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A vulnerability assessment at national level in Grenada

Climate change and variability pose specific risks to the Caribbean island state of Grenada. A national vulnerability assessment helped to raise awareness of the effects of climate change on health and to get the health sector more involved in national adaptation planning.

As a small island state, Grenada faces distinct risks related to climate variability and change. It is vulnerable to extreme weather events such as hurricanes, to rising sea levels which affect the coastal areas, and to an overall decrease in rainfall combined with an increase in heavy precipitation events. All of these have potentially detrimental consequences for agriculture, fisheries and tourism, as well as for human health.

Bringing the health sector into Grenada’s climate change adaptation process

Map of Grenada

In 2015 German Development Cooperation conducted a Vulnerability and Adaptation Assessment (V&A) in Grenada to explore the climate-related vulnerabilities of the health sector, to raise awareness of the effects of climate change on health, and to identify priorities for action. The assessment was jointly conducted by the German-supported programmes “Adaptation to Climate Change in the Health Sector”, which operates at the global level, and “Integrated Climate Change Adaptation Strategies in Grenada” (ICCAS), which facilitates the development of Grenada’s Climate Change Adaptation Plan.

At the time the assessment was initiated, there was little scientific evidence about the effects of climate change on health in Grenada. In the absence of quantitative data, the assessment team decided to use a qualitative approach to gather information directly from people working within the health system at local and national levels, as well as from experts working in the Caribbean region. This participatory approach was also an important way to sensitise people to the topic. As Andre Worme, Grenada’s Chief Environmental Health Officer, put it: ‘What we need first and foremost in Grenada is to raise awareness about the impacts of climate change on health.’

Talking to health workers about climate change and health

Located right on the water, St George’s General Hospital is vulnerable to the impacts of climate change
Located right on the water, St George’s General Hospital is vulnerable to the impacts of climate change

Following a desk review, members of the assessment team interviewed representatives of government agencies (e.g. Ministry of Health and Social Security, National Disaster Management Agency), non-governmental organisations (e.g. Red Cross) and regional agencies (e.g. Pan America Health Organisation) to develop a picture of current and potential climate-related effects on people’s health, as well as the vulnerabilities and adaptive capacities of the health care system. The interviews explored respondents’ attitudes to and understandings of climate change and health, the extent to which they considered climate change a problem, and actions which were already being undertaken to respond to the impacts of climate change.

The assessment team also organised interactive workshops with nurses and environmental health officers in St. George’s and on Carriacou. At these sessions, which were also open to the public, they introduced participants to the basics of climate change and shared what is known about the impacts of climate change on the Caribbean region and on human health. Then, they discussed whether and how climate-related vulnerabilities were already being felt in communities in Grenada and how these were affecting the work of the health sector.

The assessment identified both direct and indirect effects of climate change on health in Grenada. As a result of extreme weather events and disasters, people are increasingly vulnerable to injuries. At the same time, slow-onset climate-related changes may affect the prevalence and incidence of infectious diseases, such as Dengue, Chikungunya, leptospirosis, and diarrheal diseases, as well as chronic respiratory diseases. Grenada will also experience limited access to drinking water as a result of decreased precipitation.

Applying a ‘climate lens’ to existing plans

Climate change adaptation planning workshop
Climate change adaptation planning workshop

The team members leading the Vulnerability and Adaptation Assessment in Grenada set out, together with the Ministry of Health, to identify specific actions that could be taken to address these direct and indirect effects of climate change.

At a planning workshop conducted in June 2015, officials from the Ministry of Health, the chief medical officer, epidemiologists, health planners and nurses started out by reviewing the Health Sector Corporate Plan and the National Disaster Plan. ‘The goal of reviewing existing plans was to identify already-planned actions which were potentially climate sensitive,’ explains Maylin Meincke, an advisor with GIZ who co-facilitated the workshop. ‘Once identified, these actions were “climate proofed” and earmarked as possible adaptation measures.’

Participants then organised the actions according to the WHO’s health system building blocks – Governance & Policy, Capacity Development, Health Information System, Essential Products & Technologies, Service Delivery, and Financing – and prioritised them for inclusion in the draft health and climate adaptation plan. Actions which could realistically be undertaken, using available resources, in the coming five years were included in the draft plan. Actions which were regarded as necessary, but impossible to implement without external financing (such as retrofitting health facilities) were also included in the draft plan. In order to keep the adaptation plan focused and realistic, identified actions not meeting the above criteria were excluded from the draft plan.

Towards a climate-resilient health system

The German-supported Vulnerability and Adaptation Assessment in Grenada is an example of a ‘quick and dirty’ assessment aimed at providing a basis for adaptation planning and for future, more detailed and quantitative assessments, such as for the Second National Communication to the United Nations Framework Convention on Climate Change (UNFCCC). In this instance a qualitative assessment undertaken in a participatory manner helped to identify the main climate-related hazards and to advance discussions about adaptation measures. In the months following the assessment, enhancing climate-sensitive surveillance and reporting emerged as a top priority for the health sector in Grenada. The steps that are currently undertaken to establish and strengthen information systems will soon be available in this toolkit’s section on adaptation measures.

© GIZ/Laura Scheske
© GIZ/Laura Scheske
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