Agricultural extension workers share information about climate change and health

Balancing emergency support with long-term adaptation in Malawi

In recent years floods and droughts linked to climate change have devastated cotton farming communities in southern Malawi. In settings like these, flexible approaches are needed to balance longer-term adaptation measures with emergency support.

Climate change is deepening the challenges facing already vulnerable populations

Map of the Republic of Malawi
Map of the Republic of Malawi

When the Shire River, in southern Malawi, burst its banks in January 2015 following prolonged heavy rains, whole villages were displaced and thousands of hectares of crops were washed away. Roads and infrastructure, including health facilities, were heavily damaged with devastating consequences for people’s access to safe water for drinking, cooking and washing, and on their ability to access health services. Just over a year later, the same area was affected by a punishing El Niño-induced drought. The annual maize harvest dropped by 30 percent and thousands of households were unable to meet their food requirements for the year.

Subsistence farmers in Chikwawa District, which sits in the floodplain of the Shire River, are particularly vulnerable to negative consequences of climate variability and change, including floods and droughts, which increase their risk of malnutrition, vector- and water-borne diseases, and other health problems. Between late 2014 and mid-2016, German Development Cooperation supported a project aimed at reducing residents’ vulnerability to climate-sensitive diseases such as malaria, bilharzia and diarrheal diseases. Informed by the findings of this Vulnerability and Adaptation Assessment, the project set out to improve cotton farmers’ knowledge about common diseases and ways to prevent them, focusing on actions they could take at household and community level to improve hygiene and sanitation.

Agricultural extension workers, health promoters and radio programmes reach more than 75,000 residents with information about climate change and health

Promotion of water treatment with chlorine solutions to prevent diarrheal diseases. Illustration from training manual
Promotion of water treatment with chlorine solutions to prevent diarrheal diseases. Illustration from training manual

The NGO Concern Universal implemented the project in cooperation with the Great Lakes Cotton Company (GLCC), whose agricultural extension workers regularly visited cotton farmers in the district. The idea was to use the existing GLCC outreach system for a cascading behaviour change communication approach which, if successful, could later be integrated into GLCC’s work in other districts.

Using a specially-developed curriculum based on the findings of the vulnerability assessment, Concern Universal conducted a training of trainers for 18 GLCC supervisors and extension workers in the basics of climate-sensitive diseases. The extension workers then shared this information with more than 4,000 lead farmers in seven villages. In addition, 240 community-based health promoters under the management of the Ministry of Health were trained to integrate climate change-related information into their regular health promotion activities with households.

The project also developed 24 radio programmes and 40 short radio ‘spots’ about climate change and health which were aired on a popular national radio station. To ensure that women, in particular, were reached by these messages, the project provided radios and established 15 radio clubs for women. Over the course of the project, more than 75,000 residents were reached with information about climate change and health through these health promotion activities.

El Niño cripples the cotton harvest and undercuts the project model

The El Niño-induced drought in 2016 pushed already vulnerable communities in southern Malawi into a deep crisis. The cotton harvest was once again severely affected and the GLCC had to stop its outreach work with cotton farmers for economic reasons. Although the project rapidly adapted its strategy by involving more health promoters and intensifying communication campaigns, El Niño had another important effect in terms of the project’s original expectations: As a result of the poor harvest, households in the target communities were left with dramatically reduced incomes and were not in a position to invest in any of the preventive measures they had learned about through the project. They had no resources to pay for mosquito nets and repellant, chlorine tablets to treat drinking water or charcoal to boil it, or the construction of community toilets with hand-washing facilities – all of which are important ways to prevent malaria and diarrheal diseases. Although the project succeeded in increasing people’s knowledge about common climate-sensitive diseases, this did not translate into behaviour change because of an absence of the conditions needed to apply this knowledge consistently in practice.

Comprehensive, sustained and sufficiently flexible interventions are needed in settings prone to climate-induced emergencies

A Malawian girl with her anti-malarial mosquito net
A Malawian girl with her anti-malarial mosquito net

A number of lessons were learned over the course of this project. First, behaviour change communication interventions promoting behaviours that require a particular infrastructure or specific materials (i.e. mosquito nets and repellant, chlorine solutions, sanitation facilities) should ensure that these are available or can be obtained by the target audience at accessible prices. The situation of impoverished communities, communities shaken by crises, and those – like the cotton farmers in Chikwawa District – who fall into both categories, may worsen over time. In such situations, behavioural interventions need to provide the materials or structures that are required to actually practice the promoted behaviours.

Second, development interventions aimed at extremely vulnerable populations need to bear in mind that precarious, but seemingly viable situations can rapidly turn into humanitarian crises. When this happens, projects need to be conceptually and financially flexible enough to adapt planned activities and investments accordingly, including by supporting relief measures which contribute to getting communities back to the point that they can again benefit from development interventions. While this has long been understood by those implementing development measures in fragile states and post-conflict settings, this case suggests that it may now be equally true in settings where already vulnerable populations are prone to climate-induced emergencies.

Related materials and useful tools

© GIZ/Global Program on Adaptation to Climate Change in the Health Sector
© GIZ
© Photoshare / Paul Jeffrey

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