Skip to main content

Advertisement

SpringerLink
Log in

Implementation of national health adaptation policy: a case study of policy principles and implementation barriers in the Philippines

  • Original Article
  • Published:
Regional Environmental Change Aims and scope Submit manuscript

Abstract

Health risks from climate change are increasing and becoming a critical global concern. Implementation of health adaptation policies is vital, particularly in settings with high socioeconomic vulnerability and physical exposure to climate-risks, such as the Philippines. We identified from the literature a set of reference principles and categories of barriers to the implementation of national health adaptation policy. These were then used to assess the extent to which these policy principles and barriers are evident in Philippine national health adaptation. This assessment was undertaken based on data and information from policy analysis, key informant interviews, and an expert workshop. The results suggest that the Philippines have made notable progress on health adaptation by establishing a strong policy framework. However, implementation remains challenging and requires continued commitment. The health adaptation policy principles identified in the Philippines are policy congruence, mainstreaming, multi-sectoral approach, multiscale approach, adaptive management, and evidence-based decision-making. The most important implementation barriers are uncertain leadership, appropriateness and longevity of the governance structures within the Department of Health, and data and evidence. The value of considering policy principles alongside implementation barriers is twofold. First, this enables understanding of how implementation barriers relate directly to policy principles. Second, it facilitates identification of future implementation barriers that may arise in relation to current policy principles. Multi-sectoral governance and the integration of evidence in decision-making arose as potential future challenges in the Philippines. These areas may require special consideration in future policy design and planning.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  • Adger WN, Arnell NW, Tompkins EL (2005) Successful adaptation to climate change across scales. Glob Environ Change 15:77–86. https://doi.org/10.1016/j.gloenvcha.2004.12.005

  • Ampaire EL, Jassogne L, Providence H, Acosta M, Twyman J et al (2017) Institutional challenges to climate change adaptation: a case study on policy action gaps in Uganda. Environ Sci Policy 75:81–90. https://doi.org/10.1016/j.envsci.2017.05.013

  • Austin SE, Biesbroek R, Berrang-Ford L, Ford JD, Parker S et al (2016) Public health adaptation to climate change in OECD countries. Int J Environ Res Public Health 13:889. https://doi.org/10.3390/ijerph13090889

  • Austin SE, Ford JD, Berrang-Ford L, Biesbroek R, Tosun J et al (2018) Intergovernmental relations for public health adaptation to climate change in the federalist states of Canada and Germany. Glob Environ Change 52:226–237. https://doi.org/10.1016/j.gloenvcha.2018.07.010

  • Austin SE, Ford JD, Berrang-Ford L, Biesbroek R, Ross NA (2019) Enabling local public health adaptation to climate change. Soc Sci Med 220:236–244. https://doi.org/10.1016/j.socscimed.2018.11.002

    Article  Google Scholar 

  • Awuor L, Meldrum R, Liberda EN (2020) Institutional engagement practices as barriers to public health capacity in climate change policy discourse: lessons from the Canadian Province of Ontario. Int J Environ Res Public Health 17:6338. https://doi.org/10.3390/ijerph17176338

    Article  Google Scholar 

  • Banwell N, Rutherford S, Mackey B, Chu C (2018) Towards improved linkage of disaster risk reduction and climate change adaptation in health: a review. Int J Environ Res Public Health 15:793. https://doi.org/10.3390/ijerph15040793

  • Banwell N, Gesche AS, Vilches OR, Hostettler S (2020) Barriers to the implementation of international agreements on the ground: climate change and resilience building in the Araucanía Region of Chile. Int J Disaster Risk Reduct 50:101703. https://doi.org/10.1016/j.ijdrr.2020.101703

  • Belesova K, Kelman I, Boyd R (2016) Governance through economic paradigms: addressing climate change by accounting for health. Politics Gov 4:87–96. https://doi.org/10.17645/pag.v4i4.729

  • Berrang-Ford L, Biesbroek R, Ford JD, Lesnikowski A, Tanabe A et al (2019) Tracking global climate change adaptation among governments. Nat Clim Change 9:440–449. https://doi.org/10.1038/s41558-019-0490-0

