Capitalising on local expertise to protect the health of Malawi communities from climate change

Since 2014 an ambitious health and climate change program is being implemented in Malawi. Building on previous efforts, an alliance of local communities, organisations, experts and government representatives is working with WHO and others to build resilience and implement climate and health solutions.

Background

A climate change and health program was set up in Malawi in January 2014, as part of the “Adaptation for Africa” project. The project was created with support from the Global Framework for Climate Services (GFCS), an initiative that enables vulnerable sectors and populations to better manage climate variability and adapt to climate change.
The project engaged 9 different districts in the country: Chikwawa, Zomba, Phalombe, Salima, Kasungu, Nkhatabay, Karonga, Chitipa and Lilongwe. Across the districts, the initiative helped to build local capacity, improved access to climate data, and led to the development and implementation of new policies. As a result, Malawi has successfully introduced an early warning system, developed a communication strategy, a Health National Adaptation Plan (HNAP) and created public health advisories for extreme weather events. 

Recently, the institutional capacity built through the GFCS project was leveraged for the implementation of a ‘Delivering climate resilient water and sanitation in Africa and Asia’ project in the country, funded by the UK Foreign, Commonwealth & Development Office (FCDO). Building on existing local capacity and expertise, both the old and new initiative brought together a core team of key stakeholders in health and climate change together. 

The Health and Climate Change Core Team (HCCCT) was the same in both projects and included representatives from various government sectors, WHO, academia, media and civil society organisations.

To ensure smooth implementation, the HCCCT was established at a national level with the aim to oversee the planning, formulation, implementation, monitoring and evaluation of project activities across partner organizations and districts in the country. 

“I feel HCCCT has run its course as it has assisted in laying a roadmap on health and climate change in Malawi. As we move forward, this grouping might still be relevant in helping to upscale climate change and health aspects to other areas that have not been reached. We have built some capacity and institutional memory which might help propel Health and Climate Change into the uncertain future.”

–Maxwell Luhanga, Senior Lecturer, Department of Environmental Health, Malawi College of Health Sciences

The Challenge

Despite significant progress in building resilience and strengthening local capacity, Malawi remains one of the countries most vulnerable to the impacts of climate change. Additionally, the health sector has limited expertise on climate change and lacks the capacity to fully respond to, recover from and adapt to climate-related shocks and stresses, while ensuring essential health services. The project’s core coordinating team (HCCCT) played a crucial role in building local capacity, but an important need for additional support remains.

"COVID 19 has opened a new challenge as to how this group can effectively meet and brainstorm on health and climate change. We also did not diversify our resource pool and this I feel constrained progress. We need to work on this!”"

–Dr Abel Chiwatakwenda, HCCCT member

Figure: Members of the Health and Climate Change Core Team.

Climate and Health Solutions

Significant porgress was made under Malawi’s climate change and health program, with increased capacity, the implementation of projects, and improved cross-sectoral collaboration. These outcomes include:

A Vulnerability and Adaptation assessment (V&A) : A Vulnerability and Adaptation (V&A) assessment was conducted in order to asses which populations and districts are most vulnerable to different kinds of health impacts, as well as the capacity of Malawi’s current health systems to manage these impacts. The V&A thereby served as a baseline analysis against which changes in disease risks and protective measures can be monitored, and offered an opportunity for further capacity building. The involvement and feedback of the HCCCT members was crucial in conducting the assement and ensuring its local relevance.

Figure: Vulnerability and Adaptation Assessment report for health sector in Malawi.

Policy briefs: In response, policy briefs were developed by HCCCT to mainstream health and climate change into policies and plans and provide an even more comprehensive outline of the already produced  policy documents e.g. Health Sector Strategic Plan (HSSP), National Adaptation Programme of Action (NAPA) and Environmental Health Policy (EH-P).

Communication startegy: Realizing the limited national capacity to respond to extreme weather events, the HCCCT in collaboration with climate and health experts developed and finalised a structured communication strategy. To improve the climate resilience of communities, public health advisories on extreme weather events such as floods, heat wave, high temperatures, extreme cold etc, were developed and translated in local languages and field tested.

Figure: HCCCT members pretesting health advisories at Medrum village in Chikwawa District.

A Health National Adaptation Plan  (HNAP): The severe drought and food insecurity experienced throughout the country in 2016 further strengthened the need to develop strong policies that ensure health systems resilience and adaptive capacity, in the form of a Health National Adaptation Plan (HNAP).  The Ministry of Health was further assissted to enhance its capacity in 4 districts on EWARS (Early Warning, Alert and Response System) for predicting vector -borne disease outbreaks and trained district field satff on data synthesis, modelling and interpretation of the early warning system.

Curricula on climate change and health: The HCCCT has championed the introduction of a curriculum on climate change and health in several health training institutions e.g Malawi College of Health Sciences (MCHS)  in Malawi. By reviewing and adapting several curricula, key issues on climate change and health e.g. climate change science and health, climate change impact on human health have been included in the training materials of several institutions.

"The HCCCT team has already booked some significant progress. It has championed the introduction of a curriculum on climate change and health in training institutions in Malawi. It has developed health advisories on climate change, and helped in applying for climate finance from the Green Climate fund.” 

–Maxwell Luhanga, Senior Lecturer, Department of Environmental Health, Malawi College of Health Sciences, HCCCT member.

Cross-sectoral collaboration: By ensuring cross-sectoral membership and inputs througout the climate and health programme, the various policy products helped to mainstream health as a cross-cutting issue, stimulated transformational changes across various sectors, and ensured a better allignment between sectoral and national policies.

Lessons Learned

The project’s core team has shared several key lessons it has learned from the project so far:

• Team work plays a vital role in responding to the acute shortages of human and financial resources. Building capacity and strengthening partnerships allows for a better use of resources and helps build climate resilient health systems;
• Effective communication and collaboration among sectors builds a solid knowledge foundation on which to ground the advocacy, capacity, awareness rising and development of services;
• Media have played a useful role in disseminating information on climate change and human health, allowing for a more informed and resilient population;
• District and community participation in planning and decision making are key drivers of significant contributions to big changes. Without the involvement at the community and district levels, adoption and imlementation of measures would be slow. 

Next Steps

The climate programme was succesfully implemented at national level, but some challenges around coordination with districts and communities remain. Outreach will be steped up further to ensure that practices in the districts and communities are well understood and replicated elsewhere. 

"With this work, we have now built some capacity in the community, which might help us to be more prepared to deal with climate change and health in the uncertain future.”

–Hanna Kasongo- Siame, HCCCT member, Environemental Affairs Department (EAD)