Measuring Climate Resilience and Health-System GHG Emissions: What WHO's 2026 Indicators Mean for Viet Nam
GLOBAL FRAMEWORKS & GUIDANCE · CLIMATE-RESILIENT HEALTHCARE
Last reviewed: October 23, 2026
Imagine a health authority reviewing two reports. One describes the progress made in developing climate preparedness plans, training healthcare workers, and strengthening essential services. The other presents estimates of greenhouse gas emissions associated with healthcare activities.
Both reports may contain encouraging findings, but they answer different questions. The first provides information about the health system's capacity to manage climate-related risks. The second helps explain its environmental impact. Neither, on its own, provides a complete picture of whether healthcare is becoming more resilient, safer, or less carbon-intensive.
The distinction becomes even more important when results are expressed as numerical indicators. A high implementation score may suggest that relevant policies and activities are in place, but it does not guarantee that services will remain safe during every climate-related emergency. Likewise, a reduction in reported emissions does not necessarily mean that an organization has become more environmentally efficient. Changes in clinical activity, reporting boundaries, energy sources, or calculation methods may influence the result.
In March 2026, the World Health Organization published Indicators of Climate Resilience and GHG Emissions in Health Systems, proposing a structured approach to measuring progress toward more climate-resilient and lower-carbon health systems.
The publication is particularly relevant to Viet Nam. WHO has confirmed that the country is participating in pilot work to examine selected indicators, assess available data, consider their practical application, and identify opportunities to strengthen measurement capacity.
For healthcare leaders and professionals, these developments raise questions that go beyond the indicators themselves. What exactly is being measured? How reliable is the information? Can results from different organizations be compared? And how can measurement support decisions that protect patients while reducing unnecessary environmental impacts?
Understanding these questions is essential if climate and health measurement is to become a useful part of healthcare improvement rather than another reporting exercise.
What WHO Introduced in 2026
WHO's Indicators of Climate Resilience and GHG Emissions in Health Systems, published on March 11, 2026, addresses an important gap in monitoring progress toward more climate-resilient and lower-carbon health systems.
The publication builds on WHO's Operational Framework for Building Climate Resilient and Low Carbon Health Systems (2023), which identifies ten interconnected components of health system resilience and emissions reduction.
These components include climate-transformative leadership and governance, a climate-smart health workforce, assessment of climate and health risks and greenhouse gas emissions, integrated monitoring and early warning, health and climate research, climate-resilient and low-carbon infrastructure and supply chains, management of environmental determinants of health, climate-informed health programs, emergency preparedness, and sustainable climate and health financing.
The 2026 publication proposes indicators associated with these components to support assessment, monitoring, planning, and learning.
Its development is linked to WHO's Fourteenth General Programme of Work (GPW-14), which includes two climate-related health system outcomes.
The first concerns strengthening the capacity of health systems to address climate-related health risks and impacts. Progress toward this outcome is measured through an index of national climate change and health capacity.
The second concerns lower-carbon health systems and societies contributing to health and well-being. Its corresponding outcome indicator is greenhouse gas emissions associated with the healthcare sector.
These outcomes are related, but they require different forms of measurement.
Climate resilience concerns the capacity of a health system to anticipate, respond to, cope with, recover from, and adapt to climate-related shocks and stresses while continuing to protect population health.
Greenhouse gas measurement concerns emissions associated with defined activities, resources, goods, and services. It provides evidence for identifying emissions sources, setting reduction priorities, and monitoring environmental performance.
A health system may improve its capacity to respond to climate-related disruption without immediately reducing emissions. Conversely, lower emissions do not automatically demonstrate greater resilience.
WHO's framework brings both objectives into a common planning context while recognizing that the evidence supporting each must be interpreted separately.
An important qualification is that the PDF available through WHO's publication page is labeled Advanced draft version. It contains proposed indicators and an index calculation methodology, but it should not be presented as a mandatory national regulation, an established hospital accreditation standard, or evidence that every measure has been fully validated for all healthcare settings.
Why WHO's Indicator Pilot Matters for Viet Nam
Viet Nam's participation in WHO's indicator pilot provides an opportunity to examine how international measurement approaches work within a healthcare system with diverse geographical, environmental, organizational, and service delivery conditions.
