Climate Exchange

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ealth

roles of each sector in the implementation of climate observation

on the sites.

Local health staff members were trained in the measurement of

daily rainfall, maximum and minimum temperatures, humidity and

evaporation, as well as cloud cover and wind observations. Climate

experts also provided on-site training on simple weather- and climate-

related issues and the use of the African Centre of Meteorological

Applications for Development’s Climat Sante (CLIMS) code for the

weekly transmission of the data. On-site training was given on the use

of the climate data for local epidemiological monitoring and surveil-

lance. Climate data were collected daily and transmitted to the central

health centres including the Institut Pasteur de Madagascar and the

NMHS and, once verified, shared with all stakeholders.

As a result of the project, meteorological data can be analysed

together with epidemiological data (historical, real time and fore-

cast) to facilitate early detection of fresh disease outbreaks and/

or probable epidemics. Data transformed into information can be

forwarded to decision makers and managers at all levels for early

response or preventative actions.

Health sector benefits from climate data and information

The use of climate parameters (temperature, rainfall, humid-

ity) as predictive indicators of the resurgence of priority diseases

improves the surveillance of diseases dependent on weather and

climate variability. For example, early detection of malaria resur-

gence in Ifanadiana (Vatovavy Fitovinany) took place in February

2012 after tropical cyclone Irina caused raised temperatures and

heavy rainfall.

Malaria in Madagascar is favoured by monthly temperatures

between 18° C and 32° C, monthly rainfall above 80mm and

humidity above 60 per cent. Plague needs temperatures between

19° C and 25° C during the rainy season from October to April and

a soil humidity of 85-95 per cent. RVF is favored by a temperature

between 21° C and 24° C after heavy rainfall (176mm-255mm) in

the wet areas.

Quick decision-making supports early detection of possible

epidemic outbreaks in order to adapt the strategy for prevention

and response. The Climate Outlook and the Climate and Health

Bulletin are very helpful in that sense. Climate observation stations

at the sentinel sites add value in improving the local management

of an epidemic by enabling direct use of the meteorological data

collected for analysis and action.

Building capacity, ensuring support

WMO provided the funding for the implementation of the pilot

project, covering workshop training, international training and

exchanges, strengthening of the climate observation network

through the installation of climate stations at six health sentinel

sites, on-site training of local health experts in climate observation

and station maintenance, and follow-up visits to the sentinel site

stations. The development and delivery of climate products are

supported by the NMHS budget.

The service involves two main institutions: the Ministry of

Public Health and the Ministry of Meteorology. The Institut

Pasteur de Madagascar as a private institution is involved in

the financial management of the health sentinel sites and in the

research component of the activities of the CHWG. IRI was the

facilitator for the two training workshop series. MOUs for data

access and exchange and research collaboration were signed

between the NMHS and IRI and the Ministry of

Public Health and IRI.

A process for the evaluation of the impact of the serv-

ices on health in Madagascar remains to be established.

The CHWG believes that the assessment could not be

performed until four or five years after the end of the pilot

project. WMO and WHO are invited to provide some

guidance in the project/service evaluation methodologies.

However, the health actors already recognize the benefits

gained from the use of climate data and information and

the existing climate stations on the sentinel sites.

At Madagascar NMHS, the Applied Research Service

has been in charge of the development and dissemination

of climate information since 1997. Capacity-building of

human resources occurred through the participation

in the SARCOF climate experts’ meeting and training

through the SADC community and the visiting scien-

tist process at the National Oceanic and Atmospheric

Administration/National Weather Service/Climate

Prediction Center in the USA.

During the training workshops and the on-site installa-

tion of the climate stations, NMHS experts provided courses

for user organizations on weather and climate and on how

to interpret climate information. Health staff at the central

level learned from IRI facilitators how to use the climate

data for health issue purposes. Most of the health trainees at

the central level hold postgraduate degrees in public health.

The future

The main challenges facing all the stakeholders are

sustainability of the activities and maintenance of the

current dynamism and enthusiasm. For the NMHS, the

main goal is the improvement of the quality of services

provided in terms of tailoring, accuracy and timeliness

in dissemination. For the health sector, the main goal

is optimal, efficient use of climate data and information

to reduce the burden from climate-dependent diseases.

Keeping the local health staff motivated in the observation

tasks is another challenge for the health sector.

Four key factors will be crucial to the long-term

success of the health and climate working groups:

• Interest in working together

• Awareness of health professionals of the need for

climate information and services

• Presence of an external agent (such as WMO) acting

as a catalyst to bring the groups together

• Availability of seed funding mechanisms for pilot

projects.

It is likely to require approximately three to five years

of experience (and hence of sustained seed funding)

before the first results are seen.

Scaling up of this kind of programme is an important

long-term goal, which depends mainly on the avail-

ability of budget from the institutions involved in the

process and the willingness of the decision makers to

support the programme, both financially and institu-

tionally. The lessons learned can be transferred to other

sectors and locations.