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Table 4 The consensus over 75% on components related to the functions and policymaking of health system in Iran extracted from Paris Agreement on climate change

From: Health system plan for implementation of Paris agreement on climate change (COP 21): a qualitative study in Iran

  Pillar1: Mitigation Mean ± SD Consensus (%)
1 Limiting the greenhouse gas emissions from health buildings and facilities 4.00 ± 0.73 75%
2 Participation of the Ministry of Health in formulation of strategies, programs and implementation of mitigation measures by emphasizing on the health effects of climate change 4.37 ± 0.80 93.8%
3 Improving the efficiency of energy carriers and using renewable and clean energies in health centers and all health-related manufacturing units, including cosmetics, health, and pharmaceuticals 4.12 ± 0.50 93.8%
4 Reducing the energy, water, and waste production consumption in the health services and manufacturing centers 4.18 ± 0.54 93.8%
5 Reducing fossil fuel consumption in the health services and manufacturing centers 3.93 ± 0.92 81.2%
6 Intergovernmental cooperation in formulation and implementation of mitigation laws 4.31 ± 1.07 87.5%
7 Paying attention to the resolutions of the supreme council regarding health and food security on formulation of laws on climate change 4.25 ± 0.68 87.5%
Pillar 2: Adaptation
  Capacity building Mean Consensus (%)
8 Increasing the capacity of healthcare infrastructures and providing safe facilities based on population needs and density for more coverage of health services related to climate change consequences 4.18 ± 0.65 87.5%
9 Implementing structural, non-structural, and functional measures in hospitals and health centers to reduce the vulnerability to the consequences of extreme climate events 4.00 ± 0.89 75%
10 Using the laboratory networks to quickly detect and control the communicable diseases sensitive to climate change 4.12 ± 0.95 75%
11 Increasing the access to safe and sanitary water 4.87 ± 1.25 75%
12 Using indigenous and local capacity for adaptation to health effects of climate change 4.18 ± 0.83 87.5%
13 Developing the guidelines for protecting and adapting the people in jobs sensitive to climatic variables 3.93 ± 1.18 75%
14 Developing the strategies for resilient health system to cope with the health consequences of climate change 4.00 ± 1.09 87.5%
15 Promoting the healthcare procedures in order to cope with the adverse health effects of climate change 4.18 ± 0.75 81.2%
16 Identifying the vulnerable groups in relation to the consequences of climate change and performing special protective interventions for them 4.43 ± 0.89 87.5%
17 Participation of the health system in formulation of national adaptation plan 4.62 ± 0.61 93.8%
18 Developing the public health insurance coverage to increase the adaptation to the consequences of climate change 4.18 ± 0.75 81.2%
19 Formulating the protocols for identification of the diseases and healthcare intervention for diseases sensitive to climate change 4.62 ± 0.80 93.8%
20 Establishing the membership of the Ministry of Health in national and international working groups on climate change 4.56 ± 0.51 100%
21 Applying prevention and control measures for emerging and re-emerging diseases caused by climate change 4.62 ± 0.55 100%
22 Applying the interventions to control climatic risk factors 4.43 ± 0.62 93.8%
23 Providing the provincial adaptation plans according to their risks 4.56 ± 0.62 93.8%
24 Providing the health services related to the health effects of climate change equitably and without discrimination on the grounds of sex and ethnicity 4.25 ± 1.06 87.5%
25 Providing the national plans for nutrition management in extreme climate events such as floods, heat waves, and cold waves 4.18 ± 0.65 87.5%
26 Providing the National Adaptation Strategy and Plan of Action (NASPA) for health issues related to climate changes by the Ministry of Health 4.81 ± 0.40 100%
27 Providing the healthcare preparedness plans for extreme climate events to reduce the mortalities and injuries 4.43 ± 0.51 100%
28 Creating an Incident Command System (ICS) in case of extreme climate events to quickly respond to such emergencies 4.25 ± 0.68 87.5%
29 Saving health-related resources in order to become prepared against the extreme climate events 4.06 ± 0.68 81.2%
30 Integrating the comprehensive risk assessment plans for extreme climate events in the health service delivery system 4.31 ± 0.60 93.8%
  Advocacy Mean Consensus (%)
31 Involving the participation of the public and private institutions in the measures related to climate change 4.00 ± 0.89 75%
32 Performing the intergovernmental cooperation on nutrition policies, especially in critical situations 4.00 ± 0.96 81.2%
33 Implementing the international agreements and partnerships to control the communicable diseases through the borders 4.56 ± 0.72 87.5%
  Technology development and transfer Mean Consensus (%)
34 Collaboration of the Ministry of Health with the universities in applying new technologies for adaptation 4.06 ± 0.77 75%
35 Reducing the waste production in the health centers and hospitals using modern methods of re-engineering the processes and upgrading the existing systems 4.23 ± 0.68 87.5%
36 Modernization and rehabilitation of the technologies and processes to reduce energy consumption in the pharmaceutical and sanitary industries 4.00 ± 0.81 81.2%
37 Using modern methods to predict the outbreak of climate change-sensitive diseases 4.43 ± 0.51 100%
  Financial affairs Mean Consensus (%)
38 Encouraging the authorities to allocate the funds in order to reduce the health effects of climate change in the country’s annual budget 4.18 ± 1.10 81.2%
