| 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% |