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

RENEWABLE & SUSTAINABLE ENERGY REVIEWS

卷:141

Article

Cristiano, S.^1,2,3,4  Ulgiati, S.^4,5  Gonella, F.^2,3 

[1] Univ Ca Foscari Venezia, Dept Environm Sci Informat & Stat, I-30172 Venice, Italy

[2] Univ Ca Foscari Venezia, Dept Mol Sci & Nanosyst, I-30172 Venice, Italy

[3] Univ Ca Foscari Venezia, Res Inst Complex, I-30123 Venice, Italy

[4] Univ Napoli Parthenope, Dept Sci & Technol, I-80143 Naples, Italy

[5] Beijing Normal Univ, Sch Environm, Beijing 100875, Peoples R China

关键词: Emergy accounting;    Systems thinking;    Healthcare;    Resilience;    Sustainable design;    Bioclimatic building;    Sudan;    Energy poverty;    Renewables;    Resource use;    Geographical divide;    Ethics;    Socio-ecological sustainability;   

DOI  :  10.1016/j.rser.2021.110765

来源: Elsevier

【 摘 要 】

Health services represent a cornerstone to ensure well-being and human rights, particularly in deprived areas. The resource cost and appropriate use for the implementation of a top-quality hospital in Sudan are here investigated. An emerging approach such as systems-based Emergy Accounting is applied to assess its sustain ability and resilience, also relying on Life-Cycle Assessment data to calculate some new unit emergy values. Very few similar studies have addressed civil works so far, even less bioclimatic buildings, while the focus on health systems is an absolute novelty. Particular attention is paid to 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, also letting local practitioners 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. Besides 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.

【 授权许可】

Free