Climate change: an urgent priority for health policy and systems research

Climate Change, Community Action, and Health in the Anglophone Caribbean: A Scoping Review

Objective: This scoping review investigates the status of research focusing on the nexus of community action, climate change, and health and wellbeing in anglophone Caribbean Small Island Developing States (SIDS). Methods: This review was guided by Arksey and O'Malley framework and utilized the PRISMA-ScR checklist. We searched Medline/OVID, PsychInfo, VHL, Sociological Abstracts, Google Scholar, and Scopus to capture interdisciplinary studies published from 1946 to 2021. Results: The search yielded 3,828 records of which fourteen studies met the eligibility criteria. The analysis assessed study aim, geographic focus, community stakeholders, community action, climate perspective, health impact, as well as dimensions including resources/assets, education/information, organization and governance, innovation and flexibility, and efficacy and agency. Nearly all studies were case studies using mixed method approaches involving qualitative and quantitative data. Community groups organized around focal areas related to fishing, farming, food security, conservation, and the environment. Conclusion: Despite the bearing these areas have on public health, few studies explicitly examine direct links between health and climate change. Research dedicated to the nexus of community action, climate change, and health in the anglophone Caribbean warrants further study.

Pandemic preparedness and response: exploring the role of universal health coverage within the global health security architecture

In response to the COVID-19 pandemic, several international initiatives have been developed to strengthen and reform the global architecture for pandemic preparedness and response, including proposals for a pandemic treaty, a Pandemic Fund, and mechanisms for equitable access to medical countermeasures. These initiatives seek to make use of crucial lessons gleaned from the ongoing pandemic by addressing gaps in health security and traditional public health functions. However, there has been insufficient consideration of the vital role of universal health coverage in sustainably mitigating outbreaks, and the importance of robust primary health care in equitably and efficiently safeguarding communities from future health threats. The international community should not repeat the mistakes of past health security efforts that ultimately contributed to the rapid spread of the COVID-19 pandemic and disproportionately affected vulnerable and marginalised populations, especially by overlooking the importance of coherent, multisectoral health systems. This Health Policy paper outlines major (although often neglected) gaps in pandemic preparedness and response, which are applicable to broader health emergency preparedness and response efforts, and identifies opportunities to reconceptualise health security by scaling up universal health coverage. We then offer a comprehensive set of recommendations to help inform the development of key pandemic preparedness and response proposals across three themes-governance, financing, and supporting initiatives. By identifying approaches that simultaneously strengthen health systems through global health security and universal health coverage, we aim to provide tangible solutions that equitably meet the needs of all communities while ensuring resilience to future pandemic threats.

The Adoption of Digital Technologies and Artificial Intelligence in Urban Health: A Scoping Review

As more people live in cities, the impact of urban settings on population health has been increasing. One of the main strategies to cope with urbanization is adopting artificial intelligence (AI) and new digital technologies to develop new urban services that improve citizens’ health and well-being. The aim of this study is to review urban interventions and adopting digital technologies and AI-based algorithms to improve population health. A scoping review of the literature was conducted by querying MEDLINE, Web of Science, and Scopus databases. The included studies were categorized into one urban health area, suggested by the WHO, according to the type of intervention investigated. Out of 3733 records screened, 12 papers met all inclusion criteria. Four studies investigated the “outdoor and indoor pollution” area, one “climate change”, one “housing”, two “health and social services” and four “urban transport” areas. Only one article used a comprehensive approach to public health, investigating the use of AI and digital technologies both to characterize exposure conditions to health determinants and to monitor population health effects, while the others were limited to characterizing exposure conditions to health determinants, thus employing a preliminary public health perspective. From this point of view, countries should foster synergy for the development of research on digital technologies to address the determinants of health in the urban context. From a global health perspective, sharing results with the scientific community would also allow other countries to use those technologies that have been shown to be effective, paving the way for more sustainable living conditions worldwide.

Healthcare system resilience in Bangladesh and Haiti in times of global changes (climate-related events, migration and Covid-19): an interdisciplinary mixed method research protocol

Background

Since climate change, pandemics and population mobility are challenging healthcare systems, an empirical and integrative research to studying and help improving the health systems resilience is needed. We present an interdisciplinary and mixed-methods research protocol, ClimHB, focusing on vulnerable localities in Bangladesh and Haiti, two countries highly sensitive to global changes. We develop a protocol studying the resilience of the healthcare system at multiple levels in the context of climate change and variability, population mobility and the Covid-19 pandemic, both from an institutional and community perspective.

Methods

The conceptual framework designed is based on a combination of Levesque’s Health Access Framework and the Foreign, Commonwealth and Development Office’s Resilience Framework to address both outputs and the processes of resilience of healthcare systems. It uses a mixed-method sequential exploratory research design combining multi-sites and longitudinal approaches. Forty clusters spread over four sites will be studied to understand the importance of context, involving more than 40 healthcare service providers and 2000 households to be surveyed. We will collect primary data through questionnaires, in-depth and semi-structured interviews, focus groups and participatory filming. We will also use secondary data on environmental events sensitive to climate change and potential health risks, healthcare providers’ functioning and organisation. Statistical analyses will include event-history analyses, development of composite indices, multilevel modelling and spatial analyses.

Discussion

This research will generate inter-disciplinary evidence and thus, through knowledge transfer activities, contribute to research on low and middle-income countries (LMIC) health systems and global changes and will better inform decision-makers and populations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-07294-3.