Monitoring and surveillance of climate risks on health in Mozambique

Mozambique is one of the world’s vulnerable countries to the climate change. The country has experienced significant natural disasters over the past 45 years, which have impacted its health system. The major disasters are related to extreme weather events such as floods, droughts and tropical cyclones.

The health impacts are diverse; encompassing communicable and non-communicable diseases. The diseases with major public health concern are malaria and diarrhea.

The Ministry of Health of Mozambique created the National Health Observatory in 2015, with a dedicated section for Climate, Environment and Health. This is an appropriate structure to explore environmental and climatic risks on health based on secondary data with the aim of providing evidence to influence the decision-making process.

The evidence generated through the Observatory has mainly related to risk maps for climate sensitive diseases and analytic products, such as reports, epi bulletins, infographics, policy briefs, and others. These are used to support monitoring and surveillance activities specifically in the anticipation of risk at the local level and have informed planning for interventions related to prevention and promotion.

1. Mozambique recently conducted the first Vulnerability and Adaptation Assessment of the Health Sector to the impacts of climate change. The analysis used existing data from 1979 up to 2019and through triangulation analysis of different variables it was possible to generate maps of exposure (climatic variables and extreme weather events), sensitivity (ecosystem and geography and its risks, demography, population, and vulnerable population), adaptative capacity (human resources and budget for health, access to the health system and WASH and social determinants of health).
   • the findings showed that around 90% of districts have low to very low adaptative capacity.  Using these parameters (based on IPCC guidelines) for all 160 districts the Vulnerability index was generated at national level.
      
2. The analysis provided a list of recommendations for the health system as a whole and informed the Health National Adaptation Plan for Climate Change.With the support of the WHO, the Observatory tested an Early Warning System, based on the triangulation of health routine and epidemiological data with climatic and meteorological data. The system was calibrated based on the epi channel for malaria. A web-based system was tested in four vulnerable districts (Marracuene, Govuro, Buzi and Nampula city).
   • findings showed a system that could generate trends over several years, determine the RR of an outbreak, and georeference potential cases within the district.
   • the system could anticipate the risk at least 10 weeks in advance.
      
3. In collaboration with the National Meteorology Institute, the Observatory is working towards building climate services for health as part of the National Forecast Cluster in which different sectors are providing predictive scenarios for the next rainy season according to the Met Office Outlook.
   • since 2018 risk maps have been generated at national level highlighting geographical areas in which the sector should pay attention during the rainy and cyclonic season (October up to March of the following year)
   • since 2020, the risk maps for malaria and diarrhea are included in the National Contingency plans for the Rainy and Cyclonic season
   • This is one of the health sector preparedness strategies for future emergencies, using a multi-sectoral collaboration approach