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Review
. 2018 Nov 26;15(12):2643.
doi: 10.3390/ijerph15122643.

Assessment of Risk, Vulnerability and Adaptation to Climate Change by the Health Sector in Madagascar

Norohasina Rakotoarison  1 , Nirivololona Raholijao  2 , Lalao Madeleine Razafindramavo  3 , Zo Andrianina Patrick Herintiana Rakotomavo  4 , Alain Rakotoarisoa  5 , Joy Shumake Guillemot  6 , Zazaravaka Jacques Randriamialisoa  7 , Victor Mafilaza  8 , Voahanginirina Anne Marie Pierrette Ramiandrisoa  9 , Rhino Rajaonarivony  10 , Solonomenjanahary Andrianjafinirina  11 , Venance Tata  12 , Manuela Christophère Vololoniaina  13 , Fanjasoa Rakotomanana  14 , Volahanta Malala Raminosoa  15
Affiliations
Review

Assessment of Risk, Vulnerability and Adaptation to Climate Change by the Health Sector in Madagascar

Norohasina Rakotoarison et al. Int J Environ Res Public Health. .

Abstract

Madagascar is cited as one of the most vulnerable countries to the effects of climate change, with significant impacts to the health of its population. In this study, the vulnerability of Madagascar's health sector to climate change was assessed and appropriate adaptation measures were identified. In order to assess climate risks, vulnerability and identify adaptation options, the Madagascar Ministry of Public Health as well as the National Meteorological and Hydrological Service worked in close collaboration with a team of local experts to conduct a literature review, field surveys, and analyses of current and future climate and health trends. Four climate-sensitive diseases of primary concern are described in the study: acute respiratory infections (ARI), diarrhea, malnutrition, and malaria. Baseline conditions of these four diseases from 2000 to 2014 show acute respiratory infections and diarrheal diseases are increasing in incidence; while incidence of malnutrition and malaria decreased over this period. To assess future impacts in Madagascar, this baseline information was used with climate projections for the two scenarios-RCP 4.5 and RCP 8.5-for the periods 2016⁻2035, 2036⁻2070 and 2071⁻2100. Future climate conditions are shown to exacerbate and increase the incidence of all four climate sensitive diseases. Further analysis of the exposure, sensitivity and adaptive capacity to the climate hazards suggests that the health sector in four regions of Madagascar is particularly vulnerable. The study recommends adaptation measures to improve the monitoring and early warning systems for climate sensitive diseases, as well as to reduce population vulnerability.

Keywords: Madagascar; adaptation; assessment; climate projections; climate trends; climate-sensitive diseases; health; vulnerability.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, and in the decision to publish the results.

Figures

Figure 1
Figure 1
The five climate regions of Madagascar.
Figure 2
Figure 2
The target districts for the assessment of climate and health trends.
Figure 3
Figure 3
Observed trends of (a) malnutrition in the city of Antananarivo and (b) malaria in Morondava.
Figure 4
Figure 4
Observed trends of (a) diarrhea in Antsiranana and (b) ARI in Farafangana.
Figure 5
Figure 5
Projected trends of (a) Malnutrition in Antananarivo and (b) Malaria in Morondava.
Figure 6
Figure 6
Projected trends of (a) ARI in Farafangana and (b) Diarrhea in Antsiranana.
Figure 7
Figure 7
Vulnerability (a) and exposure (b) of regions in Madagascar to climate hazards.
Figure 8
Figure 8
Sensitivity (a) and adaptive capacity (b) of regions in Madagascar to climate hazards.
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