Introduction

This guide was developed in the context of the Healthy Environments for Healthy Children (HEHC) Framework, which highlights that children’s health is strongly shaped by environmental conditions and by the capacity of health services to respond safely and continuously in the face of climate and environmental risks. Although a growing number of technical documents address resilient, safe, and sustainable health facilities, most are written from engineering, infrastructure, or systems-design perspectives, and relatively few focus specifically on the practical implications for primary health care (PHC), maternal and child health, and low- and middle-income country settings. This document responds to that gap by translating relevant technical measures into a more accessible format that can support discussion and decision-making among health managers, planners, and health professionals. [1–4]

This guide was developed in the context of the Healthy Environments for Healthy Children (HEHC) Framework, which highlights that children’s health is strongly shaped by environmental conditions and by the capacity of health services to respond safely and continuously in the face of climate and environmental risks. Although a growing number of technical documents address resilient, safe, and sustainable health facilities, most are written from engineering, infrastructure, or systems-design perspectives, and relatively few focus specifically on the practical implications for primary health care (PHC), maternal and child health, and low- and middle-income country settings. This document responds to that gap by translating relevant technical measures into a more accessible format that can support discussion and decision-making among health managers, planners, and health professionals. [1–4]

As shown in the following Table, the reference base used to structure this glossary brings together several types ofdocuments with complementary roles. At the broadest level, health-sector frameworks help explain why climate resilience, environmental sustainability, and primary health care matter for health systems, but they do not
usually provide enough detail to guide facility-level decisions on specific infrastructure measures [1–2]. Cross-cutting technical guidance fills part of this gap by addressing health facility resilience, safety, and sustainability across planning, design, operation, hazard assessment, and emergency functioning. These documents are essential for framing service continuity and climate risk, but they are still often written at a general facility level
and not specifically for PHC or child health priorities [3–5].

A more practical group of references provides retrofit-oriented and implementation-focused guidance, especially for small and medium-sized facilities in hazard-prone settings. These materials are particularly useful because they translate broad resilience concepts into more realistic discussions of retrofitting, procurement, and incremental upgrading [6–8]. Other references are narrower and more service-specific, focusing on areas such as WASH, off-grid energy, and lighting. These are critical because they connect infrastructure decisions with day-to-day service quality, infection prevention, and continuity of care, especially in resource-constrained settings [9–11].

Finally, some references are much more engineering-heavy and are especially useful for technical measures related to drainage, flood protection, roof systems, openings, utilities, and wind resistance [12–13]. These documents provide strong technical grounding, but on their own they do not fully address PHC realities,
operational constraints, or maternal, newborn, and child health priorities. For this reason, they need to be interpreted alongside more health-sector and PHC-oriented references. Additional operational and maintenance documents help bridge this gap by linking resilient design with routine facility management, practical retrofit
choices, and maintenance-dependent interventions [14–18]. Supporting spreadsheet tools were also used for internal screening and comparative review, although they function differently from narrative guidance documents [19–20]. Each measure is also supported by selected complementary references that provide more specific technical evidence where relevant.

Taken together, this reference base provides a strong foundation, but it also shows an important limitation: existing guidance is often either too broad, too specialized, or too engineering-focused to directly support everyday PHC planning. This glossary was therefore structured to bring these sources into a more accessible and PHC-relevant form, with particular attention to low- and middle-income settings and to maternal, newborn, and child health services.