Heat Indicators for Global Health: Surveillance, Early Warning Systems and adaptation-mitigation actions to reduce heat impacts in pregnant women, infants and health workers in the EU and Africa (HIGH Horizons)

There are major gaps in surveillance of climate change and health in the EU and globally, making it difficult to track health burdens and policy outcomes. The Heat Indicators for Global Health (HIGH Horizons): monitoring, Early Warning Systems and health facility interventions for pregnant and postpartum women, infants and young children and health workers (HIGH Horizons) project, to be conducted over four years, involves one UK partner along with six partners in the EU, three in Africa and one international organisations (WHO). It centres on vulnerable groups affected by climate change: pregnant and postpartum women, infants, and health workers, groups heavily affected by climate change. We will quantify and monitor direct and indirect health impacts of extreme heat; test a personalised Early Warning System (EWS); and implement integrated adaptation-mitigation actions in health facilities. Analyses of heat impacts and data science predictive modelling using data from Sweden; Lazio Italy, Greece and health facilities in Kenya and South Africa underpin all activities. Specific biomarkers will be measured during pregnancy and in infants in a prospective mother-childbirth cohort in Greece to explain the role of heat exposures on adverse health effects. These analyses and systematic reviews inform testing and selection of global, EU and national indicators. Analyses also inform cut-off thresholds for EWSs, stratified by risk groups. A smartphone app (ClimApp-MCH) will deliver warnings and setting-specific messages, co-designed locally. The app will be evaluated among 200 mothers and infants in Sweden, South Africa and Zimbabwe, from antepartum through 12 months of infant age. Simultaneously, we will document impacts of heat exposure on health worker wellbeing, health, productivity and quality of care, including through time-motion studies. Modifications to health facilities will be co-designed and modelled to reduce heat exposure for health workers and to limit...