MSH’s Gashaw Shiferaw on Training Health Workers for Climate Resilience

No one knows where and when the next pandemic will strike, but the world needs to be ready when it does. Management Sciences for Health (MSH) helped many countries respond to the COVID-19 pandemic, and we should look to the lessons learned to inform future preparedness efforts. A focus of our work with the USAID Medicines, Technologies, and Pharmaceutical Services (MTaPS) Program included updating—and in some cases creating—standard operating procedures and health worker training on infection prevention and control (IPC), medical waste management, and emergency supply chain management. With climate change already affecting health, what can health systems and health workers do to mitigate the impact? MSH Principal Technical Advisor Gashaw Shiferaw tells us about his experience in the Philippines and how pandemic-related courses are being adapted to make health systems more climate resilient.

What links climate change with IPC practices at health facilities, medical waste management, and emergency supply chains?

Climate change is increasing the frequency and intensity of extreme weather events—floods, landslides, typhoons—that damage health care infrastructure and increase the risk and spread of infectious diseases.

Climate-driven health emergencies generate more medical waste due to the increased use of disposable personal protective equipment, syringes, testing materials, and other supplies. This waste must be managed and disposed of properly to avoid further contamination and harm.

Climate disasters can also disrupt global and local supply chains, sometimes cutting off access to essential and lifesaving medical products. That challenge only adds pressure to the new channels of services created to serve those affected by a disaster.

To mitigate weather-related shocks to supply chains, infection control efforts, and medical waste management, we must build resilient and sustainable health systems, with a particular emphasis on service delivery points.

You oversaw the USAID MTaPS Program in the Philippines throughout the COVID-19 pandemic. During that time, the Department of Health developed manuals and standard operating procedures for IPC, medical waste management, and emergency supply chains. Can you tell us why such guidance was needed and how it informs the current work adapting it to climate resilience?

During the pandemic, health workers all over the world faced unprecedented infection risk, large volumes of medical waste, and shortages of personal protective equipment and other supplies. Having clear guidance on standardized IPC measures, proper medical waste management practices, and knowledge around setting up and managing emergency supply chains at all facilities became a crucial part of the response. MTaPS, the Philippines Department of Health, and other partners developed standard manuals and trained health workers. Those manuals helped workers follow proper IPC, medical waste management, and emergency supply chain practices and identify the resources they need and the staff responsible for executing each step.

We directly supported 42 hospitals to implement those standards, and the manuals were uniformly implemented across all public and private health facilities in the country.

As we continue strengthening health systems and preparing for the future, we need to make sure that the lessons learned from the COVID-19 response are integrated and sustainable. One strategy we employed was to adapt all of the materials we used to train facility staff during the pandemic to an eLearning platform so that more health workers can easily complete the training at their own pace.

The manuals and guidelines developed remain highly relevant for health workers in their daily operations, equipping them with the necessary tools and knowledge to effectively manage routine tasks. These resources are also crucial for preparing health workers to respond to disasters, including those related to climate change. By providing clear protocols and best practices, the manuals ensure that health personnel are adequately equipped to navigate challenges and maintain essential health services during emergencies.

What do those courses cover, and how do they help build climate resilience?

The courses are comprehensive—covering foundational aspects of IPC, medical waste management, and emergency supply as well as self-assessments and monitoring tools, feedback loops, and of course specific aspects within each area. For example, the medical waste management course covers legislative, regulatory, and policy aspects of health care waste. The emergency supply chain course breaks the topic down into three core categories, each with key elements essential for effective emergency response: people and processes, commodity planning, and logistics and transport.

We used a training-of-trainers approach guided by adult learning theories, experiential learning, and teaching back practices in addition to the technical content.

While the courses were prepared during the COVID-19 pandemic, they are designed to enhance the capacity of health systems to mitigate infection risks, manage medical waste, and prepare the supply chain to respond to any shock. Transitioning the courses to an eLearning platform and accepting them as continuous professional development credits has made it easier for more health workers to complete the courses at their own pace and prepare themselves for the next climate-related health emergency.

Learn more: Preparing health workers to respond to health emergencies due to climate change in the Philippines