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Dagnew Tadesse(BSc, MSc)
Hygiene and Environmental Health Directorate Director Ethiopia Addis Ababa
Overview
Current status◦ Base Line Study
◦ Health National Adaptation Plan Development
◦ Additional Achievements
Technical Challenges
Opportunities
Existing Risks/Threats
The Way forward
◦ The adverse effects of climate change are all round and top issues globally.
◦ Developing countries including Ethiopia are more vulnerable to climate change effects as they have less capacity to adapt.
Ethiopia has ragged topography (Ras Dashen= +4533m & Dalol=-125m)
Two rain seasons (kiremt and Belg)
Much of the economic growth is dependent on climate-sensitive sectors
◦ Majority (95%) of the households in Ethiopia usebiomass fuel as source of energy (cause indoorair pollution and are highly associated withrespiratory impairment )
Women and children are usually the most affected
◦ Ethiopia GHGs emission is insignificantcomparing to developed countries
Both agriculture and forest sectors attribute 87%of the country GHGs emission
◦ The ambient air pollution is also becoming aserious problem in cities and big towns of Ethiopia
The Government of Ethiopia launched Climate Resilient Green Economy (CRGE) in 2011 to avert the threat posed by climate change and to build sustainable economy.
The health sector is one of the three most vulnerable sectors together with water and agriculture sectors.
Base line study:◦Vulnerability and Adaptation Assessment of
Health to Climate Change in Ethiopia
conducted◦ Objective: to assess the vulnerability of the population and HS to Climate change
To develop National Health Adaptation Plan
Secondary Data on:◦ Climate Information
◦ Climate sensitive diseases
◦ Socioeconomic determinates
Key study variables
◦ Exposure
◦ Sensitivity
◦ Adaptive capacity
Data Source
Literature Review
National Metrology Agency
HMIS• EDHS
7
Vulnerability
Factors
Health
status
determ
inants
Profiles Indicators/ Units of Measurements
Exposure Climat
e
1.Climate • Changes over time, oC
• Changes over time, mm
2. Hazard • No of population supported
with PSPN
• No of events and affected
population over the last 20
years
Sensitivity Natural
Capital
3. Ecosystem
/Geographic
• % of the area prevalent to CC
sensitive health issues
4. Demography • % of young children, women and
elderly, exposed work force
• % HHs in the exposed area
Vulnerability factors, Health determinants, profiles, & indicators
8
Adaptive
Capacity
Financial
Capital
5. Wealth
(Health care
financing )
• Wealth profile
• Per capita government expenditure on health
• Percentage budget of national budget allocated to health
• Per capita government expenditure on health
Physical
capital
6. Technology
and Medicine
• Status of health facility systems such as electrical,
telecommunication, water supply, waste management, fuel
storage, medical supplies, equipment and supply , access
7.
Infrastructure
• Physical infrastructures status
• No and type of health facilities
• Health coverage
• Safe water coverage and trend
• Latrine coverage and trend
• Physical infrastructures status
• No and type of health facilities
• Health coverage
• Health care waste management
Human
capital
8. Community • Health professional (doctors, nurses, midwives) proportion
per population by geographic area
• Number of Health Extension workers per 5 000 by admin
unit
• # of HDA (Health Development Army) per 5 HHs
