O-17 Methodologies for assessing water sanitation and hygiene resilience in climate-vulnerable primary care facilities: a critical review for Guyana
Author(s):
N Persaud
Year of Presentation:
2026
Objective: This study reports on a critical review of global
methodologies for assessing the climate resilience of Water,
Sanitation, and Hygiene services in primary health care settings. It specifically evaluates the WHO’s WASH FIT v2.0
and PAHO’s Smart Hospitals Toolkit against the unique
hydrological realities of Guyana, proposing an integrated
framework for the local context.
Methods: The research employed a desk review and comparative analysis of international frameworks (WHO/ UNICEF JMP, GLAAS), Guyana’s Low Carbon Development Strategy (LCDS) 2030, and post-implementation evaluations of the “Smart Health Care Facilities” project. A dual-lens approach assessed tool applicability for both flood-prone coastal zones (Regions 2–6) and drought-susceptible hinterland communities (Regions 1, 7–9).
Results: The PAHO Smart Hospitals Toolkit offers superior engineering metrics for structural hardening (e.g., wind/flood resistance), evidenced by retrofits at Diamond Diagnostic Centre. However, its high technical resource requirements limit scalability for Level 1 and 2 facilities. Conversely, WHO WASH FIT v2.0 excels in operational management and behavioral change but historically lacks the rigorous hydraulic indicators necessary for Guyana’s catastrophic flood events. Evaluations indicate that structural retrofitting without soft-systems management remains a critical failure point.
Conclusion: Neither framework in isolation is sufficient for Guyana’s multi-hazard profile. A hybrid “Guyana SmartFIT Framework” is proposed, embedding the structural rigor of the Smart Toolkit into the iterative management cycle of WASH FIT. Supported by LCDS 2030 carbon financing, this approach offers a sustainable pathway for securing continuity of care.