Co-developing climate services for public health: Stakeholder needs and perceptions for the prevention and control of Aedes-transmitted diseases in the Caribbean

Abstract

Background: Small island developing states (SIDS) in the Caribbean region are challenged with managing the health outcomes of a changing climate. Health and climate sectors have partnered to co-develop climate services to improve the management of emerging arboviral diseases such as dengue fever, for example, through the development of climate-driven early warning systems. The objective of this study was to identify health and climate stakeholder perceptions and needs in the Caribbean, with respect to the development of climate services for arboviruses.

Methods: Stakeholders included public decision makers and practitioners from the climate and health sectors at the regional (Caribbean) level and from the countries of Dominica and Barbados. From April to June 2017, we conducted interviews (n = 41), surveys (n = 32), and national workshops with stakeholders. Survey responses were tabulated, and audio recordings were transcribed and analyzed using qualitative coding to identify responses by research topic, country/region, and sector.

Results: Health practitioners indicated that their jurisdiction is currently experiencing an increased risk of arboviral diseases associated with climate variability, and most anticipated that this risk will increase in the future. National health sectors reported financial limitations and a lack of technical expertise in geographic information systems (GIS), statistics, and modeling, which constrained their ability to implement climate services for arboviruses. National climate sectors were constrained by a lack of personnel. Stakeholders highlighted the need to strengthen partnerships with the private sector, academia, and civil society. They identified a gap in local research on climate-arbovirus linkages, which constrained the ability of the health sector to make informed decisions. Strategies to strengthen the climate-health partnership included a top-down approach by engaging senior leadership, multi-lateral collaboration agreements, national committees on climate and health, and shared spaces of dialogue. Mechanisms for mainstreaming climate services for health operations to control arboviruses included climatic-health bulletins and an online GIS platform that would allow for regional data sharing and the generation of spatiotemporal epidemic forecasts. Stakeholders identified a 3-month forecast of arboviral illness as the optimal time frame for an epidemic forecast.

Conclusions: These findings support the creation of interdisciplinary and intersectoral 'communities of practice' and the co-design of climate services for the Caribbean public health sector. By fostering the effective use of climate information within health policy, research and practice, nations will have greater capacity to adapt to a changing climate.

Fig 1. Map of the study region.

(A) Location of the Caribbean region within the Americas, (B) Archipelago of islands making up the Caribbean and their location within Meso-America. (C) Location of Dominica (purple) and Barbados (green) within the islands in the region. This map was created using freely available country boundary datafrom GADM.org, rendered in ArcGIS. Image files were created using GIMP freeware.

Fig 2. Stakeholder analysis.

Organizations that partner with the health sector (in white) in Barbados and Dominica on issues related to vector control and climate services for health. Organizations in black are current functioning partnerships. Organizations in red are partnerships that need to be strengthened with the health sector.

Fig 3. Perceptions of the strengths and weaknesses of the health sector with respect to the capacity to implement an early warning system for arboviral diseases.

EWS = early warning system, GIS = geographic information system, VBDs = vector borne diseases. Results shown as the number of health sector survey respondents (n = 32).