Harnessing Digital Health and Data Innovation for Climate-Adaptive Health Systems

Author: Karin Kallander, Chief of Digital Health and Information System, United Nations Children's Fund (UNICEF), August 27 2024 - Climate change is reshaping the lives of children, affecting their health and well-being from the earliest stages of development through adolescence. As the climate crisis deepens, the world must uphold the 1.5-degree target to curb air pollution and promote healthier diets.

To protect children, we must urgently intensify efforts on multiple fronts: equipping caregivers and frontline workers with vital knowledge and skills; strengthening climate-resilient primary healthcare to ensure essential services remain uninterrupted; securing access to nutritious food and clean water, and expanding social protection measures; enhancing preparedness and response to extreme weather events and disease outbreaks; and prioritizing child health and well-being in climate policy, investment, and action.

UNICEF's 2024 analysis highlights that one in 5 children - or 466 million - live in areas that experience at least double the number of extremely hot days every year compared to just six decades ago. Using a comparison between a 1960s and a 2020-2024 average, the analysis issues a stark warning about the speed and scale at which extremely hot days - measured as more than 35 degrees Celsius / 95 degrees Fahrenheit - are increasing for almost half a billion children worldwide, many without the infrastructure or services to endure it.

Children with disabilities are particularly vulnerable to the effects of climate change, which exacerbates the challenges they already face. Disasters, increasingly frequent and severe due to climate change, disproportionately impact these children, putting their health, safety, and education at greater risk. For example, they may struggle with mobility or communication, making evacuation and accessing emergency services more difficult.

Efforts to support children with disabilities in the context of climate change should focus on enhancing their resilience through accessible infrastructure, inclusive policies, and tailored health and education services. By prioritizing inclusivity in climate responses, we can help safeguard the well-being and rights of all children, especially the most marginalized.

Integrating climate and health data for predictive management

To tackle climate-related health risks effectively, we need to integrate climate data with health data and employ artificial intelligence (AI) and geospatial technologies. 

During climate crises, various data systems - encompassing environmental, meteorological, population and civil registration datasets, and health data - must exchange information seamlessly. This integration, powered by AI and predictive analytics, enhances our understanding and management of health risks. Population data can help identify geographical hotspots and convey safety alerts to targeted populations.

For instance, analyzing air quality trends, precipitation patterns, and other climate factors helps health systems anticipate and respond to seasonal changes, outbreaks, and disasters. By predicting pollution trends, heatwave impacts, and the spread of vector-borne diseases, health systems can tailor interventions and improve service delivery, reducing climate-related health vulnerabilities. The Advanced Early Detection and Exploration Service (AEDES) in the Philippines, for example, uses climate and health data for dengue prediction, which improves public health responses and prevents disease spread. Similarly, the "Clear the Air for Children" report utilizes global geospatial data to map air pollution and population distribution.

Empowering communities through digital platforms

Throughout my career as a public health professional, I've been a staunch advocate of community-driven initiatives. Recently, attending the 2nd High Level Partners Meeting of the Community Health Delivery Partnership (CHDP) further reinforced my belief in the power of community engagement for achieving Universal Health Coverage. The meeting highlighted examples from Afghanistan, showcasing robust community health programmes that support and protect community health workers.

This approach aligns seamlessly with UNICEF's Voices of Change (VoC), which harnesses community reporting through digital platforms like RapidPro and U-Report to enhance engagement and accelerate outcomes for children. By allowing communities to report environmental changes and health emergencies directly, these platforms empower local populations to adapt and respond swiftly to climate-related health challenges. Additionally, UNICEF plans to implement a combination of two-way SMS messaging, GIS mapping, and digital platforms to enhance service delivery in climate-affected areas. These technologies will ensure that essential maternal and newborn supplies, including vaccines and medicines, reach those in need.

Building capacity for frontline health workers

To improve community health reporting, especially in remote areas, we must leverage low-tech digital communication platforms like WhatsApp and SMS. Equally crucial is enhancing the skills of community leaders and frontline health workers to manage health data in the context of climate change. Specialized programs will equip them to address climate-related health issues effectively.

To address this need, the World Health Organization (WHO) and UNICEF have launched a free online course on children's environmental health. It covers key issues like air pollution, climate change, and e-waste, providing practical strategies for managing these challenges. This course aims to fill gaps in knowledge and empower healthcare professionals to better protect children’s health amidst environmental and climate challenges.

Leveraging geospatial data for resilient health systems

Mapping climate and environmental data alongside demographic and health data helps identify vulnerable populations and ensure that health services are available where they are most needed. This approach also informs the design of resilient health infrastructure and optimizes the management of medical supplies during extreme weather events.

Enhancing health information systems

Integrating climate-related health impact indicators into primary healthcare information systems is critical for fully harnessing these insights. This integration allows for a clearer understanding of how climate variables affect health outcomes, enabling health providers to track climate-related trends, anticipate needs, and tailor services accordingly. Strengthening primary healthcare responses ensures that services adapt to the evolving challenges posed by climate change.

Developing digital tools for policymakers

Advanced digital tools, such as interactive dashboards and predictive analytics, are essential for policymakers to translate complex data from primary healthcare information systems into actionable insights. These tools support informed decision-making and advocacy for climate-adaptive policies and investments in health infrastructure. For instance, the UNICEF Climate Dashboard evaluates the sensitivity of Nationally Determined Contributions (NDCs) to children and youth, aiding in the development of evidence-based climate strategies.

Strengthening collaborations with tech companies

To address emerging challenges and unlock new insights, collaborating with tech companies is vital. Partnering with the tech industry provides access to cutting-edge technologies and innovative solutions necessary for navigating evolving health and climate issues. By integrating diverse data sources and leveraging advanced technology, we can improve health outcomes, overcome existing barriers, and adapt our strategies to meet new challenges effectively. This collaboration supports the development and implementation of technologies like two-way SMS, GIS mapping, and digital tracking systems that enhance service delivery and capacity-building efforts in climate-affected areas.

These collaborations mentioned above not only lead to the development of new technological tools but also improve our ability to manage and interpret health data more effectively. They help eliminate paper-based systems in health services, which impose a heavy clerical burden on health workers, who often spend over 30% of their time on data reporting. Manual data entry is prone to errors, resulting in poor-quality data.

In our concept note "The Once and Done Approach - Using Digital Health to Deliver Services Across the Life Course for Improved Maternal and Child Health," I advocate for transitioning to digital tracking of clients' health status and services using standards-based personal health records (PHRs). This recommendation, aligned with WHO's guidelines on digital health interventions, can alleviate the burden in fragile regions. PHRs efficiently capture and store health information, enabling better follow-up on services and continuity of care. For example, standards-based PHRs can include maternal antenatal care records and child immunization records in a format that can be accessed by the individual as well as their health providers, even across national borders, ensuring comprehensive family care. This transition not only reduces the workload for health workers, enhances data accuracy and improves health service delivery, but it also helps individuals manage and understand their health.

The Organisation for Economic Co-operation and Development’s (OECD) "States of Fragility 2022" report highlights climate change as one of the top three crises, disproportionately affecting 60 fragile regions. Addressing this crisis requires harnessing digital health and data innovations to provide a holistic strategy for tackling the multifaceted health impacts of climate change. 

Integrating climate and health data, empowering communities, building capacity, utilizing geospatial insights, enhancing health information systems, developing advanced tools for policymakers, and collaborating with tech companies are all crucial for creating adaptive health systems. This integrated approach will protect vulnerable populations, particularly children, and bolster resilience as we navigate the challenges of a changing climate.

Image credit: © UNICEF/UNI394830/Dejongh

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