  • Berry P, Enright P, Shumake-Guillemot J, Villalobos Prats E, Campbell-Lendrum D (2018) Assessing health vulnerabilities and adaptation to climate Change: a review of international progress. Int J Environ Res Public Health 15:2626. https://doi.org/10.3390/ijerph15122626

  • Biesbroek R, Delaney A (2020) Mapping the evidence of climate change adaptation policy instruments in Europe. Environ Res Lett 15:083005. https://doi.org/10.1088/1748-9326/ab8fd1

  • Birkmann J, Garschagen M, Mucke P, Schauder A, Seibert T et al (2014) World Risk Report 2014. Retrieved from https://i.unu.edu/media/ehs.unu.edu/news/4070/11895.pdf

  • Birt L, Scott S, Cavers D, Campbell C, Walter F (2016) Member checking: a tool to enhance trustworthiness or merely a nod to validation? Qual Health Res 26:1802–1811. https://doi.org/10.1177/1049732316654870

    Article  Google Scholar 

  • Bouzid M, Hooper L, Hunter PR (2013) The effectiveness of public health interventions to reduce the health impact of climate change: a systematic review of systematic reviews. PloS One 8:e62041. https://doi.org/10.1371/journal.pone.0062041

  • Bowen KJ, Ebi KL (2015) Governing the health risks of climate change: towards multi-sector responses. Curr Opin Environ Sustain 12:80–85. https://doi.org/10.1016/j.cosust.2014.12.001

  • Bowen KJ, Friel S (2012) Climate change adaptation: where does global health fit in the agenda? Glob Health 8:10. https://doi.org/10.1186/1744-8603-8-10

    Article  Google Scholar 

  • Bowen KJ, Friel S, Ebi KL, Butler CD, Miller F et al (2012) Governing for a healthy population: towards an understanding of how decision-making will determine our global health in a changing climate. Int J Environ Res Public Health 9:55–72. https://doi.org/10.3390/ijerph9010055

  • Bowen KJ, Ebi KL, Friel S, McMichael AJ (2013a) A multi-layered governance framework for incorporating social science insights into adapting to the health impacts of climate change. Glob Health Action 6:21820. https://doi.org/10.3402/gha.v6i0.21820

  • Bowen KJ, Miller F, Dany V, McMichael AJ, Friel S (2013b) Enabling environments? Insights into the policy context for climate change and health adaptation decision-making in Cambodia. Clim Dev 5:277–287. https://doi.org/10.1080/17565529.2013.833077

  • Browne J, Coffey B, Cook K, Meiklejohn S, Palermo C (2019) A guide to policy analysis as a research method. Health Promot Int 34:1032–1044. https://doi.org/10.1093/heapro/day052

    Article  Google Scholar 

  • Chua PL, Dorotan MM, Sigua JA, Estanislao RD, Hashizume M et al (2019) Scoping review of climate change and health research in the Philippines: a complementary tool in research agenda-setting. Int J Environ Res Public Health 16:2624. https://doi.org/10.3390/ijerph16142624

  • Cinco TA, Hilario FD, de Guzman RG, Ares ED (2013) Climate trends and projections in the Philippines. In: Proceedings of the 12th National Convention on Statistics (NCS), Mandaluyong City, Philippines. pp 1–2

  • Climate Change Commission (2011) National climate change action plan 2011–2028. Manila, Philippines

  • Climate Change Commission (2010) National framework strategy on climate change 2010–2022. Manila, Philippines

  • Creswell JW (2014) Research design: qualitative, quantitative, and mixed methods approaches. Sage

  • Curtis S, Fair A, Wistow J, Val DV, Oven K (2017) Impact of extreme weather events and climate change for health and social care systems. Environ Health 16:128. https://doi.org/10.1186/s12940-017-0324-3

    Article  Google Scholar 

  • Dayrit MM, Lagrada LP, Picazo OF, Pons MC, Villaverde MC (2018) The Philippines health system review. Retrieved from: https://apps.who.int/iris/handle/10665/274579

