International Strategy for Disaster Reduction
Latin America and the Caribbean   

Newsletter ISDR Inform - Latin America and the Caribbean
Issue: 13/2006- 12/2006 - 11/2005 - 10/2005 - 9/2004 - 8/2003 - 7/2003 - 6/2002 - 5/2002 - 4/2001- 3/2001



Guidelines for Vulnerability Reduction in the Design of New Health Facilities

It is almost a rule that hospital services are disrupted, temporarily or permanently, particularly due to the damage caused to their infrastructure when affected by large-scale natural phenomena. The loss of the functional capacity of health facilities not only represents a loss of investment but, most importantly, involves a great negative impact to the well-being and social and economic development of the population and the country at large.

In recent years, several member States of PAHO/WHO have been able to reduce the vulnerability of some of their hospital facilities, which successfully resisted the effects of disasters. This has shown that even countries with limited resources have the capacity to provide their populations with health facilities resistant to natural hazards.

This publication, prepared in cooperation with the WHO Collaborating Center on Disaster Mitigation in Health Facilities, at the University of Chile, proposes three protection levels to cope with adverse events: life protection, infrastructure protection, and operations protection.

PAHO/WHO recommends that all essential facilities of a hospital be built bearing in mind the third protection level, and that new health facilities at large be built, at minimum, with the first protection level.

International experience has shown that the cost of building a new hospital and applying this philosophy does not increase by more than 4% to achieve the third protection level. This maximum cost –which authorities, planners, implementing bodies and financial agents should take into account, is low compared to the potential social, political and economic impact that represents the disruption or total loss of such services when they are needed the most. However, if innovative approaches are introduced during the stage of design and selection of a new facility’s site, it is possible that these structures may be safer and more efficient without increasing such costs.

This book helps formulate projects, keeping in mind this new vision. It is intended for administrators, professionals and technical advisers in the field of health who are responsible for managing, designing, building and inspecting health facility projects.

This document is available on the Internet at