Climate & Health

Executive Summary

The Climate & Health Program is a comprehensive, multi-sectoral initiative designed to address the profound and growing health impacts of climate change in Kenya. Launched in 2025, this flagship program represents UWRA's commitment to understanding, mitigating, and adapting to the health consequences of a changing climate. It recognizes that climate change is not merely an environmental or economic issue — it is one of the most significant public health threats of the twenty-first century, with far-reaching implications for infectious disease patterns, food and water security, mental health, and the resilience of health systems themselves.

The program is grounded in a thorough appreciation of the complex pathways through which climate change affects health: extreme weather events such as droughts and floods directly cause injury and death; shifts in temperature and rainfall patterns alter the distribution of vector-borne diseases such as malaria and dengue; rising temperatures exacerbate air pollution and heat-related illnesses; and climate-induced disruptions to agriculture and water supplies undermine nutrition and food security. Moreover, the psychological toll of climate change — including anxiety, depression, and trauma — is increasingly recognized as a major public health concern. The program therefore adopts a holistic, systems-oriented approach that addresses the multiple pathways through which climate change affects health, encompassing both direct and indirect impacts, as well as the cross-cutting vulnerability of populations who are already marginalized and underserved.

Working across four counties in Kenya, the program combines direct health interventions with climate adaptation, health systems strengthening, and policy engagement. It is implemented in close partnership with county health and environment departments, meteorological services, community-based organizations, and international partners. The program is designed to be scalable and replicable, with a robust monitoring and evaluation framework that enables continuous learning and adaptation. By building climate-resilient health systems and empowering communities to adapt to climate change, the program aims to protect and improve the health of vulnerable populations now and into the future.

Background & Rationale

Climate change is already affecting health in Kenya and across Africa, and these impacts are projected to intensify in the coming decades. Kenya is experiencing more frequent and severe droughts, floods, and heatwaves, all of which have direct and indirect effects on health. The country is also seeing shifts in the distribution of vector-borne diseases, including malaria, which is moving to higher altitudes as temperatures rise. Water scarcity, exacerbated by climate change, contributes to the burden of waterborne diseases and undermines hygiene and sanitation. Food insecurity, driven by climate-induced agricultural losses, perpetuates malnutrition and weakens immune systems. These health impacts are unevenly distributed, with the poorest and most vulnerable communities — including women, children, the elderly, and those living in arid and semi-arid lands — bearing the greatest burden.

The health system in Kenya is not yet adequately prepared to respond to these emerging challenges. Health facilities are often vulnerable to climate shocks, such as flooding and power outages, which disrupt service delivery. Health workers lack training on the health impacts of climate change and the skills needed to manage climate-related health conditions. Surveillance systems are not fully equipped to detect and respond to climate-sensitive diseases. Furthermore, the intersection of climate change with other drivers of vulnerability, such as poverty, conflict, and displacement, creates complex health emergencies that require coordinated responses.

Despite the urgency of the issue, there has been limited investment in climate and health research, capacity building, and program implementation in Kenya. The Climate & Health Program is designed to address these gaps by generating evidence, building capacity, and implementing interventions that strengthen health system resilience, protect communities from climate-related health risks, and inform policy and planning. The program is aligned with Kenya's National Climate Change Action Plan, the Kenya Health Policy, and the World Health Organization's framework for climate-resilient health systems.

Program Objectives

The program is guided by a set of clear, measurable objectives that address the multiple pathways through which climate change affects health.

Program Components

The program is organized around five interconnected components that address the multiple pathways through which climate change affects health.

Component 1: Health System Resilience Strengthening

This component focuses on strengthening the capacity of health systems to anticipate, prepare for, and respond to climate-related health risks. It includes the development and implementation of climate risk assessments for health facilities, the integration of climate information into health planning and decision-making, and the training of health workers on the health impacts of climate change. The component also supports the development and operationalization of early warning systems for climate-sensitive diseases, including malaria, dengue, and cholera. It works to ensure that health facilities are climate-resilient, with reliable water and energy supplies, and that they have the capacity to manage surges in demand during extreme weather events. Additionally, it strengthens supply chains for essential medicines and commodities to ensure continuity of care during climate-related disruptions.

Component 2: Climate-Sensitive Disease Surveillance and Control

This component focuses on reducing the burden of climate-sensitive diseases through enhanced surveillance, early detection, and targeted control measures. It includes the strengthening of disease surveillance systems to monitor climate-sensitive diseases, including malaria, dengue, cholera, and other waterborne diseases. The component supports the development and implementation of climate-informed malaria stratification and vector control strategies. It also includes the establishment of early warning systems for disease outbreaks that are linked to climate information, enabling proactive responses. The component works to improve diagnosis and case management of climate-sensitive diseases, ensuring that communities have access to timely and effective treatment.

Component 3: Community Adaptation and Health Promotion

This component focuses on promoting climate-adaptive behaviors and building community resilience to climate shocks. It includes community-based health education on climate-related health risks, including heat stress, waterborne diseases, and vector-borne diseases. The component supports the adoption of climate-smart agricultural practices that improve food security and nutrition, as well as the diversification of livelihoods to reduce vulnerability to climate shocks. It also includes the promotion of water conservation, rainwater harvesting, and other water security measures. The component engages communities in the co-design and implementation of adaptation strategies, ensuring that they are culturally appropriate and responsive to local needs and priorities.

