Building and strengthening climate resilient health systems in low- and middle-income country contexts

Climate change poses a significant threat to health systems, particularly in low- and middle-income countries (LMICs), which often face resource constraints and heightened vulnerabilities. This report, commissioned by NORAD and conducted by the Norwegian Institute of Public Health, provides a comprehensive overview that addresses seven critical aspects necessary for building and strengthening climate resilient health systems in these contexts, supported by a scoping review. The report explores effective strategies for health system resilience; addresses the opportunities and challenges in implementing these strategies; assesses the vulnerabilities of health systems to climate change; identifies key stakeholders involved in climate resilient health systems; examines the data needs for informed decision-making; highlights the importance of addressing equity and the needs of vulnerable populations; and identifies research gaps that need to be addressed to support the development of climate resilient health systems.

Background and Rationale

Climate resilient health systems are essential to ensure that health services can anticipate, respond to, cope with, recover from, and adapt to climate-related shocks and stresses. This report addresses the urgent need for resilient health systems that can sustain improvements in population health despite an unstable climate. The review builds on extensive evidence from the World Health Organization (WHO), the Intergovernmental Panel on Climate Change (IPCC), and various scientific publications, aiming to fill the gap in understanding how to build climate resilient systems in resource-constrained settings. The report is organized into seven chapters that address specific research questions dedicated to different aspects of climate-resilient health systems. 

Methodology

A scoping review methodology was employed to explore the range and breadth of studies on climate change and health systems in LMICs.

Key Findings

The first chapter organizes the findings according to the WHO health system pillars.

Chapter 1 - Key Strategies for Climate Resilient Health Systems:

• Service Delivery: Enhancing infrastructure resilience, ensuring basic public health standards, empowering primary healthcare, expanding local health services, addressing mental health needs, and integrating emergency preparedness into the health system culture are critical strategies.
• Health Workforce: Comprehensive training programs for health professionals on climate-related health issues and building an adaptable workforce are essential.
• Health Information Systems: Developing robust health information systems that integrate climate, health and environmental data to support decision-making.
• Access to Medical Products: Ensuring the availability of essential medical supplies through strategic procurement and storage solutions.
• Financing: Establishing sustainable financing mechanisms that integrate climate resilience into national health budgets.
• Leadership and Governance: Strengthening governance structures to incorporate climate adaptation into health policy and practice.

Chapter 2 - Opportunities and challenges of climate resilient health systems strategies: engaging local communities, leveraging innovative technologies, and fostering multi-sectoral collaboration and integrated policies are emerging opportunities, while addressing the lack of climate financing, improving preparedness, and overcoming barriers related to coordination and governance are crucial challenges for building climate resilient health systems.

Chapter 3 - Vulnerability of health systems: Assessing and understanding the vulnerabilities of health systems to climate change is crucial for effective adaptation and mitigation. Studies highlight the increased risks to health from climate variability, emphasizing the need for detailed vulnerability assessments at national and regional levels.

Chapter 4 - Stakeholders of climate resilient health systems: effective climate resilience requires the involvement of various stakeholders, including government agencies, NGOs, international organizations, and local communities. Their roles and contributions are essential for comprehensive disaster response and health system resilience.

Chapter 5 - Data for climate resilient health systems: high-quality data on health status, health systems, and climate-related factors are essential for informed decision-making. Strengthening Health Information Systems and integrating climate data are critical for assessing risks and planning effective responses.

Chapter 6 - Equity and vulnerability in climate change and health: addressing health disparities and promoting equity are crucial for climate resilient health systems. Vulnerable populations require targeted interventions to ensure their health and safety in the face of climate change.

Chapter 7 - Future investigation: there is a need for further research on sustainable financing, effective communication strategies for diverse vulnerable groups, and comprehensive policies to support climate resilient health systems.

Concluding remarks

Building climate resilient health systems in LMICs requires a comprehensive approach that addresses the vulnerabilities and capacities of health systems. This report provides valuable insights and practical strategies to support the development of resilient health systems capable of withstanding the impacts of climate change.

This report sets the stage for a detailed exploration of the strategies and practices necessary for building climate resilient health systems, offering a valuable resource for policymakers, health practitioners, and researchers committed to improving health outcomes in the face of climate change.