Fig 1.
Revised ClimHB integrative conceptual framework.
In our conceptual model, access to healthcare is achieved when the health services available (supply-side) meet the population’s needs (demand-side). However, in a context where climate change may lead to disruptive events on both the demand and the supply sides, health systems will change (collapse, deteriorate, recover, improve) through a process of resilience influenced by their exposure, sensitivity, and capacity to adapt. It follows that health system resilience will impact access to care, population health, and socio-ecological outcomes. Finally, it is essential to note that population health is not solely linked to the health system; other factors outside it also shape population health.
Fig 2.
Demand-side of healthcare access and health system resilience in the context of climate change and population (im)mobilities.
Fig 3.
Supply-side of healthcare access and health system resilience in the context of climate change and (im)mobilities.
Fig 4.
Resilience and outcome of resilience of healthcare access and health system resilience in the context of climate change and (im)mobilities.
Fig 5.
ClimHB conceptual framework adapted to healthcare providers.
Coloured elements are areas they can act upon or are affected by.
Fig 6.
ClimHB conceptual framework adapted to the case study of Bangladesh.
Fig 7.
ClimHB conceptual framework adapted to the case study of Haiti.
Fig 8.
ClimHB simplified conceptual framework.
This simplified figure shows, on the same plane, that although their relationships are complex (Fig 1), the 10 dimensions are to be considered to study and strengthen the resilience of a health system facing multiple shocks (1 and 4). It should be noted that resilience is not only a process (exposure, sensitivity, adaptation) but also an outcome (7) aimed at guaranteeing access to healthcare (8).