WHO's pilot documentation describes 20 core indicators organized around the ten components of its operational framework. Ten address climate resilience, while the other ten concern actions and capacities associated with reducing greenhouse gas emissions.
The exercise was designed to examine existing information, identify relevant data sources, assess feasibility, and establish an initial understanding of national progress.
In September 2026, WHO reported that Viet Nam was one of two countries selected to test the indicators. WHO Viet Nam and the Ministry of Health's Viet Nam Administration of Disease Prevention convened national and local stakeholders to review the pilot, discuss findings, examine data availability, assess the practicality of the indicators, and identify needs for further capacity development.
This is a meaningful development for climate and health measurement in Viet Nam. It creates an opportunity to understand which data are already available, where definitions may need clarification, and what technical or organizational capabilities would be required for more consistent monitoring.
However, participation in the pilot should not be confused with full validation of the indicators for every hospital, clinic, or healthcare setting in the country.
Nor does the pilot establish that participating organizations have comparable data, that complete national results are publicly available, or that a mandatory facility ranking has been introduced.
The purpose of a pilot is partly to reveal uncertainty and practical limitations. An indicator may be conceptually relevant but difficult to calculate because the required information is incomplete. Another may be feasible at national level but require additional adaptation before it can support decisions at a healthcare facility.
These findings can be valuable even when they identify gaps rather than demonstrate immediate progress.
For Viet Nam, the opportunity lies in developing measurement approaches that are credible, feasible, and relevant to health sector planning, without assuming that an international framework can be applied uniformly across all healthcare organizations.
Health-System Indicators Are Not the Same as Hospital Indicators
One of the most important distinctions in interpreting WHO's work is the level at which an indicator is intended to operate.
A national health system includes hospitals, outpatient services, primary healthcare, public health programs, regulatory authorities, financing arrangements, workforce development, surveillance systems, and relationships with other sectors.
Its ability to respond to climate-related risks depends on more than the condition of individual healthcare buildings.
For example, WHO's proposed climate resilience indicators address areas such as national health adaptation planning, workforce training, integrated monitoring systems, climate-informed health programs, and sustainable financing.
Evidence for these indicators may come from national policies, administrative records, public health information, regional reporting, or several organizations working together.
An individual hospital may contribute relevant information, but that does not mean the national indicator can automatically be used as a hospital performance measure.
The reverse is also true.
A hospital may maintain detailed records concerning equipment, staff training, energy consumption, or service interruptions. These records may support local management, but they do not necessarily describe the resilience of the wider health system.
The facility's performance may also depend on external factors such as referral networks, community access, public health capacity, financing, and infrastructure outside its direct control.
WHO's 2026 publication includes an indicator concerning the proportion of healthcare facilities built or retrofitted to improve climate resilience. This illustrates how facility-level information can contribute to an aggregate health system indicator.
However, reporting the proportion of facilities meeting defined criteria is not equivalent to assigning an officially validated resilience score to each hospital.
Differences in data collection create further challenges. Healthcare organizations may use different definitions, reporting periods, or methods for documenting similar activities. Even when information can be combined into a national result, that result may conceal important differences between geographical areas or types of healthcare facilities.
WHO's proposed indicators are designed primarily for national and subnational monitoring, although healthcare facility managers and local professionals are also among their intended audiences.
An indicator may therefore be relevant to organizational learning without being directly transferable into a hospital-level scoring or certification system.
The appropriate measurement level, population, reporting boundary, and intended use must be understood before a result can be meaningfully interpreted.
WHO Proposes an Index, but What Does It Actually Measure?
The 2026 WHO publication does more than identify indicators. It also proposes a method for calculating composite indexes related to climate resilience and actions intended to reduce greenhouse gas emissions.
The proposed approach uses six implementation levels, ranging from no action at Level 0 to very high implementation at Level 5.
These levels correspond to values of 0, 20, 40, 60, 80, and 100. Each of the ten component indicators receives equal weighting, and the composite index is calculated as their arithmetic mean.
This provides a structured way to summarize progress in developing and implementing relevant health system capacities and activities.
However, the resulting values require careful interpretation.
The proposed climate resilience index primarily reflects progress in establishing and implementing relevant policies, institutional arrangements, systems, and activities. It does not directly measure every aspect of a health system's ability to protect patients during future climate-related emergencies.
