Climate-ready communities: Mobilising health workers

According to The Indian Meteorological Department, in 2023, India recorded its warmest February since 1901, reaching a maximum temperature of 29.5°C (85.1°F). Heatwaves in the country have extended by about two-and-a-half days from 1961 to 2021, leading to unbearable summers in many regions. Extreme heat causes illness, and sometimes deaths especially among vulnerable communities like famers, construction workers, factory workers, street vendors, pregnant women, children, and the elderly. India saw a 55% increase in heat-related deaths from 2001-2004 to 2017-2021, resulting in a loss of around 259 billion labour hours annually between 2001 and 2020, totalling ₹46 lakh crores.

High temperatures worsen health conditions, including respiratory and cardiovascular diseases, pregnancy complications, sleep disorders, mental health issues, and injury-related fatalities. Heat exposure also links to adverse birth outcomes like preterm birth, stillbirth, and low birth weight infants. Thus, prioritising long-term community resilience over short-term fixes is imperative. We need proactive measures: enabling/capacitating communities, strengthening healthcare systems, and prioritising climate-friendly solutions. This is only possible through multisectoral collaboration across diverse stakeholders including government, private, and civil society organisations, and funding agencies.

In the face of escalating climate crisis impacts, the role of community health workers (CHWs) emerge as indispensable in the pursuit of health resilience for communities. Their unique position, rooted in trust within their communities, positions them as catalysts for transformative change, making them indispensable architects of a more resilient and sustainable future.

India has one million accredited social health activists (ASHAs), the largest group of Community Health Workers (CHW) in the world. CHWs serve as essential connectors between health systems and communities. These frontline health advocates play a pivotal role not only in addressing immediate health concerns but also in fostering climate-ready communities. Little is understood about the ground-level challenges faced by communities as a result of the climate crisis and CHWs play the critical role of ensuring the most vulnerable communities are included.

By empowering CHWs with the knowledge and tools necessary to tackle the adverse effects of climate change, we can enable entire communities to withstand, adapt, and ultimately thrive amidst the unfolding environmental crisis. Enabled CHWs are well-positioned to disseminate information about climate resilience, offering guidance on adapting to changing environmental conditions and mitigating health risks. By investing in their training and capacity-building, we build the resilience of individuals and communities.

Advocating for a community-driven approach to mobilise CHWs is not just prudent but pivotal in addressing the multifaceted challenges posed by the climate crisis. By endorsing this approach, we recognise the inherent strength and resilience within communities, empowering them to take charge of their health and well-being. Community-driven strategies harness local expertise, promote ownership, and develop sustainable solutions tailored to each community's needs. To bolster CHW-led initiatives in climate resilience, focused actions are essential. First, CHWs should undergo comprehensive training to identify and address climate-related health risks proficiently. Additionally, forging partnerships among CHWs, local authorities, and stakeholders can integrate climate resilience strategies into health care systems and community development efforts effectively.

Leveraging a solution-driven approach among CHWs can be instrumental in building climate resilience within vulnerable communities. With proper training, CHWs can effectively educate themselves, their families and their communities about climate-related health risks and adaptation strategies. They can also play a vital role in collecting data on the local health impacts of the climate crisis, ensuring that specific needs are addressed in climate action plans. Additionally, they can act as catalysts for local and community-level action, further bridging the gap between communities and relevant authorities.

Additionally, providing CHWs with access to relevant resources, technology, and ongoing support systems can enhance their capacity to implement and sustain climate resilience interventions effectively. Equipping them with the right information materials, such as Information, Education, and Communication (IEC) materials and Risk Communication and Community Engagement (RCCE) tools, is crucial for effective communication, promoting positive health behaviors, and improving healthcare services. Ultimately, by embracing a community-driven approach and empowering CHWs, we lay the foundation for resilient communities capable of weathering the impacts of the climate crisis while fostering long-term health and well-being.

This article is authored by Angela Chaudhuri, chief executive officer and chief catalyst, Swasti Health Catalyst.