HEALTH NATIONAL ADAPTATION PLAN TO CLIMATE CHANGE
REPUBLIC OF ZAMBIAMINISTRY OF HEALTHHEALTH NATIONALADAPTATION PLAN TOCLIMATE CHANGE2019
FOREWORDThe Government of the Republic of Zambia’s aspiration is to become aprosperous middle-income country as enshrined in the Vision 2030. Tocontribute to this Ministry of Health has pitched the health of theZambian Citizenry high as health is wealth. The Ministry isstrengthening health systems through an integrated community basedprimary health care approach in its pursuit to attaining Universal HealthCoverage. However, the impact of climate change on health may negatethis important aspiration.The health sector like other sectors is expected to be severely affected by climate change therefore,the need to adapt is necessary. This document has been developed to help mitigate the effects ofclimate change on the health sector.The Government in the Seventh National Development Plan (7-NDP) recognises that adaptation andmitigation to climate change is cardinal as this promotes social wellbeing. The Health NationalAdaptation Plan that you have in your hands is designed to ensure that the health of the population inZambia is protected from the effects arising from climate change. The Ministry of Health is amongthe rst institution in the country to have developed a sector National Adaptation Plan whichdemonstrates the Ministry’s commitment to ensuring that the Zambian community is safeguardedagainst climate variability and change.The Health National Adaptation Plan will be extensively used by the Ministry to reduce risks, whileadvancing local and national adaptive capacity and resilience in the health system with an overallgoal of minimising vulnerability to the negative impacts of climate change.I recommend this document to you.Hon. Dr Chitalu Chilufya MP MCCMINISTER OF HEALTH
ACKNOWLEDGEMENTThe process of developing the Health National Adaptation Plan (HNAP)involved consultations with a wide cross section of stakeholders whosecontributions nancially, technically and materially has made it possiblefor this document to be produced. The Health National Adaptation Planstrengthens health systems through various action plans that addressclimate variability and change, including dealing with upstream driversof health risks associated with climate change.Sincere gratitude goes to the United Nations (UN) Joint Program and United Nations DevelopmentProgram (UNDP) for providing nancial and technical support towards the development of thisvaluable document. The Ministry of Health would like to pay special tribute to the Ministry of Landsand Natural Resources and the Ministry of Transport and Communication for their invaluablecontributions towards the development of this document.Special appreciation goes to all members of staff in the Ministry of Health who provided appropriateinput and comments towards the nalisation of this document.Dr Kennedy MalamaPermanent Secretary- Technical ServicesMINISTRY OF HEALTHiii
TABLE OF CONTENTSFOREW ORD. .iiAcknowledgement .iiiList of tables . viList of gures . viABBREVIATIONS . viiDEFINITIONS . ixEXECUTIVE SUMMARY .x1.INTRODUCTION .12.METHODOLOGY .33.BACKGROUND INFORMATION .64.SITUATION ANALYSIS . 94.1 Key Health Indicators. 94.2 Burden of climate sensitive diseases . 104.2.1Infectious/communicable diseases . 104.3 Non communicable diseases . 154.4 Determinants of health impacting on disease burden. 154.4.1Poverty . 1654.4.2Nutrition . 164.4.3Water, Sanitation and hygiene . 164.4.4Housing . 174.4.5Energy sources . 174.4.6Education and literacy. 174.4.7Population structure and growth . 184.4.8Health systems and access to health services . 184.4.9Policy environment . 21OBSERVED CLIMATE VARIABILITY AND HEALTH IMPACTS .235.1 Observed climate variability . 235.1.1Variability in precipitation patterns . 235.1.2Temperature variability . 255.1.3Community perception of climate variability . 255.2 In uence of observed climatic conditions on selected diseases . 255.3 Health impacts from observed climate risks . 295.3.1Floods or excessive rainfall: . 296iv5.3.2Droughts . 325.3.3Temperature: . 32PROJECTED CLIMATE CHANGE AND HEALTH IMPACTS .36
6.1 Projected climate change for Zambia . 366.1.1Temperature . 367.6.1.2Rainfall . 366.26.2.1Health impacts from projected climate variability. 36Diarrhoea: . 376.2.2Cholera . 376.2.3Under-nutrition . 386.2.4Malaria: . 39VULNERABILITY TO CLIMATE CHANGE .407.1 Geographical . 407.2 Current disease burden . 417.2.1Malaria . 417.2.2Diarrhoeal diseases . 427.2.3Respiratory diseases . 437.2.4Under-nutrition . 447.2.5HIV and AIDS . 448.7.3 Socioeconomic status . 447.4 Education and literacy . 457.5 Access to health services . 457.6 Population growth and urbanization . 46ADAPTATION .499.8.1 Evaluation of adaptation options . 498.2 Selection of proposed adaptation measures . 558.3 Mainstreaming climate change into the public health . 59APPENDICES .609.1 ADAPTATION OPTIONS AND IMPLEMENTATION PLAN: 2018 -2021 . 609.2 Sources of information . 659.3 STAKEHOLDERS IN THE IMPLEMENTATION OF H -NAP . 669.4 Questionnaires . 6810. REFERENCES .7v
