REACH: Resilient Equitable Access to Care after Hazards

Climate change is increasing the frequency and intensity of natural hazards such as heatwaves, floods, wildfires and storms. Beyond their direct effects on health, such events can disrupt the infrastructures, workforce, supply chains, transport and communication systems required to maintain healthcare delivery. They can therefore reduce healthcare capacity precisely when demand is increasing. These disruptions may be particularly critical in rural, remote and underserved territories that already face structural difficulties in accessing care. The REACH project (Resilient Equitable Access to Care after Hazards) aims to investigate how healthcare networks can be designed and managed to maintain resilient and equitable access to care when healthcare demand, facility and workforce availability, and transport conditions are uncertain and evolve rapidly over time and space. The methodology will primarily rely on stochastic and robust optimization models to represent a range of disruption conditions and identify strategies that perform well across different scenarios. The project will investigate strategies such as resource allocation, coordination of patient diversion and inter-hospital transfers, and deployment of temporary or mobile healthcare capacity. Equity in access to care will be explicitly incorporated through indicators such as geographical coverage, travel and waiting times, and unmet demand. Where necessary, simulation approaches will complement optimization models to represent congestion and rapidly evolving post-disaster conditions. The project will adopt a dynamic and multi-scale perspective and investigate two complementary contexts, in France and Türkiye. The objective is not to develop two separate models, but to build a generic and adaptable framework for resilient and equitable healthcare network design under uncertainty. The two case studies will make it possible to identify common mechanisms and transferable strategies while accounting for differences in healthcare organization and hazard characteristics. REACH will contribute to the development of more robust, adaptive and equitable preparedness and response strategies. The results will provide quantitative tools and recommendations for healthcare planners, health authorities and emergency-management actors, supporting the resilience of healthcare systems while avoiding the amplification of existing territorial inequalities in access to care. École doctorale : SYSTEMES Direction : Safa LAYEB Financement : MSCA COFUND BEST