Health system adaptation to climate change: a perspective from Antique, Philippines
Written by Geminn Louis Apostol, Jemar Anne Sigua, Mary Camille Samson, and Leonicio Abiera Jr.
UPDATE: The presentation can be viewed here.
The Global Climate Risk Index 2020 ranked the Philippines second on its list of countries most affected by extreme weather events related to climate change in 2018. Building health system resilience in the context of climate change requires a response that is anchored in multisectoral collaboration. This type of collaboration can ensure coordination and synergy of programs and policies beyond the health and environmental sectors. ThinkWell’s Philippines team conducted a study to understand how different stakeholders respond to issues in climate change adaptation in health (CCAH), and how they may be effectively mobilized to further strengthen CCAH initiatives on the ground.
The province of Antique, located in the Western Visayas region of the Philippines, is classified as a province with high risk of climate disasters. Fifteen out of its 18 coastal towns are prone to extreme weather events, such as cyclones and storm surges. In collaboration with the Provincial Health Office, we conducted participatory stakeholder and qualitative social network mapping of CCAH stakeholders in Antique. We found that the CCAH agenda in Antique is largely driven by the environmental sector, while health and other sectors fall behind in terms of knowledge, awareness, and resource commitment. The qualitative social network mapping revealed that there are minimal interactions between stakeholders in different sectors when it comes to CCAH initiatives. The flow of money, information, and accountability is largely siloed within sectors.
We also conducted cognitive interviews to determine barriers and facilitators to implement CCAH strategies and initiatives in Antique. We analyzed these against the six themes of the country’s National Climate Change Adaptation in Health Strategic Plan for 2014-2016. Stakeholders emphasized that while Antique already has certain systems, programs, and policies in place, effective implementation is hampered by a lack of leadership and political will resulting in a health system that is more reactive than proactive to climate change-related events. To further galvanize multi-sectoral participation in CCAH, we believe that national and local governments should identify specific linkages and entry points between CCAH and other sectors, which can be used to anchor concrete multi-sectoral collaborations.
Our study suggests that stakeholder knowledge and awareness are key drivers for their support and resource commitment to CCAH initiatives. Inter-professional education at all levels can therefore be an important lever to increase commitment. National and local governments should also clarify the areas of responsibility and accountability of different sectors in the implementation of CCAH strategies to ensure multi-sectoral results. Ultimately, all sectors within and beyond the health system are enjoined to work together in addressing larger socio-economic determinants that influence climate risk, and only then can we truly push for climate-resilient health systems and communities.
To find out more about the study, join our presentation, “A stakeholder-based approach to assessment of barriers to climate change adaptation of local health systems in an at-risk province in the Philippines,” on November 25, 2020 at the Phase 2 of the Sixth Global Symposium on Health Systems Research, organized by Health Systems Global, under the track Health System Resilience and Adaptation to Climate Change: Lessons from Developing Countries.