Social
Capital
9. Social • Male No education (%)
• Female No education (%)
• Safe water coverage (%)
• Latrine coverage (%)
9
Vulnerability factor
Determinants
Profile Indicators/ Unit of Measurement
10
Key findings
Addis Ababa DireD SNNPR
AfarSomali
Gambella
TigrayAmhara Harari
OromiaBensahngul
Figure: Rain Fall Trend: 1994-2014
11
Region Sub-
Component
Exposu
re Clima
te
Hazar
d
AA 0.23 0.036 0.12
Afar 0.41 0.480 0.45
Amhara 0.09 0.398 0.26
B.Gumu
z
0.96 0.401 0.64
Dire D 0.15 0.206 0.18
Gambell
a
0.88 0.540 0.69
Harari 0.61 0.166 0.36
Oromia 0.09 0.151 0.13
SNNPR 0.37 0.483 0.43
Somali 0.43 0.575 0.51
Tigray 0.21 0.344 0.29
Avg 0.40 0.343 0.37
Max 0.96 0.575 0.69
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
Ind
ex
12
Region Climate
Sensitiv
e Area
(%)
% HHs
in the
expos
ed
area
Depen
dency
Ration
Populatio
n at Risk
for
Malaria
%
Sen
siti
vity
Addis
Ababa0.15 0.26 0.50 0.00 0.2
3Afar 1.00 1.00 0.74 0.98 0.9
3Amhara 0.57 0.67 0.87 0.75 0.7
2Ben- G 0.98 0.91 0.51 0.79 0.8
0Dire
Dawa1.00 0.88 0.43 0.42 0.6
8Gambella 1.00 0.92 0.55 1.00 0.8
7Hareri 0.77 0.88 0.53 0.79 0.7
4Oromia 0.79 0.55 0.98 0.65 0.7
4SNNPR 1.00 0.59 1.00 0.63 0.8
0Somali 0.80 0.83 0.80 0.89 0.8
0
0.2
0.4
0.6
0.8
1
Index
• % of the area prevalent to CC
sensitive health issues
• % of young children, women and
elderly, exposed work force
• % HHs in the exposed area
13
Region
Finance
Resource
s (3)
Physical
Facilities
(7)
Human
Resources
(4)
Social
Determinants
(6)
Adapt
ive
Capac
ityAddis
Ababa 0.34 0.73 0.47 0.83 0.650
Afar 0.20 0.35 0.11 0.22 0.240
Amhara 0.36 0.57 0.09 0.35 0.377
Ben-Gum 0.42 0.32 0.39 0.37 0.365
Dire Dawa 0.63 0.63 0.32 0.55 0.543
Gambella 0.34 0.36 0.34 0.41 0.369
Harari 0.58 0.70 0.75 0.56 0.650
Oromiya 0.53 0.32 0.11 0.38 0.328
SNNPR 0.44 0.45 0.17 0.44 0.389
Somali 0.26 0.38 0.00 0.12 0.208
Tigray 0.31 0.53 0.20 0.46 0.410
Average 0.40 0.49 0.27 0.43 0.412
Max 0.63 0.73 0.75 0.83 0.650
Min 0.20 0.32 0.00 0.12 0.208
14
Access to health service, sanitation, andimproved water with variance amongregions
Emerging regions are relatively the mostvulnerable and Cities are relatively lessvulnerable
➢ Limited knowledge about CC effects & adaptation options
Key Areas of the HNAP:-
Objective:- Contributes to Goal of HSTP with the focus to make sure the health system is climate resilient
Enhance the early warning and surveillance in the context of health emergency risk management
Building the capacity of health system for realization of climate resilient health system
Enhance the resilience of health system in provision universal health coverage
Create enabling environment for health adaption to climate change implementation
Community Mobilization
Strengthening partnership
Strengthening the existing health system
➢ Strengthen health care delivery
➢ Strengthen IDSR
➢ Improve HMIS
Strengthening and Expanding Health Infrastructure
revising building codes of health facilities and Promoting climate resilient WASH facilities
Strengthening existing Integrated Disease Surveillance and Response
Promoting climate resilient water safety plan◦ Preventing water scarcity through water conservation
and keeping the water available safe
Advocacy and creating awareness◦ Promoting climate change mitigation initiatives
M and E, operational research
Revising the Building Blocks of HFs
Appropriate engineering design to overcome
weather extremes that include having better
natural ventilation and plants for shading.
