Resilient and Equitable Health Workforce to Address Climate Threats (REACT)

Introduction

The climate crisis is a global health threat. Heatwaves, droughts, floods and landslides cause substantial morbidity and mortality either directly or indirectly through infectious diseases, respiratory illnesses and food insecurity. The Health Workforce (HWF) plays a critical role in care, treatment, and building climate-resilient communities, yet evidence suggests that HWF resilience is inadequate, particularly in low and middle-income countries.

Nepal is among the most climate-vulnerable countries, facing extreme weather events, rising temperatures, and erratic rainfall, which impact food security and public health. Despite having different policies in place such as Climate Change Policy and Health National Adaptation Plan, progress on climate-resilient health infrastructure remains minimal. Challenges include shortages of health workers, inadequate investment, and gaps in climate-health awareness.

Project Objectives

• To assess preparedness and capacities of health system actors to respond to climate crisis related health impacts
• To co-create context sensitive and gender equitable interventions to improve HWF and community resilience to climate crisis related health impacts
• To pilot the co-created interventions and evaluate them for equity, feasibility, effectiveness, costs, sustainability and scalability
• To promote uptake of learning on climate crisis and health among health systems actors and researchers

Methods

The REACT Project aims to strengthen HWF responsiveness to climate-related health impacts in Nepal and Zimbabwe. The first step in this endeavour is to conduct a study at select implementation sites in both countries. This study consists of various phases, starting with refinement of consortium values, strengthening partnerships, and co-development of research protocols before obtaining ethical approval. A formative research will then be conducted, entailing a scoping review, policy analysis, qualitative studies, and surveys to establish baseline knowledge and practices on climate crisis and HWF.

Based on the findings, stakeholders will collaborate with consortium partners to co-create interventions to improve HWF and community resilience to climate crisis. The interventions will be piloted and refined using participatory action research with qualitative studies, cost analysis, and end-line survey assessing the impact of the intervention. Following the evaluation, the policymakers, health workers and community will be pro-actively engaged to use research evidence to inform policy and decisions. Additionally, we will support researchers, and partner organizations with relevant trainings and other capacity building activities.

Study Sites

Research Partners

This four-year (2025-2028) research project, funded by National Institute for Health and Care Research (NIHR), UK, is a collaborative effort between the Liverpool School of Tropical Medicine (LSTM), UK, the Center for Sexual Health, HIV & AIDS Research (CeSHHAR), Zimbabwe, HERD International, Nepal, Ghorahi Sub-metropolitan City and Chandannath Municipality of Nepal and Mount Darwin District and Harare Local Authority in Zimbabwe.