Flood impacts on healthcare facilities and disaster preparedness – A systematic review

Abstract

Hydrometeorological hazards, particularly floods and cyclones, pose significant threats to human health, including fatalities, damage to healthcare facilities (HCFs), and disruptions to health services. This study systematically reviewed scientific articles to identify the direct and indirect impacts of floods on HCFs and the risk management strategies implemented to address these challenges. To that end, we searched four databases (MEDLINE, Embase, Web of Science and Scopus) for articles written in English. Our search query included terms related to flood and cyclone hazards, HCF types and disaster risk management strategies. We followed the PRISMA guidelines to conduct the study. The search resulted in 7500 records, which were finally filtered down to 74 studies after removing duplicates, screening records and full article eligibility checks. Approximately 76 % of the included studies addressed cyclone-related flood impacts and were conducted in the United States. Hospitals were the most studied HCFs (n = 54) followed by long-term care facilities (n = 11). The main impact of floods on hospitals was due to flooded basements as they house important services including equipment, supplies and backup generators. Interruptions of electricity and water supplies were reported to cause serious challenges. Regarding flood risk management, patient evacuation was mentioned by more than 66 % of the studies while few studies reported the implementation of structural measures. More than a third of the studies reported the availability of preparedness plans. The review revealed inconsistencies in the flood preparedness of HCFs. The main policy recommendations are the availability of guidelines to standardize preparedness plans and oversight. • The review analyzed 74 scientific articles written in English and published before November 2023. • Most studies focused on hurricane-induced flooding of hospitals and were conducted in the United States. • Evacuation was the most reported flood risk reduction measure although its implementation was challenging. • Healthcare facilities' disaster preparedness was not consistent and improvement is necessary. • More publications from flood-prone countries and on non-hospital facilities are needed to strengthen global evidence.

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