Integrating climate change into the management of priority health risks in Ghana
The project aimed to strategically develop systems, processes and thinking to strengthen the integration of climate change into the health sector and shift the current response towards being more anticipatory, deliberate and systematic. It is intended that this will result in a scenario in which the focus is placed on identifying, implementing, monitoring, and evaluating adaptations to reduce current and likely future burdens of malaria, diarrhoeal diseases, and meningococcal meningitis, which are the priority climate-related health issues identified by national stakeholders for targeting under this project. This focus was achieved by actions organised around three components:
1. Strengthening technical capacities to manage climate change-related health risks;
2. Mainstreaming climate change health risks into decision-making at local and national health policy levels;
3. Strengthening the climate change-health risk knowledge base through managing information and effectively disseminating it.
The project involved national-level (with Ministry of Health and Ghana Health Service) and sub-national-level activities in three pilot districts (Gomoa West in Central Region, Bongo in Upper East Region, and Keta in Volta Region). The support to the districts was channelled through the District Health Management Team (DHMT) and corresponding Regional Health Directorate, under Ghana Health Service.
● Mechanisms were established for cross-sectoral coordination to support climate change-resilient health policy formulation and implementation at national and local levels. For example, in 2013, interagency climate change committees were established in all the pilot districts. These committees are still functioning and have helped raised the level of awareness of the impact of climate change on health and the need to develop appropriate response strategies to minimize these impacts.
● Gender sensitive actions were included in the 2014-2017 Health Sector Medium Term Development Strategy.
● A gender sensitive communication strategy was developed to create awareness and knowledge about climate change and gender in the promotion of health and the facilitation of positive attitudes and behaviours that effectively respond to climate variability.
● A set of indicators for monitoring and measuring climate change resilience in the health sector have been developed. These indicators are being used by the Ministry of Health and Ghana Health Service in measuring progress made in responding to climate change impacts on healthcare delivery in Ghana.
● The project carried out the following assessments: climate projections for the health sector to improve responses at the national, regional and district levels; climate change health risks at the national level and at the three pilot districts; disease surveillance systems. These studies informed the development of a Climate Change and Health Action Plan being implemented by the Ministry of Health.
● The disease surveillance assessment has assisted the health sector to avoid, prepare for and respond to climate change-related health risks, especially those relating to reducing current and likely future burdens of malaria, diarrhoeal diseases and meningococcal meningitis. The project trained over 180 disease surveillance volunteers across the pilot districts.
● Over 750 health workers from the pilot districts, regional and national level staff were trained, re-orientated, prepared to identify and manage climate sensitive diseases. These covered areas in health support services such as preparing health workers to use mobile handsets as means of communicating with medical physicians to address health needs of periphery community members who cannot travel to central hospitals because of extreme weather conditions such as flooding.
● Teleconsultation Medicine Centres were established in the three pilot districts and improved healthcare delivery. For instance, between 2008 and 2013, the Keta Municipality in the Volta Region recorded an average of 100 cholera cases annually. But in 2014 when more than 28,000 cholera cases and 200 deaths were recorded in Ghana, Keta had none, even when the Volta Region to which Keta belongs reported 646 cholera cases. Teleconsultation is an innovation to quicken surveillance response and provide prompt health care to people in remote areas and other places cut off by the effects of climate change such as extreme flooding. It takes advantage of mobile telephony where coverage is available to provide medical consultation services on mobile telephones to patients and health facilities at referral levels.
● Oral Rehydration Therapy corners in 58 health facilities in the pilot districts were established. Patients with mild/moderate dehydration can be managed through the provision of Oral Rehydration Salts (ORS) and zinc, screened for severe dehydration and referred to a health facility as needed. ORT corners are not equipped to handle longer-term treatments such as intravenous rehydration, which require a well-equipped health facility, but help reduce the severity of dehydration. Patients are also taught how to prepare ORS, use it at home, and given other key information on preventing and managing cholera and diarrhoea.
● The level of awareness of the nexus between climate change and health was increased in the pilot districts through a series of community durbars involving the youth, traditional leaders and women.
USD 1,718,182 (Special Climate Change Fund - SCCF| Global Environment Facility); USD 200,000 (UNDP)