Africa contributes the least of any continent to global warming. People living on the continent are in line to be the hardest hit.[1,2]
Climate has always featured prominently in African development, and people across the continent have been living with and adapting to a high degree of climate variability and its associated risks for many centuries. Yet the accelerated changes in the climate and increasing incidence of climatic disasters (floods, droughts, cyclones) as well as the impact of wars, famine and disease (notably but not exclusively HIV & AIDS) during the last century - and the scientific consensus that Africa is the continent most vulnerable and least able to cope with these changes - have brought these risks into sharper focus, and made the need to address them more urgent. The major challenge presented is to identify actions that will support, strengthen and accelerate ongoing development efforts while making them more resilient to climatic risks and vulnerabilities. Therefore, the need to link adaptation to adequate healthcare, knowledge and human and social development, and to evaluate these facets within the climate change context is imperative. The projects’ strategy proposed by the Foundation for Professional Development (FPD) and Africa Health Placements (AHP) is based on the premise that increased climate variability threatens the human and social development gains of vulnerable African communities, and that these effects require urgent addressing through the implementation, monitoring and evaluation of education, measuring of attitudes to climate change over time, advocacy of policy advancement, and access to healthcare, so that efforts can be made towards the development and strengthening of more resilient communities. We aim to implement the project in 10 African countries. It is further envisaged that collaboration and campaigning with Greenpeace (Africa) will take place within the consortium, in this way further promoting a more sustainable future for the world's people based on fair and sustainable use of resources.
Category of the action
What actions do you propose?
Africa will be unable to prevent the build-up of greenhouse gases. What is required to counter the impact is to develop strategies on how to adapt to the build-up, and to develop the resilience of communities and societies. Our strategy will be to 1) develop health care support to African affected populations, and 2) to develop knowledge and capacity building of both national and regional institutions, with a priority for climate and meteorological information, as well as disaster preparedness, healthcare and strategic planning. The project will focus on capacity building linked to comprehensive action research involving cross-sector longitudinal cohort impact studies that can inform policy and practice in 10 African countries most affected.
The African countries, in which this consortium will implement the proposed programme and conduct climate-related research, are already facing severe shortages in human resources in health (HRH). This is creating massive problems in access to health care – acknowledged as one of the major contributing factors to the region not meeting health-related Millennium Developmental Goals.  Shortages are linked to these countries’ inability to train, recruit, deploy and retain staff in areas of the greatest need. Several factors, including increased service demand due to rapid population growth, the highest HIV prevalence rate in the world, workforce attrition due to high HIV prevalence rates amongst healthcare workers, emigration of highly skilled healthcare workers, and working conditions that create little incentive to attract and retain skilled workers, compound this problem. Production of healthcare workers is stagnant or declining in most countries due to insufficient investment. The skills mix is often inadequate to address current health and welfare needs. Healthcare workers who do remain in the system are often poorly trained and struggle to cope with the increasing complexity of managing patients on prolonged chronic treatment, or dealing with climate-related diseases such as an outbreak of vector- borne diseases. They also do not have access to continuing education programmes. As the health of the most vulnerable and poverty-stricken people in this region are further impacted by climate-related health issues, this crisis in access to health care is set to devastate current and future generations. The likelihood and ability of African governments to prepare for such climate-related impacts are further diminished by the lack of skills and knowledge in such issues, as well as by a short-term focus needed to deal with the current health crisis that is at hand. In order for the health of the people in a semi-arid region that is highly susceptible to climate changes to be protected, it is vital that Africa immediately starts developing strategies to become more resilient.
The climate change course proposed under this activity covers a range of competencies required to provide comprehensive knowledge, and can be conducted across consortia and anywhere in the world (FPD is the only private health specific institution of higher education in South Africa that can do so). Each of these training programmes combines comprehensive, evaluated, self-study with 1 to 3 days facilitated contact sessions. Participants receive face-to-face tuition in a workshop format. Participants are provided with comprehensive self study manuals designed to eliminate the need for participants to buy expensive textbooks or access libraries or journals that are often unavailable. This methodology is designed to limit time away from the work place, facilitate access to adult learning through presenting training and workshops in venues close to where participants work, reduce costs – by offering training at decentralized venues no costs are incurred for participant travel and accommodation, optimize the use of scarce local experts as faculty and mentors, and promote a culture of continuous learning through an alumni society.
