Environmental determinants of health and community health behaviours and any existing poor practice environment related health provision behaviours might increase health needs and the use of health items as well as increasing the need for staff.

Ensure traditions are safeguarded if needed, such as different transportation vehicles for men and women.

Climate change
Natural Resource depletion
Impact on wellbeing / mental health

• Additional staff can increase air pollution and greenhouse gas – emissions if additional travel is required
• Additional use of fossil fuels if expatriate staff are employed

Travel and transportation required used by staff to move between countries releases greenhouse gases, contributing to climate change. Expat staff tend to use greater quantities of fossil fuels for household cooking, heating and ventilation and tend to consume more natural resources through local and international purchases.

Use of local staff wherever possible. Minimise transport when possible. Source staff accommodation that maximises the use of natural heating, cooling, and lighting where possible.

When recruiting or relocating staff the environmental impacts of transportation and energy used need to be considered. Greenhouse gas emissions from travel can easily be reduced by recruiting local staff where they are available and training them where necessary. This has other benefits such as staff who understand local languages, customs, and behaviours and retention of knowledge and expertise within a country of need, as well as contributing to the local economy and lower environmental footprints of local staff.

Encourage or require staff to share transport and trips to maximise vehicle usage efficiency and reduce emissions.

Be aware of the displacement and emigration of healthcare workers during the conflict.

Promote and enable the use of public transport and non-motorized transportation wherever safe to do so (cycling and walking) for staff as well as for patients and visitors. This is also good for people’s physical and mental health.

UNICEF responding to the Covid-19 spread in Yemen demonstrated that there were existing trained health staff available in the community who could be incentivised to return to work in the public health sector and help reduce the spread of the disease. Their refresher training included environmental determinants of health.

# of local staff recruited

# of local staff trained

• Prevention of environmental damage
• Mitigation of environmental damage

Time and resources to assess the skills and competencies of local people and amend recruitment and transfer policies to ensure environmental footprint is reduced.