Some component indicators concern whether plans exist, personnel have received training, monitoring arrangements have been developed, or specific activities are being implemented.
These are meaningful forms of evidence, but they do not automatically demonstrate that every arrangement will function effectively under disruptive conditions.
The greenhouse gas indicators introduce another distinction.
WHO's publication proposes process indicators that can be combined into an index describing a health system's capacity and actions to reduce emissions.
The document distinguishes this supplementary process index from the GPW-14 outcome indicator for lower-carbon health systems, which concerns actual healthcare sector greenhouse gas emissions.
An index describing progress in developing emissions reduction policies, monitoring arrangements, financing, or technologies is not the same as an emissions inventory expressed in tonnes of carbon dioxide equivalent (tCO₂e).
A health system may have developed comprehensive emissions reduction plans while still lacking reliable information about its actual emissions. Another may report lower emissions without having implemented every institutional arrangement described in the process indicators.
Both types of information can be useful, but they answer different questions.
The equal-weighting method also has limitations. It simplifies calculation and avoids the complexity of assigning different weights, but it does not establish that every component has an identical influence on patient safety, environmental performance, or resilience under real conditions.
Two health systems may receive the same composite value while having very different strengths and weaknesses.
The way missing or uncertain data are treated also matters. An inability to verify that an activity occurred is not necessarily equivalent to establishing that no action was taken. Such situations require interpretation consistent with the methodology and appropriate documentation of uncertainty.
For Climate & Health Vietnam, these distinctions are particularly important.
The existence of a WHO index methodology does not mean that an independently developed hospital score can be presented as an officially validated WHO assessment.
Any adaptation would require a clearly defined purpose, an appropriate methodology, evidence of suitability, and a transparent explanation of its relationship to the original WHO publication.
A proposed health-system capacity index is not automatically a hospital ranking, a patient safety outcome measure, or an accreditation result.
For a professional knowledge-sharing platform, explaining this distinction is more valuable than reproducing a scoring system without the necessary context.
Measuring Preparedness Is Different From Measuring Performance
Climate resilience is challenging to measure because it concerns how a health system functions under changing conditions, including circumstances that may not have occurred during the reporting period.
Some indicators describe whether resources or arrangements exist. Others describe actions implemented, the performance of safeguards, or results observed during actual disruptions.
These forms of evidence have different meanings.
Consider a hospital that reports having backup electricity. The existence of a generator provides information about infrastructure. Maintenance records may show that the equipment has been inspected. A successful operational test provides evidence of its performance under specified testing conditions.
An actual electricity disruption may then reveal whether the system supported the clinical services that depended on it.
Each finding contributes information, but none should automatically be treated as equivalent to the others. A successful test does not guarantee performance during every possible emergency, while the absence of a recent power failure does not demonstrate that backup arrangements are adequate.
For climate resilience, measurement should distinguish between available resources, implementation activities, demonstrated performance, and consequences for healthcare delivery.
WHO's Measuring the Climate Resilience of Health Systems (2022) emphasizes the importance of selecting indicators relevant to health authorities' needs and the climate risks being addressed.
This approach recognizes that resilience cannot be adequately described by a small number of documents or physical resources alone.
A preparedness measure can identify an important capability, but its interpretation should remain connected to the circumstances in which that capability would be needed.
The value of measurement lies in making these differences visible rather than treating every favorable finding as evidence of the same outcome.
Data Availability Does Not Establish Data Quality
Healthcare organizations already collect substantial information for clinical care, administration, finance, quality management, maintenance, and regulatory reporting.
Some of these records may be relevant to climate resilience and greenhouse gas measurement. However, information collected for one purpose may not be suitable for another without further examination.
Consider a hospital that records interruptions to clinical services. One department may document every temporary delay, while another records only interruptions requiring cancellation or patient transfer.
If these records are combined without understanding their definitions, the resulting figure may be misleading.
Similar difficulties arise with energy data, maintenance information, workforce records, purchasing information, and incident reporting.
Data quality depends on completeness, accuracy, consistency, timeliness, traceability, and relevance to the question being examined.
The method used to obtain information also matters. A directly measured value, a calculated estimate, an administrative classification, and a professional assessment may all provide useful evidence, but they do not necessarily offer the same level of certainty.
