Hospital Safety Index training in the former Yugoslav Republic of Macedonia


As part of the Biennial Collaborative Agreement 2016–2017, WHO supported the organization of a Hospital Safety Index training in the former Yugoslav Republic of Macedonia, in cooperation with the Ministry of Health. The training took place on 19–21 April 2017, in Ohrid. It aimed to improve the skills of hospital representatives to carry out full hospital assessments, and consequently to improve hospital safety and reduce human and economic losses during disasters and health emergencies.

The 30 participants included representatives from hospitals country-wide, as well as representatives from university clinics for paediatrics, cardiology and infectious diseases.

“We hope the training will reduce the risks of losing functionality of hospitals during disasters and mitigate the suffering of people affected by disasters,” said Dr Mihail Kochubovski, the WHO National Counterpart for Disaster Preparedness and Response in his opening speech.

The country is challenged by frequent natural disasters such as earthquakes and severe flooding, which have the potential to cause injuries, deaths, population displacements, destruction of health facilities and disruption of health-care services. Thus capacity-building and training become imperative at all levels, to prepare for an emergency – from knowledge sharing to ensuring health-care services are safe, effective and available to those in need.

The training comes after WHO launched the Hospital Safety Index (Second Edition) in 2015, which is an assessment tool for safety and preparedness of hospitals, and released the Comprehensive Safe Hospital Framework, which guides the development and implementation of the Safe Hospital programmes at national, subnational and facility levels.

Following the training, the participants will perform an evaluation of their respective hospitals under supervision of a national team of experts in the area of health systems and disaster preparedness and response. In addition, a detailed Hospital Safety Index assessment will be undertaken, with WHO support, in eight selected health institutions: the general hospitals in Gevgelija, Kumanovo, Ohrid, Prilep, Skopje, Strumica and Veles, as well as the clinical hospital in Bitola. The criteria and requirements of the Hospital Safety Index will be embedded into the country’s hospital accreditation process.

A detailed report with recommendations will be developed for each of the hospitals, as well as a summary report.


After the Pan American Health Organization (PAHO) and WHO released the first version of the Hospital Safety Index in 2008, the growing interest in safe hospitals led to calls from countries and other stakeholders for the revision of the Index to make it a truly global assessment tool, applicable to all hazards and all country contexts. The new Hospital Safety Index meets the specific considerations of regions, including sections on assessing the availability and training of the health workforce and the security of health facilities, staff and patients.

The Hospital Safety Index provides a snapshot of the probability that a hospital or health facility will continue to function in emergency situations, based on structural, nonstructural and functional factors, including the environment and the health services network to which it belongs. By determining a hospital’s Safety Index or score, countries and decision-makers will have an overall idea of its ability to respond to major emergencies and disasters. The Hospital Safety Index does not replace costly and detailed vulnerability studies; however, because it is relatively inexpensive and easy to apply, it is an important first step towards prioritizing a country’s investments in hospital safety.

The ‘WHO Hospital Safety Index – Guide for evaluators’ (2015) provides a step-by-step explanation of how to use the Safe Hospitals Checklist, and how the evaluation can be used to obtain a rating of the structural and nonstructural safety, and the emergency and disaster management capacity of the hospital. The guide is intended and has been used by ministries of health and other health entities, other government ministries and agencies, and public and private hospitals across the six regions of the WHO.