Planetary health for health systems: A scoping review and content analysis of frameworks

Planetary health movements have advanced substantially within the last ten years with new frameworks and models being considered within health systems in varied contexts. Despite advancements, there continues to be an overall lack of accessible and regional- or field-specific planetary health frameworks to inform health systems. We therefore set out to conduct a scoping review to identify current planetary health-related frameworks that have been developed for health systems. We systematically searched the following electronic databases up to November 2023: Medline, CAB Abstracts, and Scopus; and carried out manual searches in Overton, Policy Commons, Google, and Google Scholar. We engaged a two-stage article review process, then used content analysis to identify the different domains. We identified six overarching categories within the planetary health-related frameworks including: 1) health system and environmental impacts; 2) vision, advocacy, leadership, and communication elements; 3) key structural components for environmentally sustainable health systems; 4) climate resiliency and environmental sustainability of healthcare facilities and systems; 5) climate-resilient and sustainable technologies and infrastructure; and 6) evaluation and accountability mechanisms. Regional, national, and international governments, funding agencies, and organizations are called to support greater research and implementation work around planetary health-informed health systems change while considering existing frameworks. Better inclusion of all facets of planetary health (e.g., biodiversity), as well as key acknowledgement and work with other knowledge systems (e.g., Indigenous Peoples and their knowledge systems) are needed to ensure planetary health-related frameworks are grounded in what we are trying to protect-the planet itself.