Where information is estimated, assumptions should be documented. Where records are incomplete or inconsistent, those limitations should remain visible.
It is equally important not to confuse missing evidence with evidence that no action has occurred.
An organization may be unable to confirm whether an activity was implemented because its documentation is incomplete. That is different from establishing that the activity did not take place.
For indicators based on implementation levels, this distinction can influence the interpretation of results.
Missing information should not automatically be assigned the lowest implementation level unless the applicable methodology supports that treatment.
A reasonable response is to identify the uncertainty, determine whether additional verification is possible, and consider how much confidence can be placed in the result.
An imperfect dataset may still support preliminary learning, provided its limitations are understood. It becomes problematic when uncertain estimates are presented as precise or independently verified findings.
Measuring Actual Greenhouse Gas Emissions Requires Clear Boundaries
Greenhouse gas accounting introduces another set of technical considerations.
WHO's Measuring Greenhouse Gas Emissions in Health Systems, published on December 22, 2025, provides an approach to health system emissions measurement aligned with international standards and established practices.
The publication emphasizes that reliable measurement is necessary for identifying major emissions sources, developing reduction priorities, setting targets, and monitoring progress.
It also recognizes that health systems need institutional capacity to collect and maintain consistent information over time.
An important starting point is understanding which activities and emissions sources are included in an assessment.
Under the Greenhouse Gas Protocol, organizational emissions are commonly grouped into three categories.
Scope 1 concerns direct emissions from sources owned or controlled by the reporting organization. Scope 2 concerns indirect emissions associated with purchased electricity, steam, heat, or cooling. Scope 3 covers other relevant indirect emissions occurring across the organization's value chain.
For a healthcare organization, direct emissions may arise from fuel combustion or releases of certain refrigerants. Purchased electricity may contribute Scope 2 emissions. Scope 3 may include emissions associated with purchased medicines, medical devices, consumables, services, waste management, and other relevant activities.
The exact classification depends on the organizational and operational boundaries and the accounting methodology applied.
These distinctions matter because a reduction in one category does not necessarily mean total emissions have fallen.
A hospital may reduce onsite fuel consumption while purchasing additional services from external providers. Emissions associated with those services may occur outside the hospital's direct operations and may be accounted for within the relevant value-chain categories.
Similarly, changes in electricity consumption do not always produce proportional changes in greenhouse gas emissions. The electricity emission factor, reporting period, energy source, and accounting method can influence the calculated result.
International standards also provide relevant methodological guidance. ISO 14064-1:2018 establishes requirements for quantifying and reporting greenhouse gas emissions and removals at the organizational level.
Viet Nam has adopted TCVN ISO 14064-1:2025, which is technically identical to ISO 14064-1:2018. This national standard can provide a relevant technical reference for organizations developing greenhouse gas inventories, although its existence does not automatically establish a legal inventory obligation for every healthcare facility.
Reliable emissions reporting therefore requires more than comparing utility bills, adding together purchasing expenditures, or tracking electricity use from one year to the next.
Why the Reporting Boundary Can Change the Result
An emissions result has limited meaning unless its reporting boundary is understood.
The organizational boundary determines which entities, facilities, and operations are included. The operational or reporting boundary determines which emissions sources and categories are covered.
An assessment of an entire health system may include multiple organizations and service delivery arrangements. A hospital assessment may cover selected buildings, facilities, or activities.
Both approaches may be appropriate for their respective purposes, but their results are not automatically comparable.
Consider two hospitals reporting annual greenhouse gas emissions. One includes purchased electricity, onsite fuel, refrigerants, and selected purchased products. The other includes only electricity and fuel consumed within its buildings.
Even if both report results in tonnes of carbon dioxide equivalent, the figures describe different sets of activities. A lower reported total may simply reflect a narrower reporting boundary.
Results are also influenced by emission factors, calculation methods, assumptions, and the quality of activity data.
Expenditure-based models can help estimate broad categories of emissions when detailed information is unavailable. Such estimates may be useful for identifying potential emissions hotspots, but they are generally less suitable for determining precise differences between individual products than assessments based on appropriate product-specific data.
WHO's 2026 publication recognizes the difficulties of estimating emissions across entire health systems and discusses top-down, bottom-up, and hybrid approaches.
