Local Health System Responses to Climate Change: Lessons From Coastal Municipalities in the Philippines

Abstract

Climate change has now become humanity’s defining challenge, and its initial health effects are beginning to manifest in different parts of the world. International discourse and scholarship on the climate and health nexus have so far focused on quantifying risks and projecting future outcomes. Meanwhile, the global health community is still yet to incorporate the climate lens in the research and practice of health systems development. More specifically, little is known about how local health systems and frontline communities are addressing the early health consequences of climate change and preparing for future ones. This DELTA Project aims to generate lessons and insights on the challenges and opportunities that local health systems especially in developing countries face with regard to responding to climate change and its health impacts. Two coastal municipalities in the Philippines, one of the most climate-vulnerable countries in the world, were examined using a multiple case study approach. Through a mix of interviews, document review, and field observations, the individual case studies explored present and future climate and health risks and vulnerabilities, challenges and barriers confronted in addressing them, and enablers and opportunities that can be tapped for future implementation. In cross analyzing these cases, key concepts in climate science such as adaptation and resilience were engaged, while existing frameworks traditionally used in health systems research and practice were interrogated. Now that climate change is already part of the health system equation, new system goals may need to be considered, key determinants for enhancing health systems’ adaptive capacity and intelligence are identified, and new forms of engagement with other ‘systems for health’ become critical now more than ever. The insights drawn from this project will hopefully inform future global health practice in the pursuit of building local health systems that ensure universal healthcare, provide health protection from shocks and stresses, and achieve sustainable development in the era of climate change and planetary health.