List of tablesTable 1: Framework for climate proo ng Zambia and chapters where details are provided in thisdocument . 4Table 2: Climatic characteristics of the country based on agro-ecological zones . 6Table 3: Health system performance and attainment of MDG targets .9Table 4: Malaria epidemiological zones in Zambia . 12Table 5: Summary of extreme climate events and impact on health and livelihoods. 34Table 6: Summary of selected of drivers of vulnerability for Zambia . 48Table 7: Health conditions/diseases vulnerable to climate change and rating for need to adapt 50.Table 8: Public health principles applicable to climate change response for Zambia . 57List of figuresFigure 1: Top 7 causes of visitation to health facilities 2003 -2013 . 10Figure 2: Malaria incidence 2003 - 2013 . 11Figure 3: Incidence of respiratory tract infections (non-pneumonia) 2003 - 2013 . 13Figure 4: Incidence of non-bloody diarrhoea 2003 -2013 . 14Figure 5: Annual cholera cases by province 2009 - 2013 . 15Figure 6: Incidence of non-communicable diseases 2010 - 2013 . 15Figure 7: 30 year average rainfall indices for agro-ecological zones . 24Figure 8: In uence of climatic variables on average monthly malaria and diarrhoea cases forselected districts: averaged for 2009 - 2016. 27Figure 9: Cholera trends by epidemiological week in Lusaka District . 31Figure 10: Geographical distribution of malaria disease burden . 42vi
CRSCSOCDDDALYsDMMUDDTDPT- Hep tation FundArtemisinine combination therapyAgricultural Ecological ZoneAnnual Health Statistics BulletinBacille Calmette GuerinChurches Heath Association of ZambiaCommunity Health WorkersCapacity strengthening in the least developed countries for adaptation to climatechangeCommunicable DiseasesCentral Intelligence AgencyCentre for Energy, Environment and Engineering ZambiaCatholic Relief ServicesCentral Statistics Of ceCardio Vascular DiseasesDisability Adjusted Life YearsDisaster Mitigation and Management UnitDichlorodiphyneltrichloroneDiphtheria hepatitis-b hemophilus in uenzaExpanded Programme on ImmunisationHealth Management Information SystemHealth National Adaptation PlanHuman Resources for HealthGreen Climate FundGross Domestic ProductGross National IndexGovernment Republic of ZambiaHeadquartersIndoor Residual SprayingIntergovernmental Panel on Climate ChangeIntermittent Preventative TherapyInsecticide Treated NetsInternational Union for Conservation of NatureInternational Confederation of Red CrossHuman Ummuno-VirusLiving Conditions Monitoring SurveyMalaria Control and Elimination ProgrammeMillennium Development GoalsMinistry of HealthMinistry of Finance National PlanningMinistry of Tourism and National EnvironmentNon-Communicable DiseasesNational Disaster Management Policyvii
iNational Community Health Worker Strategy in ZambiaNational Institute for Scienti c and Industrial ResearchNational Health Strategic PlanNational Malaria Strategic PlanIntergovernmental Panel on Climate ChangeLeast Developed CountriesLeast Developed Country FundLower and Middle Income CountriesNational Adaptation PlanNational Adaptation Programme of ActionsPrimary Health CareParticulate matter of aerodynamic size of 2.5Particulate matter of aerodynamic size of 10Sexually Transmitted InfectionsTuberculosisTropical Disease Research CentreTotal Fertility RateUnited Nations Framework Convention on Climate ChangeUnited Nations Children FundWater Regulation Management AuthorityWorld Health OrganisationZambia Demographic Health SurveyZambia Red Cross SocietyZambia Vulnerability Assessment Committee
DEFINITIONSAgro-ecological zonesGeographical areas exhibiting similar climatic conditions thatdetermine their ability to support rained agriculture. These arein uenced by latitude, elevation, and temperature, as well asseasonality, and rainfall amounts and distribution during the growingseason.Improved water sourceA source of water by nature of its construction or through activeintervention, is likely to be protected from outside contamination, inparticular from contamination with fecal matter.Improved sanitationA that hygienically separates human excreta from human contact. It isnot necessarily identical with sustainable sanitation.Hot days/nightsTemperature exceeded on 10% of days/ nights in current climate of theregion and season (McSweeney,2009)Cold days/nightsTemperature below which 10% of days/nights are recorded in currentclimate of that region and seasonHeavy eventDaily rainfall total which exceeds the threshold that is exceeded on 5%for rainy days in the current climate of that region and seasonClimate changeAdaptive capacityUNFCCC refers to a change of climate that is attributed directly orindirectly to human activity that alters the composition of the globalatmosphere and that is in addition to natural climate variabilityobserved over comparable time periods.The ability of a system to adjust to climate change (including climatevariability and extremes) to moderate potential damages, to takeadvantage of opportunities, or to cope with the consequences.Vulnerability Is the degree to which a system is susceptible to, and unable to cope with, adverseeffects of climate change, including climate variability and extremes.ix