Top-down methods can support system-wide estimates using aggregated information, including economic expenditure data. Bottom-up approaches draw on more detailed information about activities and resources, while hybrid approaches combine elements of both.
Each method has strengths and limitations. The appropriate choice depends on the purpose of the assessment and the quality of available information.
A product-level carbon footprint also addresses a different unit of analysis from an organizational or national healthcare emissions inventory. These methods should not be treated as interchangeable.
Where results are reported, the measurement period, reporting unit, boundaries, calculation methods, assumptions, and significant exclusions should be clear.
Without this information, a numerical result may appear more precise or comparable than the available evidence supports.
Why Hospital Emissions Cannot Be Compared Through Totals Alone
Comparing emissions between healthcare organizations may appear straightforward when results are expressed in the same unit.
However, healthcare facilities differ considerably in size, clinical complexity, operating hours, patient populations, infrastructure, and services provided.
A hospital delivering extensive inpatient, surgical, and critical care services may require more energy and resources than a small outpatient clinic. Comparing their total emissions without considering these differences would offer limited insight into environmental performance.
Even hospitals with similar bed numbers may provide very different care.
One facility may operate specialized laboratories, high-intensity diagnostic services, or complex treatment programs. Another may provide a narrower range of services with different equipment and resource requirements.
Differences in purchased services can also affect reported emissions.
A hospital performing laboratory testing internally may have a different emissions profile from one purchasing comparable testing services from an external provider. This difference may reflect organizational arrangements rather than a genuine improvement in environmental efficiency.
Measurement approaches sometimes use denominators such as emissions per bed, occupied bed-day, patient encounter, or another service-related unit.
These measures can provide context, but no single denominator is suitable for every healthcare organization.
A bed-based measure may be inappropriate for an outpatient-only facility. A patient-encounter measure may not reflect differences in clinical complexity. Changes in occupancy or service mix may also affect a ratio without representing a corresponding improvement in emissions performance.
Fair comparisons therefore require clearly defined methods and careful consideration of relevant organizational and clinical differences.
The same caution applies to climate resilience.
Two hospitals may experience different levels of disruption because their geographical exposure, patient populations, external dependencies, and service responsibilities differ.
A lower number of reported interruptions does not automatically demonstrate greater resilience. It may reflect lower exposure, differences in reporting, or other circumstances.
Indicators are most useful when they help explain performance in context, rather than produce rankings that conceal important differences.
Interpreting Environmental and Resilience Outcomes Together
Healthcare organizations may improve environmental performance through changes in energy use, procurement, infrastructure, or other activities.
These developments can be positive, but an emissions reduction alone does not establish that patient care has improved.
Emissions may also fall because clinical activity has declined, services have been temporarily unavailable, or certain activities have moved outside the reporting boundary.
A reduction associated with fewer necessary services should not automatically be interpreted as successful healthcare decarbonization.
Similarly, improving resilience may require investment in equipment, additional capacity, or alternative arrangements that have their own environmental impacts.
Some interventions can strengthen resilience while reducing resource use and emissions. Others may involve trade-offs. The results depend on the intervention, operating conditions, and methods used to evaluate outcomes.
This is why climate resilience, environmental performance, and patient safety should be understood as related but distinct dimensions of healthcare performance.
A change intended to reduce emissions should be assessed for its implications for safe, effective, and accessible care. A resilience intervention should be examined for its effectiveness and, where relevant, its environmental consequences.
These considerations do not mean every intervention must demonstrate improvement across all dimensions before implementation.
They mean that claims about multiple benefits require appropriate evidence.
If an organization reports that a project improved resilience, reduced emissions, and protected patient safety, each conclusion should be supported by information relevant to that outcome.
A single favorable indicator should not automatically be treated as proof of all three.
Understanding Progress Over Time
Monitoring progress requires more than collecting new figures each year.
Healthcare organizations need to understand whether results remain comparable across reporting periods.
A change in reported emissions may arise from improved measurement rather than an actual change in operations.
For example, an organization may begin including additional buildings, purchased products, or emission sources that were previously excluded. This could increase reported emissions even if its underlying environmental performance has not deteriorated.
