SCALE-up - a new framework to assess the effectiveness of climate change adaptation interventions for human health and health systems

dc.contributor.authorWright, Caradee Yael
dc.contributor.authorNaidoo, Natasha
dc.contributor.authorAnand, Nalini
dc.contributor.authorKapwata, Thandi
dc.contributor.authorWebster, Candice
dc.date.accessioned2025-08-29T10:26:53Z
dc.date.available2025-08-29T10:26:53Z
dc.date.issued2025-07
dc.descriptionDATA AVAILABILITY : All data generated or analysed during this study are included in this published article and its supplementary information files. SUPPLEMENTARY MATERIAL 1 : Interview Guide. SUPPLEMENTARY MATERIAL 2 : Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Checklist. SUPPLEMENTARY MATERIAL 3 : Table S3. Grey literature search and charting of information about indicators for assessing climate change-related health outcomes and systems adaptation effectiveness. SUPPLEMENTARY MATERIAL 4 : Table S4. Notes from interviews with key experts about frameworks and indicators for assessment of climate change-related health adaptation effectiveness. SUPPLEMENTARY MATERIAL 5 : Table S5. Drop down menu options. SUPPLEMENTARY MATERIAL 6 : Key Informant Interview Questions. SUPPLEMENTARY MATERIAL 7 : Supplementary Tables.
dc.description.abstractClimate change is a grave threat to human health and wellbeing. Adaptation is one mechanism (the other is mitigation) by which we can intervene to increase adaptive capacity and preparedness to protect people. Adaptation interventions (evidence-based adjustment of programs/practices that lead to improved response and resilience to climate change) are being conducted around the world. However, existing conceptual frameworks to assess the effectiveness of these interventions, especially with respect to improving health outcomes and systems are not readily applied in areas where these are needed. This is applicable to both interventions intended to improve health as well as those without a health-focus but which may have health co-benefits. To address this gap, we conducted a multi-vocal review comprised of a scoping review and key informant interviews, which informed the development of an initial assessment framework. We included 21 academic articles and 12 reports (from the grey literature) for data collation and synthesis. Of the 21 articles analyzed, only seven presented primary evidence of health improvement outcomes, such as reduction in neo-natal care unit admissions was partially attributed to moving the maternity ward to the cooler, lower floor of the hospital. From the 10 interviewees, we learnt that most existing tools to assess the effectiveness of adaptation are for country or regional (several countries sharing borders within a large section of a continent) scales (e.g., Notre Dame Global Adaptation Initiative Index) and none focused specifically on health / health co-benefits. From these learnings together with a guiding concept, we crafted the first iteration of an assessment framework, SCALE-up, comprising six steps that prompt a researcher to consider the effectiveness of their adaptation intervention at a project-scale, including from a health benefit perspective. We apply the framework in four scenarios: hot days-heat; floods; droughts; and vector-borne diseases, to illustrate how the framework may help guide the researcher to think about effectiveness from project proposal stage. The next steps are to implement and pilot the framework in the four proposed scenarios and refine the framework.
dc.description.departmentGeography, Geoinformatics and Meteorology
dc.description.librarianhj2025
dc.description.sdgSDG-03: Good health and well-being
dc.description.sdgSDG-13: Climate action
dc.description.sponsorshipThe Climate and Health Scholars Program at the US National Institutes of Health; the South African Medical Research Council and the National Research Foundation.
dc.description.urihttps://bmcpublichealth.biomedcentral.com
dc.identifier.citationWright, C.Y., Naidoo, N., Anand, N. et al. “SCALE-up” – a new framework to assess the effectiveness of climate change adaptation interventions for human health and health systems. BMC Public Health 25, 2247 (2025). https://doi.org/10.1186/s12889-025-23358-z.
dc.identifier.issn1471-2458 (online)
dc.identifier.other10.1186/s12889-025-23358-z
dc.identifier.urihttp://hdl.handle.net/2263/104061
dc.language.isoen
dc.publisherBioMed Central
dc.rights© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
dc.subjectClimate change
dc.subjectEnvironmental health
dc.subjectImpacts
dc.subjectImplementation science
dc.subjectIndicators
dc.subjectMethods
dc.subjectMonitoring and evaluation
dc.subjectStandardized measures
dc.titleSCALE-up - a new framework to assess the effectiveness of climate change adaptation interventions for human health and health systems
dc.typeArticle

Files

Original bundle

Now showing 1 - 5 of 8
Loading...
Thumbnail Image
Name:
Wright_SCALEUp_2025.pdf
Size:
2.47 MB
Format:
Adobe Portable Document Format
Description:
Article
Loading...
Thumbnail Image
Name:
Wright_SCALEUpSuppl1_2025.pdf
Size:
74.47 KB
Format:
Adobe Portable Document Format
Description:
Supplement Material 1
Loading...
Thumbnail Image
Name:
Wright_SCALEUpSuppl2_2025.docx
Size:
83.45 KB
Format:
Microsoft Word XML
Description:
Supplement Material 2
Loading...
Thumbnail Image
Name:
Wright_SCALEUpSuppl3_2025.pdf
Size:
105.69 KB
Format:
Adobe Portable Document Format
Description:
Supplement Material 3
Loading...
Thumbnail Image
Name:
Wright_SCALEUpSuppl4_2025.pdf
Size:
196.92 KB
Format:
Adobe Portable Document Format
Description:
Supplement Material 4

License bundle

Now showing 1 - 1 of 1
Loading...
Thumbnail Image
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description: