H.-G., and Litvinovitch, J.M. (2020). Heat Extremes, Public Health Impacts, and Adaptation Policy in Germany. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17217862"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ebi, K.L., Harris, F., Sioen, G.B., Wannous, C., Anyamba, A., Bi, P., Boeckmann, M., Bowen, K., Ciss\u00e9, G., and Dasgupta, P. (2020). Transdisciplinary Research Priorities for Human and Planetary Health in the Context of the 2030 Agenda for Sustainable Development. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17238890"},{"key":"ref_27","unstructured":"CARE (2018). CARE\u2019s Resilience Marker. CARE Climate Change, Cooperative for American Relief Everywhere."},{"key":"ref_28","unstructured":"Dagneau, E., and Ehgartner, S.M. (2023). Bridging the Gap Between Climate and Health: The Value of Resilience in Facing Extreme Weather Events. [Master\u2019s Thesis, Syddansk Universitet SDU]."},{"key":"ref_29","unstructured":"(2023, May 24). WHO Global Health Expenditure Database. Available online: https:\/\/apps.who.int\/nha\/database\/Select\/Indicators\/en."},{"key":"ref_30","first-page":"1117","article-title":"The Urban Environment and Health in a World of Increasing Globalization: Issues for Developing Countries","volume":"78","author":"McMichael","year":"2000","journal-title":"Bull. World Health Organ."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1186\/s12992-020-00582-3","article-title":"\u2018Calibrating to Scale: A Framework for Humanitarian Health Organizations to Anticipate, Prevent, Prepare for and Manage Climate-Related Health Risks\u2019","volume":"16","author":"Irvine","year":"2020","journal-title":"Glob. Health"},{"key":"ref_32","unstructured":"Government of the Republic of Fiji (2018). Republic of Fiji Natiopnal Adaptation Plan: A Pathway Towards Climate Resilience, Government of the Republic of Fiji."},{"key":"ref_33","unstructured":"United Republic of Tanzania, Ministry of Health, Community Development, Gender, Elderly and Children (2018). Health\u2014National Adaptation Plan (HNAP) to Climate Change in Tanzania 2018\u20132023, United Republic of Tanzania, Ministry of Health, Community Development, Gender, Elderly and Children."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/JOM.0b013e31816fd67b","article-title":"Public Health Responses to the Risks of Climate Variability and Change in the United States","volume":"51","author":"Ebi","year":"2009","journal-title":"J. Occup. Environ. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S282","DOI":"10.4103\/0972-6748.328830","article-title":"Impact of COVID-19 Pandemic on Healthcare Workers","volume":"30","author":"Gupta","year":"2021","journal-title":"Ind. Psychiatry J."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Dall\u2019O\u2019, G. (2020). Disaster Risk Assessment, Reduction and Resilience: Their Reciprocal Contribution with Urban Planning to Advance Sustainability. Green Planning for Cities and Communities, Research for Development; Springer International Publishing.","DOI":"10.1007\/978-3-030-41072-8"},{"key":"ref_37","unstructured":"UNDP (2010). The Real Wealth of Nations: Pathways to Human Development, Human development report; Palgrave Macmillan."},{"key":"ref_38","unstructured":"Torres, J. (2025, January 13). Renolith Business Case, Available online: https:\/\/renolith.com.au\/wp-content\/uploads\/2023\/10\/2023-10-27-Renolith-2.0-Business-Case-v1.7.pdf."},{"key":"ref_39","unstructured":"Rahman, A., Mwanundu, S., and Cooke, R. (2010). Climate Change: Building the Resilience of Poor Rural Communities, IFAD."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"e2841824","DOI":"10.17061\/phrp2841824","article-title":"Climate Change, Health and Wellbeing: Challenges and Opportunities in NSW, Australia","volume":"28","author":"Hime","year":"2018","journal-title":"Public Health Res. Pract."},{"key":"ref_41","unstructured":"Soete, L., Albrecht, J., Callaert, J., Benczur, P., Elfie, B., Hobza, A., and Veugelers, R. (2024). Conference on R&D, Innovation, Sustainability, and the Societal Impact of New Technologies, BELSPO."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e367","DOI":"10.2196\/jmir.8775","article-title":"Beyond Adoption: A New Framework for Theorizing and Evaluating Nonadoption, Abandonment, and Challenges to the Scale-Up, Spread, and Sustainability of Health and Care Technologies","volume":"19","author":"Greenhalgh","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_43","unstructured":"Akenji, L., and Bengtsson, M. (2022). Enabling Sustainable Lifestyles in a Climate Emergency, United Nations Environment Programme, Hot or Cool Institute."},{"key":"ref_44","unstructured":"Ministry of Health and Medical Services (2016). Climate Change and Health Strategic Action Plan 2016\u20132020: Building Climate-Resilient Health System in Fiji, Ministry of Health and Medical Services."},{"key":"ref_45","unstructured":"The Congo Research Group (CRG) (2020). Ebola in the DRC: The Perverse Effects of a Parallel Health System, NYU Center on International Cooperation."},{"key":"ref_46","unstructured":"International Federation of Red Cross and Red Crescent Societies, Asia Pacific Regional Office (2017). Health and Care for Migrants and Displaced Persons\u2014Case Studies from the Asia Pacific Region, International Federation of Red Cross and Red Crescent Societies, Asia Pacific Regional Office."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1016\/j.pt.2018.07.004","article-title":"Human Mobility and the Global Spread of Infectious Diseases: A Focus on Air Travel","volume":"34","author":"Findlater","year":"2018","journal-title":"Trends Parasitol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e217","DOI":"10.1016\/S2542-5196(20)30125-X","article-title":"Human Mobility, Climate Change, and Health: Unpacking the Connections","volume":"4","author":"McMichael","year":"2020","journal-title":"Lancet Planet. Health"},{"key":"ref_49","unstructured":"IOM Migration, Environment and Climate Change (MECC) Division (2023). Climate Change Impacts on Health Affecting Development and Human Mobility, IOM Migration, Environment and Climate Change (MECC) Division."},{"key":"ref_50","first-page":"101","article-title":"On the Coloniality of Global Public Health","volume":"6","author":"Richardson","year":"2019","journal-title":"Med. Anthr. Theory"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"j2323","DOI":"10.1136\/bmj.j2323","article-title":"Building Resilient Health Systems: A Proposal for a Resilience Index","volume":"357","author":"Kruk","year":"2017","journal-title":"BMJ"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"759","DOI":"10.2471\/BLT.15.167031","article-title":"Climate Change, Food, Water and Population Health in China","volume":"94","author":"Tong","year":"2016","journal-title":"Bull. World Health Organ."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/8\/1258\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:24:41Z","timestamp":1760034281000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/22\/8\/1258"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,11]]},"references-count":52,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["ijerph22081258"],"URL":"https:\/\/doi.org\/10.3390\/ijerph22081258","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,11]]}}}