Conversely, incomplete reporting may produce an apparent reduction that does not reflect a real environmental improvement.
Changes in emission factors, calculation methods, organizational boundaries, or clinical activity can also influence results. These factors should be documented and considered when interpreting trends.
Where methodological changes are significant, organizations may need to recalculate previous results or explain why the figures are not directly comparable, according to the applicable accounting approach.
A baseline is most useful when its boundaries, methods, reporting period, and data limitations are sufficiently clear to support future comparisons.
Climate resilience measurement presents similar challenges.
An organization may improve its reporting system and begin documenting service interruptions that previously went unrecorded. The resulting increase in reported incidents does not necessarily mean resilience has declined. Better reporting may simply reveal weaknesses that were already present.
For this reason, trends should be examined alongside changes in monitoring practices, service delivery, climate-related exposure, and organizational circumstances.
Progress becomes more credible when measurement methods remain sufficiently consistent and changes in the underlying context are explained.
Measurement Should Support Decisions, Not Just Reporting
Collecting indicators can require considerable effort, especially when information comes from several departments, authorities, and external organizations.
The value of that effort depends on whether the results help decision-makers understand what needs attention.
An indicator may reveal that relevant information is unavailable, responsibilities for collecting data are unclear, or existing systems use inconsistent definitions.
These findings can themselves be useful.
For example, a hospital may have reliable records of total electricity consumption but limited information about how consumption differs between buildings or major activities.
Another organization may have detailed maintenance records but little information about the consequences of infrastructure problems for clinical services.
These gaps can indicate where measurement capabilities need improvement, but they do not necessarily mean the organization should immediately develop new information systems or collect every possible indicator.
WHO's Measuring the Climate Resilience of Health Systems (2022) emphasizes selecting measures relevant to health authorities' needs while building on existing surveillance and monitoring arrangements.
This principle remains important when interpreting the 2026 indicator framework.
Healthcare organizations should consider whether a proposed measure answers a meaningful question, whether reliable information can be obtained, and whether the findings can inform appropriate action.
A smaller set of well-defined and credible measures may offer more value than extensive reporting based on uncertain data.
Measurement cannot capture every dimension of healthcare resilience or sustainability. Its purpose is to make important conditions, changes, and uncertainties more visible to those responsible for planning and improvement.
What Viet Nam Can Learn From the WHO Pilot
Viet Nam's participation in WHO's indicator pilot is particularly relevant because healthcare facilities operate under different geographical, environmental, technical, and organizational conditions.
Data systems, workforce capabilities, infrastructure, and access to specialist expertise may vary considerably between settings.
The feasibility of an indicator may therefore depend on whether the necessary information exists, how it is defined, and what resources are required to collect and validate it.
Some measures may draw on existing national administrative information. Others may require data from individual healthcare facilities or additional technical assessments.
An indicator that is practical in one setting may be more difficult to implement elsewhere. These differences do not necessarily make it unsuitable; they demonstrate why feasibility, data quality, and reporting capacity need to be examined before wider use.
The pilot creates an opportunity to understand whether indicator definitions can be interpreted consistently across different levels of the health system.
Where definitions require clarification or data are incomplete, identifying those limitations is a legitimate and useful outcome.
The findings may inform future technical guidance, institutional capacity development, and decisions about which information should be collected more systematically.
However, publicly available information about the pilot does not establish that all indicators have been fully validated for every healthcare facility type in Viet Nam.
Nor should the pilot be presented as evidence that a mandatory national hospital ranking, accreditation program, or facility-level certification system has been introduced.
Any legally binding reporting or assessment requirements would need to be established through the relevant Vietnamese legal and administrative instruments.
At this stage, the most defensible interpretation is that Viet Nam is participating in an international process to examine the practicality of climate resilience and emissions indicators and strengthen the evidence available for health sector planning.
Applying International Measurement Principles Within Viet Nam's Legal Framework
International measurement frameworks can inform healthcare practice, but they must be distinguished from requirements established under Vietnamese law.
The Law on Environmental Protection, Law No. 72/2020/QH14, as amended, provides an important legal foundation for greenhouse gas management and emissions reduction.
Government Decree No. 06/2022/ND-CP addresses greenhouse gas emissions reduction and ozone layer protection. It has been amended by Decree No. 119/2025/ND-CP and Decree No. 83/2026/ND-CP, effective March 23, 2026.
