The Smart Hospital initiative builds on the Safe Hospital Initiative and focuses on improving hospitals' resilience, strengthening structural and operational aspects and providing green technologies. Energy improvements include solar panels installations, electric storage batteries, and low-consumption electrical systems, which, in addition to reducing energy consumption, reduce health sector carbon footprint in the environment and provide the hospital with energy autonomy, allowing it to continue running during emergencies and disasters.
Piloted in 2012 in Saint Vincent and the Grenadines and St. Kitts and Nevis, the Smart Hospitals project is one of PAHO’s largest partnership initiatives, together with the United Kingdom’s Foreign, Commonwealth and Development Office (FCDO).
Smart Hospitals have already shown their cost-effectiveness and resilience to disasters.
In St. Vincent and the Grenadines, Georgetown Hospital (benefiting from the intervention of a Smart hospital) was the only one that remained functional after a severe storm-affected 39 clinics and the reference hospital (Milton Cato Hospital). In addition, this hospital became a water supply center for the community after the storm, using rainwater reserves. In Jamaica after the passage of hurricane Melissa in 2025 all four smart facilities remained functional. Caribbean countries are encouraged to tackle global challenges including climate change and diseases by using smart standards in all health facilities.
Smart Tool Kit
This Smart Hospitals Toolkit is designed for hospital administrators, health disaster coordinators, health facility designers, engineers and maintenance staff to help assess disaster safety levels and energy consumption and provide recommendations and action plans for the implementation of interventions aimed at improving resilience, conserving resources, cutting energy costs and dependency, increasing energy efficiency in operations, and reducing carbon emissions.
This Toolkit is comprised of previously developed instruments such as the Hospital Safety Index, the Green Checklist and other accompanying tools aiming to guide healthcare facilities in the process of linking their structural and operational safety with green interventions, at a reasonable cost-to-benefit ratio and become Smart.
According to the Disaster Risk Reduction Action Plan 2016-2021, 77% (13,566 / 17,618) of the Region's hospitals are in at-risk areas and require urgent repair measures to protect the lives of staff and patients during and after a disaster. The International Panel on Climate Change Report AR53 indicates that extreme weather events (heat waves, storms, floods, droughts, wildfires) will occur in the coming years, leading to a decrease in available water, reduced food production, and an increase in vector-borne and other diseases, making the vulnerability of ecosystems and human systems much more evident.
Health systems will be among the most vulnerable to climate variability (according to the AR5 Report). The effects of climate change are variable; however, it is necessary to create conditions to reduce vulnerabilities before the effects manifest themselves.
PAHO has been providing technical assistance to Caribbean countries for the implementation of the Smart Hospitals initiative in phases I and 2 (2012-2014 and 2015-2023 respectively).
Making Healthcare Facilities Smart
Integrating Disaster Risk Reduction, Climate Change Adaptation, Environmental Management, and Conservation Efforts
Smart Health Care Facilities in the Caribbean aims to support safer, greener health facilities capable of delivering care during disasters and has already been implemented in more than 10 Caribbean countries with the support of strategic partners.
Many health facilities in the Caribbean are in areas of high risk and need strengthening in the face of repeated damage or increasing climate threats. Health care facilities can also be large consumers of energy, with a significant environmental footprint. With energy prices in the Caribbean among the highest in the world, savings could be better used on improving services. Natural hazards and climatic extremes, like hurricanes, earthquakes, floods and storm surge can cause significant disruption of health services and economic losses. Downtime, during and after an extreme event, limits the ability of health facilities to provide emergency care to victims and ongoing healthcare for their communities.
The purpose of the 'Smart Health Care Facilities in the Caribbean' is to provide safer, greener health facilities to deliver care in disasters. This project, funded by the UK Foreign, Commonwealth and Development Office (FCDO) was implemented by PAHO/WHO in partnership with the Ministries of Health in target countries.
A toolkit for retrofitting existing or new facilities and technical standards were developed and tested in St. Kitts and St. Vincent and the Grenadines.
The toolkit provides a step-by-step guide and includes the Hospital Safety Index (HSI), Baseline Assessment Tool (BAT), and Green Checklist and utilizes cost-benefit analysis to support investment decision making. Scale-up of the project, also supported by DFID, was implemented in seven Caribbean countries: Belize, Dominica, Grenada, Guyana, Jamaica, Saint Lucia and Saint Vincent and the Grenadines. Other donors like EU and IDB also adopted the project and funded facilities in Belize, Haiti, BVI and Sint Maarten.
Smart champions. DiMAG meeting (November 2025).
PAHO has been providing technical assistance to Caribbean countries for the implementation of the Smart Hospitals initiative in phases I and 2. As part of an external evaluation of the Smart Hospital Project, this video shows and focuses on the aim of the project, its results, lessons, and recommendations for future similar projects to increase the resilience of the health sector.
