Implementation Science to Enhance the Effectiveness of Early Warning Systems in Pacific Island Countries

Pacific Island countries are among the places most at-risk for climate change health impacts. This high risk is due to their exposure to many climate-exacerbated hazards, social and environmental vulnerabilities, and insufficient capacity to prepare and respond. Projects to support climate resilience of public health agencies in Pacific Island countries are just beginning; these aim to promote anticipating, responding to, coping with, recovering from, and adapting to climate-related shocks and stresses. Activities will include developing climate-informed early warning and response systems (EWS). These systems are one example of health adaptation interventions that, as part of a larger package of integrated surveillance systems and climate services for health, aim to enhance the capacity of health systems to prepare for and adapt to changes in the geographic range, seasonality, and intensity of transmission of climate-sensitive diseases. A climate-informed EWS supports decision-making of national and local-level institutions to enable vulnerable groups in society to take action to reduce the impacts of an impending risk. Core components of a climate informed EWS include monitoring environmental conditions or hazards; analyzing and forecasting high-risk conditions; disseminating timely alerts; and establishing a mechanism for preparedness and early response actions. When implemented effectively, climate-informed EWS have the potential to reduce health risks.

However, similar adaptation projects in other regions have often been less effective than expected, bringing fewer improvements in population health and health systems than desired. The field of implementation science seeks to systematically close the gap between what we know and what we do (often referred to as the know-do gap) by identifying and addressing the barriers that slow or halt the uptake of proven health interventions and evidence-based practices. There are nascent efforts to bring the insights of implementation science into health adaptation to facilitate the uptake of evidence-based practice and research into regular use by practitioners and policymakers.

The study will address research and operational gaps in health adaptation by generating context-specific knowledge on perceived climate change-related health risks (today and over the next few decades), the prioritization of potential adaptation interventions, and readiness to develop and operationalize climate-informed EWS for health risks from the perspective of multiple stakeholders. The study will focus on the Republic of Marshall Islands and the Republic of Kiribati, which are at similar stages of implementation for climate-informed EWS, but also face unique challenges due to exposure to climate-related hazards and health system capacities, to provide illustrative case studies from the Pacific Island context. Using a case study and action-oriented approach, different sources of data will be collected from diverse viewpoints to better understand and contextualize the situation. This study will address the need for additional exploration and description of climate change-related health risks and implementation of health adaptation interventions, including climate-informed EWS, in under-studied settings. Further, the proposed study will inform the co-design of strategies to enhance organizational readiness for the health sector and overcome barriers to implementing climate informed EWS.