39 Funding for topics related to the health and climate change in the Ministry of Health 4.31 ± 1.01 93.8%
40 Obtaining macroeconomic support at the High Council of Economics on climate change and health issue 4.12 ± 0.80 75%
41 Providing the insurance coverage for the health centers to enhance the resilience in extreme climate events 3.06 ± 0.92 75%
  Assessment, evaluation and monitoring Mean Consensus (%)
42 Continuous and systematic monitoring of the processes and measures taken to deal with the health effects of climate change 4.00 ± 1.15 75%
43 Vulnerability assessment of different population groups 4.06 ± 1.06 75%
44 Evaluating the effectiveness of adaptation and mitigation measures 4.06 ± 1.18 81.2%
45 Monitoring health information to provide early warning about the health effects of climate change 4.56 ± 0.62 93.8%
46 Cooperation with the country’s meteorological organization in monitoring of climatic variables (temperature and precipitation), amount of pollutants, and suspended particulate matter 4.00 ± 1.09 75%
47 Evaluating the effectiveness of adaptation interventions 4.50 ± 0.63 93.8%
48 Using health data in simulation and prediction models of disease burden 4.43 ± 0.72 87.5%
49 Monitoring of diseases sensitive to climate change through the national system in order to register the diseases 4.56 ± 0.51 100%
50 Monitoring of the climatic abnormalities including pollutants, dust, heat waves, cold waves, and providing related health plans 4.18 ± 0.98 87.5%
51 Diagnosing and rapid treatment of climate change-related diseases 4.31 ± 0.60 93.8%
52 Developing early warning and monitoring systems for heat and cold stresses as well as climate hazards 3.93 ± 1.34 75%
53 Assessing the deaths and injuries caused by the extreme climate events 4.06 ± 0.80 81.2%
  Education and research Mean Consensus (%)
54 Providing scientific evidence related to health and climatic variables in order to implement the health-related interventions 4.31 ± 0.60 93.8%
55 Increasing the knowledge and skills of health system staff about direct and indirect health effects of climate change 4.75 ± 0.44 100%
56 Collaboration with other educational institutions to strengthen the research and transfer of scientific knowledge related to health and climate change 4.37 ± 0.61 93.8%
57 Holding the conferences and workshops in relation to adaption to the effects of climate change 4.25 ± 0.68 87.5%
58 Collaboration with the public and private institutions to promote the education on health-related effects of climate change 4.25 ± 0.68 87.5%
59 Integrating the research findings into health policy-making to reduce the health risks 4.50 ± 0.63 93.8%
60 Developing human and research resources in the studies related to the health and climate change 4.18 ± 0.98 75%
61 Developing the educational headings on increasing the adaptation, reducing the vulnerability, and mitigation for students and university graduates 4.37 ± 1.02 93.8%
62 Collaboration with the international research centers to apply the updating science on the health effects of climate change 4.43 ± 0.81 93.8%
63 Increasing the possibility of participation and presence of health researchers in academic communities associated with climate change 3.81 ± 0.75 75%
64 Using the modern science and knowledge to enhance the individual and community adaptation 4.06 ± 1.06 81.2%
65 Performing the applied research to create individual and community adaptation in order to deal with the health effects of climate change 4.18 ± 0.83 75%
  Reporting and sharing information Mean Consensus (%)
66 Sharing the information and knowledge between the academic centers, the Ministry of Health and other relevant organizations to prevent the parallel works 4.12 ± 1.02 87.5%
67 Active participation of the health sector in climate change conventions and related scientific assemblies 4.37 ± 0.80 93.8%
68 Using all the available information and information synergies between the partner organizations 4.18 ± 0.83 75%
69 Applying the experiences and lessons learned from international conventions by the health system 4.50 ± 0.63 93.8%
70 Providing continuous and periodic reports on health system achievements and interventions for controlling the health effects caused by the climate change 4.50 ± 0.63 93.8%
71 Holding annual and joint reviews meetings, and generalization of successful experiences and lessons learned from meetings of national groups and international agencies by the Department of Environment 4.06 ± 0.92 75%
  Public education Mean Consensus (%)
72 Cultivating and raising the public and individual awareness about the health effects of climate changes 4.56 ± 0.51 100%
73 Cooperation with the medias to develop the educational programs for health warning related to climate change by the Ministry of Health 4.68 ± 0.47 100%
74 Providing the education in schools and higher education institutions about climate change and related health effects 4.31 ± 0.60 93.8%
75 Conducting the public and specialized conferences on health and climate change 4.00 ± 0.89 75%
76 Providing the educational packages including videos and pamphlets by the Ministry of Health on how to use personal protective equipment and adapt to health-related consequences of climate change 4.25 ± 0.77 81.2%
77 Increasing the public awareness about self-care in coping with the climatic disasters 4.62 ± 0.71 87.5%
78 Publishing the results of the research associated with climate change for the public 4.25 ± 0.68 87.5%
79 Enhancing the ability and readiness of the community to counteract the adverse health effects of climate change and extreme climate events 4.18 ± 0.75 81.2%