To develop, strengthen and evaluate managerial knowledge, attitudes and skills concerning climate change amongst key managers working in government and civil society in 10 African countries. The expected results are:
- Increased knowledge and evidence base amongst participants on managerial levels.
- Increased ability to undertake managerial functions such as developing strategic plans and budgets related to climate change.
- Increased ability to manage climate change sensitive projects.
- Improved evidence generated from various study scales that will inform policies and practices in order to help vulnerable populations or sectors adapt to climate change.
To develop and evaluate clinical knowledge, attitudes and skills amongst key health care workers working in the medical and para-medical field within government and civil society within the within the 10 African counties. The expected results are:
- Increased knowledge amongst participants on climate change related subjects.
- Increased ability to provide appropriate medical, clinical and social care.
- Increased numbers of clients on care at appropriate levels of the health care system.
To support the recruitment and retention of highly skilled professionals to work in 10 African countries in climate change high risk areas, and the evaluation of their impact on poor and vulnerable communities. The expected results are:
- Increased number of national and international applicants for placement that can service affected communities in a sustainable manner.
To strengthen regional alumni societies for clinical and managerial staff in identified 10 African countries. The expected results are:
- Increased access to current research and best practice through regular journals, newsletter and professional development activities.
To create a scholarship programme and networking opportunity for regional clinical and managerial leaders to participate in annual climate change related conferences. The expected results are:
- Participation in these conferences.
- Knowledge sharing.
- Increased opportunities to network.
- Increased access to potential donors.
- Advocacy and policy advancement within the climate change sector.
We propose to further:
- Identifying shortages of clinical skills in vulnerable areas through a health workforce planning exercise.
- Designing a disaster relief programme with government departments and communicating these to facilities.
- Reviewing health and environmental policies as they relate to access to health for the most vulnerable communities.
- Training a cadre of social workers who will, in turn, train two community health worker mentors. The community health worker mentors will work with government-deployed primary health care community health workers to tackle climate-related health issues in communities.
- Establishing information systems to track changes in climate-related illnesses and diseases to create early warning systems for governments.
Who will take these actions?
Both the Foundation for Professional Development (FPD) and Africa Health Placements (AHP) have a proven capacity to deliver high quality cost effective programmes in Africa and has to date collectively worked in over 15 African countries. The programme aims to lead to tangible impacts as early as possible. It is anticipated that the poor and most vulnerable will benefit both directly (though healthcare services) and indirectly (through the training of health care practitioners, government officials, and civil society) through the study interventions and all the action research (longitudinal impact cohort studies) undertaking by the consortium. FPD and AHP will focus on developing capacity in the community and community outreach, and will dedicate funding and staff to these activities. The consortium is currently in discussion with Greenpeace (Africa) and envisage a collaboration with them that will target vulnerable communities and focus on resilience building and sharing knowledge. Greenpeace is a global campaigning organisation that acts to change attitudes and behaviour to protect and conserve the environment and promote peace. Greenpeace has a Strategic Framework which focuses their global activity on addressing the key issues that threaten the global environment – particularly climate change, biodiversity erosion, genetic pollution and conflict for access to resources. Collectively, consortium community engagement projects are aimed at local public sector health delivery system, stakeholders and decisions makers in strengthening intervention formation and implementation, and therefore benefitting the poorest of the poor.
FPD will engage in the training of health care providers, governments and civil society members on aspects relating to climate change. AHP will be responsible for the recruitment, retention and support of healthcare practitioners in affected areas. Impact studies will be conducted by all the proposed organisations in the consortium.
Where will these actions be taken?
10 African countries - the proposed countries are Angola, Botswana, Kenya, Lesotho, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.
All the organisations mentioned in the outline have the experience, reach and capacity to also implement these activities on other continents.
What are other key benefits?
Our principle strategy is to enable healthcare accessibility to those most affected by climate change and to educate healthcare practitioners, government officials and civil society on climate change related aspects. We aim to build the capacity of local African institutions and societies at an early stage of the programme, and to promote advocacy and policy advancement within the climate change sector.
What are the proposal’s costs?
Approx USD 15 million for 5 years
5 years - with possible extension
- International Energy Annual 2002. 2004. DOE/EIA-0219(2002). Washington, DC.
- Fields, S. 2005. Continental divide: why Africa’s climate change burden is greater. Environ Health Perspect, 113(8): A534-A537.
- United Nations. Millennium Developmental Goals. Accessed 3 April 2013 at http://www.un.org/millenniumgoals/
What role will civil society actors play in climate adaptation?