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​​Lessons from the field: Case studies to advance research on climate adaptation strategies and their impact on public health

woman and her child stand at the bottom of a basin that used to be the community watering hole near the small town of Aje, Ethiopia Photo credit: USAID in Africa Link

Climate change poses threats to human health across a wide range of illnesses and injuries. Under-resourced and marginalized populations, especially those in low- and middle-income countries (LMICs), are at higher risk of climate change consequences. A variety of climate change adaptation strategies have been and continue to be developed to prepare for, and adjust to, both the current and projected impacts of climate change. However, the scientific evidence base for many of these strategies is limited, particularly regarding their impact on health.

Case study collection

As part of the NIH Climate Change and Health Initiative, the Fogarty Center for Global Health Studies (CGHS) invited submissions in late 2023 for a collection of case studies on adaptation strategies that respond to the impact of climate change on public health. 

Goal of the collection

The goal of this collection is to identify and understand current or historical adaptation strategies that can be better harnessed to address deteriorating health outcomes using relevant and appropriate research approaches and methodologies. When complete, the collection will strengthen the evidence base around climate change adaptation and help identify research priorities and future research needs in this area.

Selected proposals

In response to the call, 133 proposals were received and 15 were selected by the project's Steering Committee to be developed into full case studies. These manuscripts will be submitted as a supplement in Global Health: Science and Practice in mid-2025.

Proposals selected for the collection showcase climate change adaptations being deployed in more than 15 countries across Africa, Asia, and Latin America and the Caribbean (Figure 1). These case studies cover a wide range of climate stressors, health outcomes, and adaptation strategies.

  • Climate stressors: Increased temperature, precipitation extremes, extreme weather events, air quality, and sea level rise.
  • Health topics: Vector-borne diseases, heat-related illness, maternal and child health, access to health care services, non-communicable diseases, and nutrition.
  • Adaptation strategies: Community engagement and capacity building, flood management, infrastructure design and weatherization, surveillance and early warning systems, and land use planning.

Figure 1: Geographical Distribution of Case Study Collection

graphic of the world map highlighting more than 15 countries across Africa, Asia, and Latin America and the Caribbean.

Case Studies in Africa

Transforming a hospital towards climate resilience: a case study of a vulnerability and capacity assessment approach at the health facility level in N'gouri, Chad

  • Lead Author: Patricia Nayna Schwerdtle , Heidelberg University and The Climate Action Accelerator
  • Country: Chad
  • Description: The project aims to demonstrate how an adapted Vulnerability and Capacity Assessment (VCA) can start to build the climate resilience and environmental sustainability of a hospital in Chad. This case study details the results of a mixed methods participatory approach, co-constructed in collaboration with health facility managers, NGOs and practitioners based in Chad. The primary goal was to assess vulnerabilities and capacities related to climate change-related health risks and to generate a prioritized list of solutions to address these risks.

Sentinel surveillance data for effective early warning prediction modeling of climate sensitive cholera outbreaks integrating meteorological WaSH and environmental data

  • Lead Author: Hailemichael Bizuneh, St. Paul’s Hospital Milennium Medical College
  • Country: Ethiopia
  • Description: Researchers aim to share how early warning prediction modeling can be used to map climate sensitive cholera outbreaks in the wake of precipitation extremes and drought in Ethiopia.

Understanding air-noise pollution linkages and innovative community-based adaptation and mitigation strategies 

  • Lead Author: Manasi Kumar, University of Nairobi (transitioned to New York University School of Medicine)
  • Country: Kenya
  • Description: Investigators hope to demonstrate how combining air and noise sensors with community education and training can support the mental and physical health of pregnant and parenting adolescent girls in Kenya. Through participatory action and co-development of solutions to environmental health stressors mental health can also be improved. 

Designing and evaluating a health system resilient to extreme weather events in rural Madagascar 

  • Lead Author: Michelle Evans, Pivot Works
  • Country: Madagascar
  • Description: Researchers plan to showcase how a health system strengthening partnership focused on human resources and operational support increases health system resilience to protect the health of communities exposed to extreme weather events in Madagascar.

Transformation journey from taboo community to a healthy one 

  • Lead Author: Umar Ibrahim, AFREHealth
  • Country: Nigeria
  • Description: Investigators are working to share how community education and training has been able to combat flood-related maternal mortality rates in Nigeria by increasing access to antenatal care services. 

Case Studies in Asia

Understanding the dynamics of epidemics post-cyclone and tidal surge events in the Bay of Bengal region

  • Lead Author: Nirmalya Mukherjee, Center for Public Health Research, MANT
  • Country: India
  • Description: Researchers aim to demonstrate the impact of multi-purpose cyclone shelters (MPCSs) on the health outcomes of residents living in cyclone and tidal surge hotspots in India, particularly focusing on the epidemic-prone diseases affecting the Sundarbans’ residents after cyclones and tidal surges.

Climate-induced obesity in Pohnpei; Is swamp taro the answer? A mixed methods baseline study in the Federated States of Micronesia

  • Lead Author: Sandeep Kandikuppa, East-West Center; Emihner Johnson, Island Food Community of Pohnpei
  • Country: Federated States of Micronesia
  • Description: Investigators will shed light on the links between climate change and obesity in the Federated States of Micronesia by evaluating an initiative which worked to reduce community reliance on imported foods by reviving the consumption of swamp taro.

