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Blom IM, Eissa M, Mattijsen JC, Sana H, Haines A, Whitmee S. Effectiveness of greenhouse gas mitigation intervention for health-care systems: a systematic review. Bull World Health Organ 2024; 102:159-175B. [PMID: 38420573 PMCID: PMC10898283 DOI: 10.2471/blt.23.290464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 10/09/2023] [Accepted: 11/06/2023] [Indexed: 03/02/2024] Open
Abstract
Objective To identify evidence-based interventions that reduce greenhouse gas emissions in health-care systems in low- and middle-income countries and explore potential synergies from these interventions that aid climate change adaptation while mitigating emissions. Methods We systematically searched 11 electronic databases for articles published between 1990 and March 2023. We assessed risk of bias in each article and graded the quality of evidence across interventions in health-care operations, energy and supply chains. Findings After screening 25 570 unique records, we included 22 studies published between 2000 and 2022 from 11 countries across six World Health Organization regions. Identified articles reported on interventions spanning six different sources of emissions, namely energy, waste, heating and cooling, operations and logistics, building design and anaesthetic gases; all of which demonstrated potential for significant greenhouse gas emission reductions, cost savings and positive health impacts. The overall quality of evidence is low because of wide variation in greenhouse gas emissions measuring and reporting. Conclusion There are opportunities to reduce the greenhouse gas emissions from health-care systems in low- and middle-income countries, but gaps in evidence were identified across sources of emissions, such as the supply chain, as well as a lack of consideration of interactions with adaptation goals. As efforts to mitigate greenhouse gas intensify, rigorous monitoring, evaluation and reporting of these efforts are needed. Such actions will contribute to a strong evidence base that can inform policy-makers across contexts.
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Affiliation(s)
- Iris Martine Blom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, England
| | - Mohamed Eissa
- Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | - Andy Haines
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, England
| | - Sarah Whitmee
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, Keppel Street, Bloomsbury, London, WC1E 7HT, England
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Blom IM, Asfura JS, Eissa M, Mattijsen JC, Sana H, Haines A, Whitmee S. A systematic review protocol for identifying the effectiveness of greenhouse gas mitigation interventions for health care systems in low- and middle-income countries. Wellcome Open Res 2023; 7:202. [PMID: 38601328 PMCID: PMC11004597 DOI: 10.12688/wellcomeopenres.18005.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 04/12/2024] Open
Abstract
Background: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs). Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. Methods: This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. Discussion: This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.
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Affiliation(s)
- Iris Martine Blom
- Population Health, London School of Hygiene & Tropical Medicine, London, UK
| | | | | | | | - Hamaiyal Sana
- Bolan University of Medical & Health Sciences, Quetta, Pakistan
| | - Andrew Haines
- Centre on Climate Change and Planetary, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah Whitmee
- Centre on Climate Change and Planetary, London School of Hygiene & Tropical Medicine, London, UK
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Blom IM, Rupp I, de Graaf IM, Kapitein B, Timmermans A, Sperna Weiland NH. Putting planetary health at the core of the medical curriculum in Amsterdam. Lancet Planet Health 2023; 7:e15-e17. [PMID: 36608942 DOI: 10.1016/s2542-5196(22)00316-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 11/07/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Iris Martine Blom
- Department of Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
| | - Ines Rupp
- Department of Public and Occupational Health, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Irene Maria de Graaf
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Berber Kapitein
- Paediatric Intensive Care Unit, Emma Children's Hospital, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Anne Timmermans
- Department of Obstetrics and Gynaecology, Amsterdam University Medical Centers, Amsterdam, Netherlands
| | - Nicolaas H Sperna Weiland
- Department of Anaesthesiology, Amsterdam University Medical Centers, Amsterdam, Netherlands; Centre for Sustainable Healthcare, Amsterdam University Medical Centers, Amsterdam, Netherlands
