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

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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