Evaluating the long-term impact of the heat intervention in the emergency department in Karachi, Pakistan

  • Lead Author: Uzma Rahim Khan, Aga Khan University
  • Country: Pakistan
  • Description: Researchers are evaluating the long-term impact of the HEAT (Heat emergency Assessment and Treatment) intervention in a hospital in Pakistan. The HEAT intervention is an educational program targeting healthcare workers in order to address gaps in diagnosis and care management for patients presenting with heat-related illnesses.

Quantifying the impact of flood adaptation on dengue fever with geospatial analysis

  • Lead Author: Meifang Li, Dartmouth College; Sheng Sun and Valerie Fajardo, Vermont Law and Graduate School
  • Country: Philippines
  • Description: International investigators plan to use geospatial analysis and remote sensing imagery to showcase the impact of flood adaptation interventions on dengue fever epidemics in the Pasig-Marikina-Laguna de Bay Basin in the Philippines.

A case study of the impact of Resilient City Program on cognitive health in middle -aged and older adults

  • Lead Author: Fei Sun, Michigan State University
  • Country: Thailand
  • Description: Researchers are working to showcase the impact of the Resilient City Program in Bangkok, Thailand, on the mental and cognitive health of middle-aged and older adults who are exposed to flooding.

Case Studies in Latin America and the Caribbean

When data meets real life: An analysis of the One Million Cisterns Program on the health and welfare of the Brazilian semiarid population

  • Lead Author: Jose Firmino de Sousa Filho, CIDACS, FIOCRUZ
  • Country: Brazil
  • Description: Researchers plan to show the impact of a water access project in Brazil which deployed cisterns to rural communities in the country's semiarid region. Specifically, they will look at the impact of the program on child mortality, including outcomes related to poverty-related, diarrheal, and parasitic diseases.

Adapting to a changing climate in the Caribbean Small Island Developing States: The effectiveness of climate-smart health facilities for improving public health outcomes

  • Lead Author: Maureen Lichtveld, University of School of Pittsburgh Public Health
  • Country: Caribbean Small Island Nations including, Dominica, Grenada, St. Lucia, and St. Vincent and the Grenadines
  • Description: Investigators aim to demonstrate the impact of health facility-level climate adaptation strategies on the continuity of diabetes care at hospitals across several Caribbean Small Island Nations including, Dominica, Grenada, St. Lucia, and St. Vincent and the Grenadines.

Community-based solutions to address an epidemic of heat-related kidney disease in Latin American agricultural workers

  • Lead Author: Joaquin Barnoya, Colorado School of Public Health, USA and Universidad Rafael Landivar, Guatemala
  • Country: Guatemala
  • Description: Researchers are looking to evaluate the impact of a community engaged workplace-based adaptation strategy to reduce the negative health effects of excess workplace heat exposure, including acute kidney injury, among agricultural workers in Guatemala.

Implementation lessons and challenges of water insecurity interventions in households during a period of severe droughts: the case of Nuevo León, Mexico

  • Lead Author: Pablo Gaitan Rossi, Instituto de Investigaciones para el Desarrollo con Equidad (EQUIDE) at Universidad Iberoamericana, Ciudad de México
  • Country: Mexico
  • Description: Investigators plan to document lessons learned and challenges around the implementation of a water insecurity initiative in Mexico which was implemented by the Ministry of Equality and Social Inclusion to support communities during periods of severe drought and heat waves.

The Adelante Initiative: A rest-shade-hydration-hygiene program reduces heat-associated acute and chronic kidney disease among cane cutters and increases production at a sugar mill in Nicaragua

  • Lead Author: Zac Schlader, Indiana University School of Public Health - Bloomington
  • Country: Nicaragua
  • Description: Researchers and partners, including La Isla Network, aim to assess longitudinal health outcomes among agricultural workers in Nicaragua in relation to progressive improvements to a workplace heat safety adaptation strategy. In their case study, they will also quantify the financial return related to the workplace’s continued investment in the heat safety initiative.  

Steering Committee

  • Jefferson Fox, East-West Center
  • Stella Hartinger, Cayetano Heredia University
  • Saria Hassan, Emory University
  • Pamela Jagger, University of Michigan
  • NC Narayanan, Indian Institute of Technology, Bombay
  • Gila Neta, National Cancer Institute, NIH
  • Poornima Prabhakaran, Centre for Chronic Disease Control; Ashoka University
  • Josh Rosenthal, Fogarty International Center, NIH
  • Anne Dorothée Slovic, University of São Paulo; Economist Impact Unit
  • Rachel Sturke, Fogarty International Center, NIH
  • Sokhna Thiam , African Population Health Research Center – West Africa Regional Office
  • Caradee Wright, South African Medical Research Council
  • Lindsey Martin, National Institute of Environmental Health Sciences, NIH (former Steering Committee Member)


For general inquiries, please send an email to: ficclimatehealthcasestudies@mail.nih.gov.

Praveen Kumar, Ph.D.
NIH Climate and Health Scholar
Fogarty International Center
Associate Professor
Boston College School of Social Work
Email: praveen.kumar@bc.edu

Amit Mistry, Ph.D.
Senior Scientist
Center for Global Health Studies
Fogarty Division of International Science Policy, Planning and Evaluation
Email: amit.mistry@nih.gov

Jenna Durham, M.S.
Global Health Research and Policy Analyst (Contractor)
Center for Global Health Studies
Fogarty Division of International Science Policy, Planning and Evaluation
Email: jenna.durham@nih.gov

Related Information

Updated June 6, 2024