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Blom IM, Asfura JS, Eissa M, Mattijsen JC, Sana H, Haines A, Whitmee S. A systematic review protocol for identifying the effectiveness of greenhouse gas mitigation interventions for health care systems in low- and middle-income countries. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.18005.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Climate change is predicted to be our century's most significant health threat. In 2021, 46 countries committed to environmentally sustainable low carbon health care systems. Of those, 34 were from low- and middle-income countries (LMICs). Currently, health systems are responsible for 4.4% of global greenhouse gas (GHG) emissions, with health systems in high-income countries (HICs) contributing the largest proportion to the sector's GHG emissions. However, future increases are predicted in LMICs in the absence of robust GHG mitigation. This systematic review aims to identify evidence-based GHG mitigation interventions to guide the transformation of health care systems towards net zero, specifically in LMICs. Additionally, potential synergies between interventions that aid adaption to climate change and mitigate GHG emissions will be investigated. Methods: This protocol will follow the 'Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) checklist of recommended items to address in a systematic review protocol'. A comprehensive search will be conducted on electronic databases identified as relevant. Search terms were identified to capture all relevant peer-reviewed, primary research published between 1990 and 2022. The risk of bias will be assessed, and the quality of evidence graded. The eventual narrative synthesis will feed into a theory of change framework on GHG mitigation of health care systems in LMICs. Discussion: This systematic review will synthesise the existing evidence around GHG mitigation interventions across all scopes of emissions, including scope 1 (health care operations), scope 2 (energy), and scope 3 (supply chains). It can be used to inform recommendations on how health care systems in LMICs can reduce emissions while prioritising which actions to take to gain the most significant reductions in GHG emissions, considering ease of implementation, scope and cost. Finally, this can catalyse further research in this area which is urgently needed.
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Martin A, Blom IM, Whyatt G, Shaunak R, Viva MIF, Banerjee L. A Rapid Systematic Review Exploring the Involvement of Medical Students in Pandemics and Other Global Health Emergencies. Disaster Med Public Health Prep 2022; 16:360-372. [PMID: 32873349 PMCID: PMC7550875 DOI: 10.1017/dmp.2020.315] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/29/2020] [Accepted: 08/07/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The role of medical students in the current coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving. The aim of this review is to explore the involvement of medical students in past global health emergencies, to help inform current and future scenarios. METHODS A rapid systematic review was undertaken, including articles from online databases discussing the roles, willingness and appropriateness of medical student involvement in global health emergencies. Data were extracted, appraised and written up as a narrative synthesis. This study was registered with PROSPERO (CRD42020177231). RESULTS Twenty-eight articles were included. Medical students played a wide variety of clinical and nonclinical roles including education and logistics, although medical assistance was the most commonly reported role. Challenges included a lack of preparedness and negative mental health impacts. A total of 91.7% of included articles about willingness found medical students were more willing to be involved than not. CONCLUSIONS This review shows medical students are capable and willing to be involved in global health emergencies. However, there should be clear protocols for the roles that they play, taking into account the appropriateness. As a rapid review, there were study limitations and more research is required regarding the impact of these roles on medical students and the system.
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Blom IM, Campos LN, El Amine Youcef Ali M, Asyura MMAZ, von Metnitz DZ, Limann B, Janušonytė E. Youth versus pandemics: the role of future generations in the pandemic treaty. The Lancet Global Health 2021; 9:e1361-e1362. [DOI: 10.1016/s2214-109x(21)00307-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 11/29/2022]
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Wabnitz KJ, Guzman V, Haldane V, Ante-Testard PA, Shan Y, Blom IM. Planetary health: young academics ask universities to act. Lancet Planet Health 2020; 4:e257-e258. [PMID: 32681890 PMCID: PMC7363431 DOI: 10.1016/s2542-5196(20)30142-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 05/29/2020] [Indexed: 05/06/2023]
Affiliation(s)
- Katharina-Jaqueline Wabnitz
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; London School of Hygiene and Tropical Medicine, London, UK
| | - Viveka Guzman
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; Division of Population Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Victoria Haldane
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; University of Toronto, Toronto, ON, Canada
| | - Pearl Anne Ante-Testard
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; Laboratoire MESuRS and Unité PACRI, Institut Pasteur, Conservatoire National des Arts et Métiers, Paris, France
| | - Yina Shan
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; University of Toronto, Toronto, ON, Canada
| | - Iris Martine Blom
- Planetary Health Alliance Campus Ambassadors, Boston, MA, USA; University of Amsterdam, 10 12 WX Amsterdam, Netherlands.
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