➢ Self supply of Energy
➢ Self supply of water
Solar Energy Wind Energy
Key Intervention Areas Cont… Green and clean HFs
➢ Regional states will have functional CCH-TWG
➢ Regional states will have their own VA assessment
Report
➢ 65.5 million people will be sensitized about CC &
Health
➢ 754 HFs infrastructure will be re-innovated
➢ 1,126 HPs and 90 HCs will have self-supply of Water
➢ 3,789 HPs and 343 HCs will have self-generated
renewable energy
7,703,040HHs will plant trees in their cmpounds
525 drought prone kebeles will assure community inssurance
High contraceptive prevalence rate especially in drought prone areas
Ministry of Environment, Forest and Climate Change;
Ministry of Agriculture and Natural Resources; Ministry of Water, Irrigation and Electricity; Ministry of Urban Development and Housing; Office of Government Communication Affairs National Metrology Agency; Ministry of Education; etc. Communities, Universities, Development
partners
Health National Adaptation for Climate Change Advocacy Workshop conducted (70 participants )
Water Quality Monitoring Surveillance Guideline developed
Kit CD Based Operational Training provided for 120 participants
Water test kit reagents procured and distributed
Regional and Federal Water quality Monitoring and Surveillance Technical Working groups established
Climate change and Health issues included in Hygiene and Environmental Health Strategy as a core intervention
Lack of climate Resilient Designs and Standards across agro ecological zones
Capacity Changes because Climate ResilentHealth system is relatively new concept at all levels
Budget constraints to conduct regional in depth assessment considering agro-climatic zones
1. Constitution: Articles 90.1 and 92.2 (the
provision of clean & healthy environment)
2. Health Policy, proclamation and Strategies
3. HEP-HEWs and HDA + Social Mobilization in
pastoralist
4. Community-based approaches(CLTSH)
5. Water Resource Management Policy (1999),
6. Water Sector Strategy (2001)
7. WIF & revised MoU (MoWE, MOH, MoE, MoFED)
⇒ Inline with HSTP, HEH strategy endorsed with eight strategic domains and
specific focus areas
29
Community and Institution
based
Promotion
And Regulation
Sanitation
Excreta disposal
Solid waste
Waste water
Personal Hygiene
Hand hygiene
Face and Oral hygiene
Menstrual hygiene
Water access and safety
- access
- HWTS
- Surveillance
Food Hygiene
Food and Drink establishment
Inspection
Food handlersHousing and
Institutional heath
-Health Facilities
- Schools
- Others
Vector Control
Pollution
Indoor, Outdoor
Noise, Toxic chemicals
Radiation
Occupational health and
safety
HEH strategy Strategic Objectives By 2020 achieve access to adequate and equitable sanitation for all.
By 2020 promote basic hygiene behavior
By 2020 ensure safe water from the point of source to consumption.
By 2020 ensure WASH in all institutions.
By 2020 ensure food safety from farm to fork
By 2020 reduce vector borne diseases.
By 2020 ensure safe and conducive working environment in allinstitutions
By 2020 enable abatement of generation & exposure to sources ofpollution
By 2020 ensure community empowerment through organized andpromotional interventions
By 2020 enhance conducive & enabling working environment for HEH
MSF 6
Minister
H.E Dr. Amir Aman
Liquid & solid waste
management team
Water, food and
hygiene team
Institutional
WaSH team
Climate change and social
conformity team
State Minister
(Program Wing)
H.E Dr. Kebede Worku
State Minister
(Operation wing)
The team was focused on document preparation & endorsement,
promotion, regulation, capacity building, introduce & promote
technologies, resource mobilization and M&E of the following
domains:◦ Climate change adaptation to health ◦ Climate risk minimization and assessment◦ Environmental pollution ◦ Health impact assessment ◦ Climate resilience health system and health facility◦ Emergency reduction related with climate change ◦ Indoor and out door air pollution ◦ Social conformity & conformity with international laws , regulations
and declarations◦ Pollution (land, water, sound…)◦ Environmental friendly technologies ◦ Big farms and industry parks hazards and pollution
Minister of
Health
National Hygiene &
Env.tal Health Task Force
Integrated Urban
Sanitation &
Hygiene Technical
Working Group
Sanitation
Marketing
TWG
HWTSS & Water
Quality
Monitoring &
Surveillance TWG
Regional
Hygiene &
Env'tal Health
Task Force &
TWGs
Zonal Hygiene
& Env'tal Health
Task Force &
TWGs
Woreda Hygiene &
Env'tal Health Task
Force & TWGs
Kebele Hygiene &
Env'tal Health task
Force
CLimate
Change &
Health TWG
Hygiene,
Sanitation &
Env'tal Health
for SBCC
development
and Promotion
TWG
Program/Project
s development,
impelementation
, Monitoring,
Evaluation TWG
LACK of Adequate resources(Budget,
Limited Health Human Resources Capacities at all levels(Regions, Zones, Woresas )and Health Facilities
• Conduct Health Vulnerability at agro-ecology/woreda level
• Cluster adaptation responses for each agro-ecology/Woreda: –grey measures: technological solutions ; –green measures: ecosystem-based
adaptation options; and–soft measures: behavioral, managerial and
policy approaches • Use well predicted climate change scenarios
and detailed socioeconomic conditions• Measure the economic costs of adaptations
Improve public health surveillance system Establish Health and climate data
management Strengthen early warning system Improve public Health Services Improve, Water, Sanitation and Hygiene
system Human Resource Development Enhance Public Health Awareness and attitude Targeted interventions to regional contest by
enhanced financial resource Research Mainstreaming climate change adaptationn