Systemic sustainability and resilience assessment of health systems, addressing global societal priorities: Learnings from a top nonprofit hospital in a bioclimatic building in Africa

Abstract

Health services represent a cornerstone to ensure well-being and human rights everywhere, particularly in deprived areas with limited access to resources. We investigate the resource cost and appropriate use for the implementation of a top-quality hospital in Sudan. An integrated Life-Cycle Assessment and systems-based Emergy Accounting approach is applied to assess its sustainability and resilience. Very few similar studies have addressed civil works so far, even less bioclimatic buildings, while our focus on health systems is an absolute novelty. Particular attention is paid to bioclimatic design in adverse climate and economic conditions, to the humanitarian nongovernmental organisation running the hospital, and to the cutting-edge medical staff and technologies imported from abroad that at the same time allow local practitioners to train in excellence medicine. The system's direct and indirect socio-ecological requirements are expressed as emergy (resource investment) per patient-day, per cardiac surgical operation, per outpatient visit, and per year. From a quantitative viewpoint, these indicators represent a benchmark for improvement scenarios, comparison with new studies in a deserving field, and future investments, driven by effective healthcare policies. They also provide an overview of the efforts required by nature and society to ensure a human right in conditions of scarcity. In addition to the possibility to lower a hospital's environmental impact (sustainability-oriented) and to keep it functioning over time in changing climate, resource, societal, economic, and geo-political scenarios (resilience-oriented), this study leads to original remarks upon societal priorities and upon the challenges of guaranteeing high-quality health systems in an uncertain century. Highlights: • A layout and novel indicators are introduced for the evaluation of health systems • Health provision crucially relies on societal priorities and resource allocation • Remarkable performances in sustainable resource use are reached in our case study • The largest fraction of embedded energy lies in medical labour and services • Savings from a bioclimatic building can further pursued through this approach

Emergy-Based Evaluation on the Systemic Sustainability of Rural Ecosystem under China Poverty Alleviation and Rural Revitalization: A Case of the Village in North China

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Whose Health in Whose City? A Systems Thinking Approach to Support and Evaluate Plans, Policies, and Strategies for Lasting Urban Health

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Emergy-based comparative analysis of an ecological economy in the Yangtze River Delta

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