EXECUTIVE SUMMARYBackground and contextClimate change and variability poses a challenge to sustainable human development. The effectsof climate change on human health are a result of interactions of environmental, social and healthsystem conditions. Addressing the effects from climate change requires adaptation. In order tohelp the Least Developed Countries (LDCs), which are the most affected, adapt to climate changeand variability, in the medium and long term, the United Nations Framework Convention onClimate Change (UNFCCC) recommends that countries draw up their national adaptation plans(NAPs.) The NAP is a multi-sectoral process to which each socio-economic sector in a nation’sdevelopmental agenda inputs.The health sector is highly sensitive to climate change, and to ensure that the health of populationsis protected from the effects of climate change, it is imperative to include a health component (theHNAP) in the NAP. Zambia recognises the negative impact of climate change on the developmentgoals of the country and the need to respond to this threat. The government re ects this in theSeventh National Development Plan (7NDP) and other policy pronouncements: National DisasterManagement Policy and National Climate Change Policy.This document is the health national adaptation plan (HNAP) for Zambia. It presents the resultsof a national consultative process to identify climate risks and adaptation measures relevant to thehealth sector and also sets out the road map to the implementation of the HNAP.MethodologyA vulnerability and adaptation assessment exercise was carried out between November 2016 andJune 2017. A desk review was conducted and extensive consultations with environmental healthexperts and other staff within the MoH were held. Relevant documents on climate change ingeneral and its impact on public health and developmental goals of the country in particular werereviewed. Furthermore, ranking of climate-sensitive health risks, and analysis of the availablelong-term data on climate and climate-sensitive diseases in the country were done. Health data atdistrict and provincial level from 2000 – 2015, together with meteorological variables(temperature and rainfall), were analysed. Consultations with experts were undertaken throughinterviews with MoH of cers at provincial and national of ces while the district levelconsultations were through workshops.X
Situation analysisBurden of climate sensitive diseases:Malaria, diarrhoeal diseases (non -blood) and respiratory infections (non -pneumonia) together arethe major cause of morbidity and mortality. Malaria alone causes the most morbidity and is amajor contributor to maternal and child deaths. Respiratory infections and diarrhoea have shownan upward trajectory for the years reviewed although case fatality reduced. Among noti ablediseases, cholera has become endemic in Zambia occurring as annually outbreaks especially inthe wet months.Determinants of h
Seventh National Development Plan (7NDP) and other policy pronouncements: National Disaster Management Policy and National Climate Change Policy. This document is the health national adaptation plan (HNAP) for Zambia. It presents the results of a national consultative process to identify climate risks and adaptation measures relevant to the
approaches to climate change adaptation. By adopting this framework, organisations can self-identify their own level of adaptation readiness and seek to enhance it. Keywords: climate change adaptation; extreme weather; adaptation framework; adaptation pathways; re
Puyallup Tribe's video Red Lake Band of Chippewa Indians: A Climate Adaptation Plan for the Red Lake Band of Chippewa Indian. Shinnecock Indian Nation: Climate Change Adaptation Plan St. Regis Mohawk Tribe: Climate Change Adaptation Plan for Akwesasne Swinomish Tribe: Swinomish Climate Change Initiative Climate Adaptation .
Ethiopia‟s National Adaptation Plan (NAP-ETH) builds on ongoing . Implementing effective and sustainable funding mechanisms 4. Advancing adaptation research and development in the area of climate change adaptation
Climate change adaptation (CCA) approaches taken by a country or region is specific to its context and adaptation needs and could include the following: hard, engineered infrastructure-based investments (i.e. sea walls); community-based adaptation (CBA) and/or the use of nature-based solutions such ecosystem-based adaptation approaches (EbA).
1 Key Climate Change Impacts and Adaptation—Fossil Fuel Extraction and Transport 10 2 Key Climate Change Impacts and Adaptation—Thermal Power 14 3 Temperature Effect on Nuclear Power Efficiency 15 4 Key Climate Change Impacts and Adaptation—Nuclear Power 18 5 Key Climate Change Impacts and Adaptation—Hydropower 24 .
Science ABC Review Book Instructions Review Book Instructions A is for adaptation. A is for adaptation. Define adaptation . Draw a picture of a plant and an animal that has an adaptation . Explain how the each adaptation helps the animal and plant survive. B is for behavior. B is for behavior. Draw two scenes of an animal in its NATURAL habitat.
Republic of Fiji National Adaptation Plan vi Introduction In response to international commitments and national needs, under the leadership of the Ministry of Economy, the Fijian Government has prepared this high-level strategic National Adaptation Plan (NAP) to spearhead ongoing efforts to comprehensively address climate change.
The Battle of the Bulge By David Motley Photos by David Motley and Wes Lambe Old Gibson flat top guitars have their excesses and flourishes. Top belly bulges sometimes develop just below the bridge. Like a long term sweets addiction, string tension and time can play havoc with an old lady’s mid drift profile. When introduced in 1927, the Nick Lucas Special was Gibson’s top of the line .
