Climate Change Health Risk Mapping Sub-National Climate Risk Maps for Ghana CLIMATE CHANGE HEALTH RISK MAPPING i i || CLIMATE CHANGE HEALTH RISK MAPPING Background ABOUT THE PROJECT Climate change, including climate variability, has multiple influences on human health. Both direct and indirect impacts are expected. These include altera- tions in the geographic range and intensity of transmission of vector-, tick-, and rodent-borne diseases and food- and waterborne diseases, and changes in the prevalence of diseases associated with air pollutants and aeroallergens. Climate change could alter or disrupt natural systems, making it possible for diseases to spread or emerge in areas where they had been limited or had not existed, or for diseases to disappear by making areas less hospitable to the vector or the pathogen. The World Health Organization (WHO) estimates that climate change may already be causing over 150,000 deaths globally per year. While direct and immediate impacts such as deaths in heat waves and floods can often be dra- matic and provoke immediate policy-responses, the most important long-term influences will likely act through changes in natural ecosystems and their impacts on disease vectors, waterborne pathogens, and contaminants. Despite the increasing understanding of health risks associated with climate change, there has been limited identification and implementation of strategies, policies, and measures to protect the health of the most vulnerable populations. Reasons for this include the relatively recent appreciation of the links between climate change and health, which means that existing public health related poli- cies and practices globally do not reflect needs with respect to managing likely climate change-related health impacts. Recognizing the fact that Ghana experiences an extremely high burden of climate-sensitive diseases such as malaria, diarrhoeal, cerebrospinal meningitis and other infectious diseases and given the fact that Ghana is significantly vul- nerable to climatic changes, The Ministry of Health (MOH), Ghana in partnership of United Nations Development Programme (UNDP) is implementing a Global Environment Facility (GEF) funded project to pilot climate change adaptation for health in Ghana. || iii CLIMATE CHANGE HEALTH RISK MAPPING Malaria, Cerebrospinal Meningitis and Diarrhoeal Diseases, were identified as cli- mate sensitive diseases of interest for the pilot project. The pilot will cover three districts – Bongo in the Upper East Region, Keta in the Volta region and Gomoa West in the Central region. The proposed project will develop systems and response mechanisms to strength- en the integration of climate change risks into the health sector. Critical barriers will be overcome to shift the current response capacity of the health sector from being reactive towards being more anticipatory, deliberate and systematic. Project actions will identify, implement, monitor, and evaluate adaptations to reduce likely future burdens of malaria, diarrhoeal diseases, and cerebrospinal meningitis (CSM), priority climate change-related health issues identified by national stakeholders. i v || CLIMATE CHANGE HEALTH RISK MAPPING Acknowledgement The production of this report was facilitated by the Climate Change and Health Project Implementation Unit, Ministry of Health, led by Benjamin Yaw Manu, the Project Manger, with the support of Abena Nakawa, the Project Associate, and in consultation with Mr. Isaac Adams, Director, Research, Statistics, Information Management, Ghana. The content of this report was developed, discussed and validated through extensive consultations led by the Ministry of Health with stakeholders from government agencies including Ghana Health Service, Ghana Meteorological Service, National Malaria Control Programme, National Development Planning Commission, National Disaster Management Organization, Ministry of Local Government and Rural Development, Environmental Protection Agency, Ministry of Environment Science and Technology, National Disease Control Programme, Health Promotion Unit, Ministry of Health, Ministry of Finance and Economic Planning (External Relations Unit) REPUBLIC OF GHANA MINISTRY OF HEALTH INTEGRATING CLIMATE CHANGE INTO THE MANAGEMENT OF PRIORITY HEALTH RISKS IN GHANA www.climatehealthghana.org ‘Photos used in this report were taken by the project and as such are the property of the project’ || v CLIMATE CHANGE HEALTH RISK MAPPING v i || CLIMATE CHANGE HEALTH RISK MAPPING Contents Background iii Acknowledgement v Climate Change Health Risk Mapping 1 Sub-National Climate Risk Maps for Ghana Executive summary 3 1.0 Introduction 5 1.1 Aim of the study 8 1.2 Specific objectives 8 1.3 Rationale 8 1.4 Project deliverables 9 2.0 The linkages between