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December 2008 Edition

In Focus
New PAHO Tool Measures Hospital Safety

Boy taking his anti-malarial medicines
PAHO's new Hospital Safety Index can identify improvements needed to ensure that hospitals and other health facilities can keep functioning following disasters. Photo by Gilles Collette/PAHO
A new assessment tool—the Hospital Safety Index—from the Pan American Health Organization (PAHO) offers a rapid, low-cost method to evaluate the safety and reliability of health facilities during disasters or other emergencies.

Developed originally by PAHO's Disaster Mitigation Advisory Group and other outside experts, the Hospital Safety Index provides a way of estimating the probability that hospitals and other health facilities will be able to continue providing health care during floods, hurricanes, earthquakes, and other natural disasters. The index helps authorities decide which health facilities should have priority for improvements and what improvements are needed to enable them to function in emergency situations.

"It's not a substitute for a detailed, in depth study of vulnerability, but it means you don't have to approach hospital safety in an all-or-nothing manner," said Jean-Luc Poncelet, chief of PAHO's Emergency Preparedness and Disaster Response program.

"It allows you to improve a facility's safety in a gradual, prioritized way." The Hospital Safety Index is available as a tool kit and includes the following:

  • A Guide for Evaluators of Safe Hospitals, which provides theoretical and methodological guidance on the assessment process, from planning to question-answering, to calculating the index.
  • A form titled "General Information on the Health Facility," to be completed by the hospital emergency committee.
  • A "Safe Hospitals Checklist" for use by evaluation teams. It consists of 145 items whose assessment results are used to calculate the index.
  • The "Safety Index Calculator," an electronic spreadsheet that provides the final calculations of the index.

The Hospital Safety Index has already been used in a number of PAHO member countries. Preliminary results from Bolivia, Ecuador, and Peru suggest that nonstructural factors such as architectural features, basic installations, and equipment contribute more to vulnerability than structural factors. Those results also point to the importance of having a legal framework for actions that need to be taken to reduce vulnerability.

The index has also been used in Anguilla, Barbados, Dominica, Granada, Montserrat, and St. Vincent and the Grenadines, where hospitals are being upgraded according to the index results. Also, Mexico has trained and certified 336 professionals to participate in multidisciplinary safety evaluation teams and has already applied the index to more than 100 hospitals, starting with those located in high-risk zones.

Jamaica and Trinidad and Tobago are currently making plans to apply the index in various hospitals, and Central American countries are providing training for evaluators and developing new safe hospital plans.

The entire Hospital Safety Index tool kit can be downloaded at For more information, e-mail This e-mail address is being protected from spambots. You need JavaScript enabled to view it .


World Health Day 2009 to spotlight 'hospitals safe from disasters'

Keeping hospitals safe from disasters will be the focus of World Health Day 2009.The campaign will emphasize the important role hospitals and other health facilities play in saving lives and reducing suffering in the aftermath of disasters. It will focus on the need to ensure that these health facilities can continue to function when they are most needed by designing and building new facilities that are disaster-resistant and implementing measures to reduce risks in older ones.

The campaign will target a number of audiences, including the public and policy-makers as well as health professionals, who can play a vital role by identifying and reducing risks in their own health facilities.

The campaign will focus on the importance of both the structural integrity of facilities and the functional continuity of services, recommending, for example, that health workers receive training in disaster preparedness.

The World Health Day campaign will build on and culminate theWorld Disaster Reduction Campaign 2008–2009 on "Hospitals Safe from Disasters."

World Health Day is celebrated each year on April 7 and marks the anniversary of the founding of the World Health Organization (WHO) in 1948.


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