World Health Day

How to safeguard health facilities

Retrofit existing facilities


If a health facility is assessed as being unsafe, posing a threat to health or liable not to function in an emergency, retrofitting should be considered to improve its resilience. The challenge of undertaking such a project and the costs involved have in the past been cited as impediments to retrofitting health facilities.


The cost of structural retrofitting – such as bracing, reinforcement or other engineering interventions – can vary greatly according to the situation, but it may be a necessary investment in the safety of the health facility and the security of the health care system in emergencies. Retrofitting non-structural elements for a small cost – as little as 1% of the value of a hospital – may protect up to 90% of the hospital's assets, such as equipment and medicines.

WHO/PAHO/J. Vizcarra

Low-cost measures can also improve a hospital’s safety and its ability to function after emergencies. In Nepal, a study found that spending US$ 150 000 on non-structural mitigation measures in nine hospitals – securing equipment and medicines – made them better able to function in a moderate earthquake. The findings showed that before the improvements, 20% of hospitals would be able to function partially after an earthquake and 80% would be out of operation. But with the mitigation measures implemented, 20% of hospitals would be fully operational after an earthquake and 80% at least partially operational.

Retrofitted health centres in the Cayman Islands were virtually undamaged during Hurricane Ivan in 2004, as were five Costa Rican hospitals retrofitted before a 1990 earthquake. Preventive savings far exceeded the cost of retrofitting.