Another important update concerns the list of sectors and facilities required to conduct greenhouse gas inventories.
Prime Ministerial Decision No. 42/2026/QD-TTg, issued on August 10, 2026, took effect on September 25, 2026. It updated the list of sectors and facilities subject to greenhouse gas inventory requirements and replaced Decision No. 13/2024/QD-TTg.
This change matters because organizations must determine their obligations according to currently applicable legislation and the relevant list of covered facilities.
A healthcare organization should not assume that it is automatically required to conduct a complete greenhouse gas inventory merely because WHO has published health-system indicators.
Equally, an organization should not assume it has no inventory or reporting obligations without examining whether its activities, facilities, or other relevant circumstances fall within the applicable legal requirements.
Whether a facility must prepare or submit a greenhouse gas inventory depends on the relevant legislation, implementing provisions, and reporting arrangements.
Voluntary participation in international measurement or learning activities should therefore be distinguished from statutory inventory and reporting obligations.
Healthcare organizations must also comply with the legal framework governing medical examination and treatment, including Law No. 15/2023/QH15, as subsequently amended, and applicable requirements concerning healthcare quality and patient safety.
Where climate-related measurement involves identifiable patient or employee information, personal data protection and confidentiality requirements must also be considered.
The Law on Personal Data Protection, Law No. 91/2025/QH15, and Government Decree No. 356/2025/ND-CP took effect on January 1, 2026.
Some climate resilience indicators may rely mainly on aggregate organizational information. However, the underlying records used to develop them may contain personal, health-related, or otherwise confidential information.
Appropriate arrangements for lawful processing, access, sharing, security, and reporting therefore remain important.
WHO publications provide technical guidance and international reference points. They do not automatically become binding national regulations, and participation in a WHO pilot does not create a separate hospital certification obligation.
Healthcare organizations should distinguish international learning opportunities from the legal duties applicable to their own activities.
What CHVN Can Contribute Without Creating Another Score
For Climate & Health Vietnam, WHO's 2026 indicators provide an opportunity to support professional understanding and responsible knowledge sharing.
A platform dedicated to climate-resilient healthcare can help explain what different indicators measure, why definitions and reporting boundaries matter, and how results should be interpreted in the context of healthcare delivery in Viet Nam.
This may include synthesizing relevant WHO publications, explaining differences between health-system and facility-level measurement, discussing data quality challenges, and sharing credible implementation experiences.
CHVN can also help healthcare professionals understand the difference between measuring preparedness, assessing implementation, examining actual service performance, and calculating greenhouse gas emissions.
Such work is consistent with the platform's focus on healthcare quality, patient safety, governance, environmental sustainability, and essential service continuity.
However, CHVN should not develop a proprietary WHO-based climate resilience score and imply that WHO has validated, approved, or endorsed it.
The fact that WHO's 2026 publication proposes an index methodology does not mean that any third-party adaptation automatically carries the same status or can be used as an officially validated hospital assessment.
Nor should an informal compilation of indicators be presented as a national hospital standard, mandatory accreditation requirement, or determination of regulatory compliance.
There is an important difference between interpreting an international framework and operating a formal assessment, conformity, or certification program.
CHVN can add value by making this distinction clear and helping professionals understand how international evidence relates to local practice.
Its contribution should remain focused on evidence synthesis, careful interpretation, multidisciplinary learning, and collaboration without overstating the maturity of available measurement methods or the platform's institutional authority.
Moving Toward Meaningful Measurement
The development of climate resilience and greenhouse gas emissions indicators represents an important opportunity for healthcare systems to move beyond broad commitments and examine progress more systematically.
However, the usefulness of measurement depends on more than the number of indicators collected.
The measurement level must be appropriate, definitions must be clear, data sources must be sufficiently reliable, and results must be interpreted in their proper context.
A reported emissions reduction may be encouraging, but its significance depends on the reporting boundary, calculation method, clinical activity, and other relevant changes.
A preparedness indicator may demonstrate that an arrangement exists without establishing how well it will perform during a future emergency.
An index may help summarize implementation across several dimensions, but it cannot replace an understanding of the underlying evidence.
These limitations do not make measurement less important. They explain why responsible interpretation is essential.
