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Dr. Nitish Dogra, Fulbright Fellow, discusses the importance of setting up a climate and health database and presents a case study on the impact of climate change on health in two adjacent districts near Gurgaon, India.
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US-India Partnership for Climate Resilience Workshop on Development and Application of Downscaling Climate Projections Pune, 7-9th March, 2017 Dr. Nitish Dogra, MD, MPH Fulbright Fellow (2013-14) Consultant, UCHAI
Outline Fulbright Work UCHAI National Database Case Study
Rationale Why set up a climate and health database? • Climate change is an emerging issue but in the years ahead the problem is expected to increase. • Baseline is essential to compare the natural course as also the effectiveness of interventions. • Climate and health gradients will vary across districts and climate zones. • National burden of disease estimates not possible without adequate number of sites (minimum 60).’ • Future estimates requirement
Data Requirements • Historical • Last 10 year daily rainfall, temperature (max, min and mean), humidity • Predictive • 7 day temperature and rainfall • Projection • Temperature and rainfall How far into the future...2020, 2025 and 2030...beyond?
Aim of this Group work • 3) Site Meteorological station in vicinity of Community Health Centre (since rainfall cannot generally be extrapolated beyond 15 km
Aim of this Group work • 4) Approach • A) Community Medicine MD thesis through grant contest • B) Through State Health Program officers • C) Via UCHAI researchers • D) IMS collaboration • E) NCDC and IMD collaboration
Time Period 5) Time period • 3 years
Challenge1: Weather data external validity Health data from district will not coincide with historical station data
Solution1: Weather data external validity Collect data at CHC level
Challenge 2: Health data external validity Besides government health facility • Private practitioners • Indigenous system • RMPs (quacks) • Treatment at home
Solution 2: Health data external validity • Community based prospective cohort studies at each of India’s climate zones • Best to use existing sites like Vadu at KEM
CASE STUDY Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Site Selection TWO ADJACENT DISTRICTS NEAR GURGAON (MEWAT AND REWARI IN NORTH INDIA) Same climate zone (semi-arid) Sensitivity differs radically (women, children, poor) Barriers to adaptation are also markedly at variance Hence best place to study how climate change impacts health Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Background • Guidance document on V&A • Workplan Presentation: 2010 PAHO/WHO Global • Workshop in Costa Rica • WHO SEARO supported and guided project • First of it’s kind exercise in South-East Asia • Climate-proofing of interventions Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Objectives • To assess the baseline vulnerability for climate-sensitive diseases at the local level in India • To construct a pilot tool for assessment of health • vulnerability to climate change at the sub-national • level in India (SEPARATE STUDY) Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Scope • Diarrhoeal diseases • Vector-borne diseases • Heat stress Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Methods:Quantitative • Time-series analysis • Household survey • GIS Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Results:Quantitative • Time-series analysis • MEWAT: 1o rise in temp= 3.2% rise in diarrhoea • REWARI: 1o rise in temp= 4.3% rise in diarrhoea • Household survey • Community based study with contrasting findings Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Results: Qualitiative • Key informant interviews • Focus group discussions (FGDs) • o Both the above constitute additional evidence • bringing out health access issues. • o Provide a clue to the apparently contradictory • findings of the time-series analysis. Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Discussion • Prospective time-series studies required. • Detailed household surveys may not be feasible. • GIS methods need to be evolved. • Qualitiative methods apart from FGD and KII. • Mixed methods with community studies essential. Source: all-free-download.com/free-photos/download/earth_dry_dehydrated_223112.html
Thank-You Source: http://www.abc.net.au/reslib/200707/r157677_571889.jpg