Project Development Objective:

The objective is to build a program to assess and strengthen
health care system resilience to natural disasters and pandemics. The
team will draw on the accumulated experience and expertise of
infrastructure and Disaster Risk Management (DRM) communities and adapt the
framework to health care system resiliency analysis. The project will define
resilience from the perspective of the people that depend on health services,
and identify and prioritize measures to strengthen the resilience of health
care provision. Such a human-centric approach is important to reflect the
complexities of resilient health care provision, especially when accounting for
gender, age, disability, socioeconomic and environmental factors.

The project will address several key areas of health system
resilience: understanding and estimating the demand for and capacity of
health services from a system perspective; understanding and quantifying risks
of disruptions in services or surges in demand due natural disasters and health
crises (including pandemics); health care system and cross sectoral
preparedness, value of using early warning systems and anticipation of shocks
to health care system as evident by COVID-19 global pandemic, importance of
preparedness for rapid response and recovery; and the value of building back
better and strengthening of the health care system and integration with wider
emergency management frameworks to ensure open and inclusive accessibility to
health services when needed the most.

An innovative program on emergency preparedness, building on
experience and active engagements. The GFDRR and Health team have
already begun developing a suite of operational tools to strengthen the way in
which World Bank projects support health care system resilience. To further
advance this agenda, the team will build on extensive expertise in analysing
the challenges in health care systems, as well as infrastructure resilience.
Several engagements with client countries (such as Caribbean countries, Peru,
Vietnam) can serve as pilots for further scaling the contribution of this work.
In a timely and multisectoral collaboration this program will build on
innovative analytical tools to deliver more resilient and effective World Bank

This program will consider quality infrastructure systems as the
foundation for a functioning health care system. The
effective response to pandemics and/or natural disasters depends not only on
the health care system itself, but also on its supporting lifeline
infrastructure. Electricity and clean water supplies are essential for the
delivery of care, while transport networks are key to ensure efficient access to
facilities during time-sensitive emergencies. Hence, it is important that
analytical based decision support tools for preparedness and response efforts
account for the inter-dependence of these systems. This consideration becomes
especially vital for compound risks – as countries are confronted with natural
shocks, while continuing to deal with the COVID-19 pandemic.

Issues the project will address:

The World Bank’s Health Group and GFDRR are well placed to assess
the disaster and pandemic preparedness of health care systems and the
infrastructure systems on which they rely – and to support projects that
address health care system resilience. In
particular, we seek to offer project-level technical assistance in the
following areas in order to support the pandemic and disaster preparedness of
client countries:

1. Health care facilities: Demand,
capacity and readiness for shocks. Are health care systems
prepared to meet the routine and surge demand for health care services due to
common shocks, including natural disasters? This question is particularly important
when considering the threat of natural shocks while a country is working to
contain a pandemic or demand surge due to seasonal diseases such as the flu.
Data-driven analyses can help to estimate potential demand for health services,
both for routine needs and surge demand due to shocks and pandemics. By
identifying underserved regions and neighbourhoods, such analyses are essential
for prioritizing investments in the capacity and resilience of health care
facilities. For instance, health care facilities in the Caribbean region are
surveyed for hurricane risks periodically; yet, systematic and quantitative
assessments have not followed to strengthen health care capacity and
capabilities. By identifying potential needs and service gaps, such technical assistance
can help design projects that are tailored to strengthening the preparedness
and resilience of health care facilities.

2. Health care systems: Strategies to
increase surge capacity and coordination. Health
care systems in many low- and middle-income countries are not ready to function
as a connected system. In practice, health systems consist of many facilities
providing a vast variety of services. Data-driven analyses can help
facilitating a coordinated response by individual health care facilities to
enable an effective regional and system-level response. This includes the
evaluation of resource and capacity constraints, the design of contingency
plans to prioritize critical supply needs, and the identification of vital
supply chains. Such technical assistance can support direct investments to
strengthen the coordination and supply mechanisms that underpin resilient
health care provision.

3. Health care systems: Integration
and coordination with emergency management at national and local levels. Health
system preparedness needs to be closely coordinated with a country’s overall
emergency preparedness and response systems. The need is most pronounced in
post-disaster situations when multisectoral issues have to be addressed
simultaneously – including meeting basic needs such as food and shelter, and
the provision of essential public services such as security, social safety
nets, rescue and healthcare. Effective coordination is particularly important
at the interface of usually detached systems and agencies; for instance, the
way in which first responders (e.g. the military) coordinate their dispatch and
field operations with the capacity of health care facilities will be crucial to
enable an effective emergency response. Hence a resilient healthcare system
needs to be embedded in an effective disaster risk management framework at the
local and national levels. While the lack of health sector data often hindered
integrated emergency planning, this technical assistance will address these gaps
and support investments in more integrated systems.

4. Lifelines infrastructure for
resilient health care services: Quality infrastructure is
essential for effective health care services – even more so during natural
disasters and pandemics. Without reliable water and electricity supply
treatment centres cannot function. Resilient transport systems are crucial to
ensure equitable access to health care, including for elderly or low-income
households. Data-driven analyses can help to identify areas in which a lack of
infrastructure quality is obstructing an efficient response to the COVID19
pandemic. Such technical assistance can help direct investments and policy
actions towards resilient infrastructure projects – in a way that strengthens
the resilience of health care services.

Understanding the data to support this
analytical work in itself is crucial as various information layers have to be
harmonized and overplayed to evaluate the natural disaster and pandemic risks
and to evaluate health care system and infrastructure resiliency.

Sendai Priorities

Priority 1Understanding disaster risk
Priority 2Strengthening disaster risk governance to manage disaster risk
Priority 3Investing in disaster risk reduction for resilience
Priority 4Enhancing disaster preparedness for effective response and to “Build Back Better” in recovery, rehabilitation and reconstruction