WHO's 2026 publication offers a structured foundation for developing and discussing climate resilience and emissions indicators. Viet Nam's participation in the pilot provides an opportunity to examine how these approaches work in practice and what further capabilities may be needed.
For healthcare leaders, the most useful question is not whether an organization can produce a favorable number. It is whether the information collected helps identify meaningful weaknesses, understand actual progress, and support better decisions for patients, health services, and environmental performance.
Meaningful measurement should make healthcare systems more accountable and better informed, not merely easier to rank.
Selected References and Policy Context
International guidance and measurement standards
World Health Organization. Indicators of Climate Resilience and GHG Emissions in Health Systems. Published March 11, 2026. Publicly available PDF labeled Advanced draft version.
World Health Organization. Measuring Greenhouse Gas Emissions in Health Systems. December 22, 2025.
World Health Organization. Operational Framework for Building Climate Resilient and Low Carbon Health Systems. 2023.
World Health Organization. Measuring the Climate Resilience of Health Systems. November 15, 2022.
World Health Organization. Health System Resilience Indicators: An Integrated Package for Measuring and Monitoring Health System Resilience in Countries. February 21, 2024. A broader health-system resilience resource, not limited to climate-related risks.
World Health Organization. Mapping Climate Change and Health Indicators. October 10, 2025.
International Organization for Standardization. ISO 14064-1:2018 — Greenhouse Gases — Part 1: Specification With Guidance at the Organization Level for Quantification and Reporting of Greenhouse Gas Emissions and Removals.
Greenhouse Gas Protocol. A Corporate Accounting and Reporting Standard.
Greenhouse Gas Protocol. Corporate Value Chain (Scope 3) Accounting and Reporting Standard.
Selected Viet Nam evidence and developments
World Health Organization Viet Nam. Two National Consultants to Pilot Assessment of Climate Resilience and GHG Emission Indicators for Health System in Viet Nam. Call for Expressions of Interest, 2025.
World Health Organization. Donors Making a Difference: WHO and Partners Help Make Progress Towards a Safer and Healthier Viet Nam. September 10, 2026.
Viet Nam standards and regulatory context
Ministry of Science and Technology. TCVN ISO 14064-1:2025 — Greenhouse Gases — Part 1: Specification With Guidance at the Organization Level for Quantification and Reporting of Greenhouse Gas Emissions and Removals, technically identical to ISO 14064-1:2018.
National Assembly. Law on Environmental Protection No. 72/2020/QH14, as amended.
Government of Viet Nam. Decree No. 06/2022/ND-CP on greenhouse gas emissions reduction and ozone layer protection, as amended by Decree No. 119/2025/ND-CP and Decree No. 83/2026/ND-CP.
Government of Viet Nam. Decree No. 83/2026/ND-CP, dated March 23, 2026, amending the greenhouse gas emissions reduction and ozone layer protection framework, effective March 23, 2026.
Prime Minister. Decision No. 42/2026/QD-TTg, dated August 10, 2026, updating the list of sectors and facilities required to conduct greenhouse gas inventories, effective September 25, 2026, replacing Decision No. 13/2024/QD-TTg.
National Assembly. Law on Medical Examination and Treatment No. 15/2023/QH15, effective January 1, 2024, as amended and reflected in Consolidated Document No. 26/VBHN-VPQH, dated February 26, 2026.
National Assembly. Law on Personal Data Protection No. 91/2025/QH15, effective January 1, 2026.
Government of Viet Nam. Decree No. 356/2025/ND-CP, dated December 31, 2025, detailing provisions and measures for implementation of the Law on Personal Data Protection, effective January 1, 2026.
Professional scope: This article is intended for professional education, evidence synthesis, and knowledge sharing. It does not constitute legal advice, a determination of regulatory obligations for a specific organization, a verified greenhouse gas inventory, a facility-specific climate resilience assessment, an officially endorsed WHO scoring application, accreditation or certification criteria, or a determination of compliance with Vietnamese regulations. References to WHO and other international publications do not imply endorsement of Climate & Health Vietnam. Healthcare organizations should apply current national requirements, appropriate measurement standards, and qualified technical and professional judgment when collecting, interpreting, and reporting climate resilience or greenhouse gas emissions information.