climate and health risks 11 2.1 The linkages between climate and health risks 13 2.2 Malaria and climate change 13 2.3 Meningitis and climate change 15 2.4 Diarrhoea and climate change 16 2.5 Climate change health risk mapping 18 3.0 Conceptual Framework 21 3.1 Environmental health risk mapping 23 4.0 Approach and methodology 25 4.1 Study area 27 4.2 Bongo profile 27 4.3 Gomoa West Municipal profile 29 4.4 Keta Municipal profile 30 4.5 Data 32 4.5.1 Climatic, environmental and population data 32 4.5.2 Disease incidence data 33 4.6 GIS Analysis 35 4.6.1 Health hazard and risk mapping 35 4.6.2 Health risk models 37 4.6.3 Health risk maps 43 4.7 Challenges 52 5.0 Summary overview and status of the deliverables 53 5.1 Conclusion 55 5.2 Recommendations 56 Policy Brief 59 Executive Summary 61 Methodology 62 || v i i CLIMATE CHANGE HEALTH RISK MAPPING List of Tables Table 1: Health facilities in Bongo District 28 Table 2: Health staffing in Bongo District 28 Table 3: Health facilities in Gomoa Municipal 30 Table 4: Health facilities in Keta Municipal 31 Table 5: Keta Municipal health staff strength 31 Table 6: OPD cases for malaria, diarrhoea and CSM in Bongo District 2009-2011 33 Table 7: OPD cases for malaria, diarrhoea and CSM in Keta Municipal Area 2009-2011 34 Table 8: OPD cases for malaria, diarrhoea and CSM in Gomoa West Municipal Area 2009-2011 35 Table 9: Data layers used in health hazard/risk mapping 37 Table 10: CSM Hazard /Risk layer ranking and weighting 38 Table 11: Diarrhoea Hazard / Risk layer ranking and weighting 41 Table 12: Malaria Hazard / Risk layer ranking and weighting 42 Table 13: Status of project deliverables 55 List of figures Figure 1: Relationships between environmental health hazard environmental health risk and environmental health impact (source: Briggs, 2000). 23 Figure 2: Map of Ghana showing the study districts 27 Figure 3: Map of Bongo District 28 Figure 4: Map of Gomoa West Municipal Area 29 Figure 5: Map of Keta Municipal Area 30 Figure 6: Environmental Health Risk Mapping Methodological Flow Chart 37 Figure 7: Malaria Risk Model 38 Figure 8: Diarrhoea Risk Model 39 Figure 9: Meningitis Risk Model 42 Figure 10: Bongo District CSM risk map 45 Figure 11: Bongo District malaria risk map 46 Figure 12: Bongo District diarrhoea risk map 47 Figure 13: Gomoa West Municipal diarrhoea risk map 48 Figure 14: Gomoa West Municipal malaria risk map 49 Figure 15: Keta Municipal malaria risk map 50 Figure 16: Keta Municipal diarrhoea risk map 51 viii || CLIMATE CHANGE HEALTH RISK MAPPING Climate Change Health Risk Mapping Sub-National Climate Risk Maps for Ghana Final Report Submitted to UNDP/GEF Climate Change and Health Project. By: Philip Mantey Foster Mensah Kofi Nyarko The Centre for Remote Sensing and Geographic Information Services (CERSGIS), University of Ghana, Legon. PMB L17, Tel: +233 302 500301/50796, Fax: +233 302 500310, email: [email protected] || 1 CLIMATE CHANGE HEALTH RISK MAPPING 2 || CLIMATE CHANGE HEALTH RISK MAPPING Executive summary Due to Ghana’s significant vulnerability to climatic changes and consequently, the prevalence of an extremely high burden of climate-sensitive diseases, the Ministry of Health (MOH), Ghana in partnership of United Nations Development Programme (UNDP) is implementing a Global Environment Facility (GEF) funded project to pilot climate change adaptation for health in Ghana. The project focuses on three selected diseases of Malaria, Cerebrospinal Meningitis and Diarrhoeal Diseases in three pilot districts of Bongo in the Upper East region, Keta in the Volta region and Gomoa West in the Central Region. CERSGIS was tasked with the development human factors in modeling health risks in the of climate change health risk maps at sub- pilot districts. Meningitis risk in the Bongo national scales (3 pilot districts, namely district was high within the district capital Keta, Gomoa West, and Bongo) showing where there was high population density current and future severity and incidence and low in the rural and sparsely populated of climate-sensitive diseases. This involved communities. Generally, malaria risk was seen among other things; a review of the existing fairly distributed within the districts studied literature showing linkages between climate but was highest within the densely populated and health risks in Ghana, the development of communities, forest areas and along the a methodology for developing and updating coast. Diarrhoeal risk was also high along the climate change health risk maps, as well as coast and densely in populated areas. the use of appropriate surveillance data on climate-sensitive diseases and other relevant Capacity building activities on the use of GIS information to map current health risks in technology in disease epidemiology