Informing resilience-building in Colombia’s health system through a risk exposure and vulnerability-based assessment

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Informing resilience-building in Colombia’s health system through a risk exposure and vulnerability-based assessment


Few investments are as critical for population health, people’s livelihoods, and effective emergency response as those that make health systems resilient. 

According to the overwhelming consensus of the scientific community, the trend of disasters becoming more frequent and more severe will only continue, increasing pressure on health systems worldwide, especially in the poorest countries. Confronted with these challenges, health systems need to adapt and prepare to ensure continued access to life-saving services for all people, including the most vulnerable populations. Interventions to increase health systems’ resilience to shocks and their ability to maintain services and accessibility can also improve the quality and accessibility of routine care. 

Against this backdrop, in recent years, the Colombian government has worked on a range of policy and legislative instruments to increase resilience of the country’s health sector. With support from GFDRR, under the auspices of the Japan–World Bank Program for Mainstreaming Disaster Risk Management in Developing Countries, a technical team has been supporting Colombia in using innovative analytics to inform its resilience-building efforts in the health sector while also strengthening cross-sectoral collaboration. That support has been provided in the context of a request from the Colombian Ministry of Health to perform a climate and disaster hazard assessment of its health system. 

The analytical work undertaken by the team includes estimates for facility and population risk exposure to flooding and landslides, two of the most common natural disasters in Colombia. It also includes estimates on exposure to risk factors that are likely to change significantly with climate change, such as exposure to extreme heat and extreme cold. Geospatial results showed that primary health care facilities serving between 17 and 25 million people are directly exposed to the risk of flooding or landslides, and about 1 in 5 health care facilities are directly exposed to disruptive floods. The results of the analytical work will be published in a forthcoming World Bank report on climate and health, the first flagship report on that topic from the institution. 

As part of the analytical work, the team also developed a tool that enables the combined assessment of risk exposure and vulnerability indicators of people and infrastructure elements—in this case, health facilities—to identify the communities with the highest need for policy intervention. The new tool facilitates the inclusion of social vulnerability criteria to effectively target the most vulnerable populations, such as women, the elderly, or indigenous groups and ethnic minorities, while simultaneously accounting for risk exposure and availability of health services. 

Over the course of the policy engagement and dialogue in support of the analytical work, the team was able to strengthen links between different government actors and regional stakeholders, promoting cross-sectoral cooperation for health system resilience. In bi-weekly meetings, key partners included Colombia’s Department of Environmental Health, its National Health Institute, and its Department of National Planning. The French Development Agency (AFD), which co-financed the work, also had a seat at the table. Further participants included the government’s Disaster Risk Management Unit and the Pan American Health Organization (PAHO). These links are highly important in creating awareness of the cross-sectoral impacts that development projects can have on health sector resiliency and disaster preparedness. By accounting for cross-sectoral co-benefits, projects can reach more people effectively and investments can become more efficient. 

Looking ahead, this analytical work is expected to inform a forthcoming World Bank project that aims to upgrade the resilience of health facilities in Colombia to shocks, among others. The project will prioritize health facilities based on the tool assessing both risk exposure and vulnerability indicators made possible through this engagement. This prioritization will represent the adoption of a systemwide approach to risk exposure and vulnerability, as called for by the GFDRR and World Bank Lifelines report. 

Across the globe, the way in which governments prioritize their resilience investments must be constantly responsive to the ever-evolving climate and disaster risks. The hope here is that through this engagement, policy makers in Colombia will begin to have the tools they need to make that happen. In doing so, Colombia will lay the foundations for a health system resilient in the face of evolving challenges while simultaneously improving access to health services for the most vulnerable people. As this engagement illustrates, GFDRR is in a unique position to strengthen cross-sectoral collaboration and to promote the importance of disaster risk management expertise in other sectors while increasing health systems’ resilience to shocks.


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