Component 4: Environmental Health and Climate Adaptation

This component addresses the environmental determinants of health that are exacerbated by climate change. It includes interventions to improve air quality, particularly in urban areas where air pollution is a major health concern. The component also addresses water and sanitation, promoting the construction of climate-resilient water and sanitation facilities, as well as hygiene promotion to reduce the burden of waterborne diseases. It works to ensure food safety in the context of a changing climate, including the prevention of aflatoxin contamination and other foodborne hazards. The component also supports the development and implementation of urban climate adaptation plans that address health risks, such as heat islands, flooding, and air pollution.

Component 5: Policy Engagement and Evidence Generation

This component focuses on generating evidence on the health impacts of climate change and translating that evidence into policy and practice. It includes the production of policy briefs, evidence summaries, and technical reports on climate and health; the organization of policy dialogues and stakeholder workshops; and the provision of technical assistance to county and national governments. The component also generates evidence on the effectiveness of climate and health interventions, contributing to the global knowledge base. It works to strengthen the capacity of civil society organizations to advocate for climate and health policies that protect vulnerable populations.

Target Populations

The program targets vulnerable populations in four counties in Kenya, selected based on their exposure to climate risks and their vulnerability to health impacts. The primary beneficiaries include:

• Populations in arid and semi-arid lands (ASALs): These communities are highly vulnerable to droughts, food insecurity, and waterborne diseases.
• Urban poor populations: Residents of informal settlements are exposed to air pollution, flooding, and heat stress, and often have limited access to health services.
• Children and the elderly: These groups are particularly vulnerable to heat stress, infectious diseases, and the health impacts of food and water insecurity.
• Women: Women are often disproportionately affected by climate change due to their roles in food production, water collection, and caregiving.
• People with disabilities: This group is often overlooked in climate adaptation planning and is particularly vulnerable to the health impacts of climate change.

Implementation Approach

The program is implemented through a multi-stakeholder, participatory approach that involves communities, county governments, and other partners at all stages. The following principles guide our implementation approach:

• Community Engagement: We work in close collaboration with communities to co-design and co-implement interventions, ensuring that they are relevant, acceptable, and sustainable.
• Integration: The program is integrated with existing health, environmental, and social protection services to maximize efficiency and sustainability.
• Intersectoral Collaboration: We work across sectors, including health, environment, agriculture, water, and disaster management, to address the complex drivers of climate-related health risks.
• Evidence-Based: The program is grounded in the best available evidence and is continuously informed by monitoring and evaluation data.
• Systems Thinking: We adopt a systems approach that considers the complex interactions between climate, environment, health, and social systems.
• Equity and Inclusion: The program is designed to address inequalities and reach those who are most vulnerable to climate-related health risks.

Partners

The program is implemented in partnership with a range of organizations and institutions that bring complementary expertise and resources.

• County Governments: The program works closely with county health, environment, and agriculture departments to align with local priorities and systems.
• Kenya Meteorological Department: Collaboration supports the integration of climate information into health planning and early warning systems.
• Community-Based Organizations: Local CBOs are engaged in community mobilization, outreach, and implementation of interventions.
• Academic Institutions: Partnerships with universities support research, monitoring and evaluation, and capacity strengthening.
• Civil Society Organizations: Engagement with CSOs supports advocacy and community mobilization on climate and health issues.

Monitoring, Evaluation, and Learning

The program has a robust monitoring, evaluation, and learning (MEL) system that tracks progress toward objectives, assesses effectiveness, and generates evidence for program improvement. Key elements of the MEL system include:

• Baseline and Endline Surveys: Comprehensive household surveys measure changes in health outcomes, climate adaptation, and related indicators.
• Routine Data Collection: Health management information systems (HMIS), climate data, and program monitoring tools provide ongoing data on service coverage and quality.
• Qualitative Research: Focus group discussions, in-depth interviews, and participant observation explore experiences, barriers, and enablers related to climate adaptation and health.
• Climate Risk Assessments: Regular assessments of climate risks to health systems and communities inform adaptation planning and resource allocation.
• Dissemination: Findings are disseminated through reports, policy briefs, presentations, and publications.

Expected Outcomes

By the end of the program, we expect to achieve the following outcomes:

• Improved Health System Resilience: At least 80% of health facilities in target areas will have climate risk management plans in place and demonstrate enhanced capacity to respond to climate-related health risks.
• Reduced Climate-Sensitive Disease Burden: The incidence of malaria, diarrheal diseases, and heat-related illnesses will decline by at least 20% in target areas.
• Enhanced Climate-Adaptive Behaviors: At least 70% of target communities will demonstrate improved knowledge and adoption of climate-adaptive behaviors, including water conservation, early warning response, and heat stress prevention.
• Improved Environmental Health: At least 50% of target communities will have improved access to clean water, sanitation, and hygiene facilities.
• Influenced Policy: At least three policy documents will incorporate evidence generated by the program.
• Strengthened Community Resilience: Target communities will demonstrate enhanced capacity to anticipate, cope with, and recover from climate shocks.