  • De Ceukelaire W, De Vos P, Criel B (2011) Political will for better health, a bottom‐up process. Trop Med Int Health 16:1185–1189. https://doi.org/10.1111/j.1365-3156.2011.02817.x

  • Department of Health (2010) Philippine Strategy on Climate Change Adaptation for Health. Manila, Philippines

  • Department of Health (2013) 2014–2016 National climate change adaptation in health (CCAH) strategic plan. Manila, Philippines

  • Department of Health (2012a) Administrative Order No. 2012–0005 - National policy on climate change adaptation for the health sector. Manila, Philippines

  • Department of Health (2012b) Administrative Order No. 2012 - 0018: Operational guidelines of administrative order no. 2012–0005 "National policy on climate change adaptation for the health sector". Manila, Philippines

  • Department of Health (2015) Department Personnel Order No. 2015 - 5342: Creation of a DOH climate change executive committee. Manila, Philippines

  • Department of Health (2016) Amendment to Department Personnel Order No. 2015–5342 dated September 28, 2015 entitled "Creation of a DOH Climate Change Executive Committee”. Manila, Philippines

  • Ebi KL, Hess JJ (2017) The past and future in understanding the health risks of and responses to climate variability and change. Int J Biometeorol 1–10. https://doi.org/10.1007/s00484-017-1406-1

  • Ebi KL, Otmani del Barrio M (2017) Lessons learned on health adaptation to climate variability and change: experiences across low-and middle-income countries. Environ Health Perspect 125:6. https://doi.org/10.1289/EHP405

  • Ebi KL, Boyer C, Bowen K, Frumkin H, Hess J (2018) Monitoring and evaluation indicators for climate change-related health impacts, risks, adaptation, and resilience. Int J Environ Res Public Health 15:1943. https://doi.org/10.3390/ijerph15091943

  • Ebi KL, Villalobos Prats E (2015) Health in national climate change adaptation planning. Ann Glob Health 81:418. https://doi.org/10.1016/j.aogh.2015.07.001

  • Eckstein D, Künzel V, Schäfer L (2018) Global Climate Risk Index 2018. Germanwatch, Bonn, Germany

  • Eisenack K, Moser SC, Hoffmann E, Klein RJ, Oberlack C et al (2014) Explaining and overcoming barriers to climate change adaptation. Nat Clim Change 4:867. https://doi.org/10.1038/nclimate2350

  • Fedele G, Donatti CI, Harvey CA, Hannah L, Hole DG (2019) Transformative adaptation to climate change for sustainable social-ecological systems. Environ Sci Policy 101:116–125. https://doi.org/10.1016/j.envsci.2019.07.001

    Article  Google Scholar 

  • Fox M, Zuidema C, Bauman B, Burke T, Sheehan M (2019) Integrating public health into climate change policy and planning: state of practice update. Int J Environ Res Public Health 16:3232. https://doi.org/10.3390/ijerph16183232

  • Ganesh C, Smith JA (2018) Climate change, public health, and policy: a California case study. Am J Public Health 108:S114–S119. https://doi.org/10.2105/AJPH.2017.304047

  • Government of the Philippines (2009) National Climate Change Act of 2009 vol RA No. 9729. Manila, Philippines

  • Government of the Philippines (2015) Republic of the Philippines: Intended nationally determined contributions - communicated to the UNFCCC on October 2015. Manila, Philippines

  • Guha-Sapir D, Below R, Hoyois P (2018) EM-DAT: the centre for research on the epidemiology of disasters (CRED) international disaster database. Retrieved from: https://public.emdat.be/

  • Harding J (2018) Qualitative data analysis: From start to finish. Sage.

  • Hashim JH, Hashim Z (2016) Climate change, extreme weather events, and human health implications in the Asia pacific region. Asia-Pacific Journal of Public Health 28:8S–14S. https://doi.org/10.1177/1010539515599030

  • Hess JJ, Ebi KL (2016) Iterative management of heat early warning systems in a changing climate. Ann N Y Acad Sci 1382:21–30. https://doi.org/10.1111/nyas.13258

    Article  Google Scholar 

  • Hess JJ, McDowell JZ, Luber G (2012) Integrating climate change adaptation into public health practice: using adaptive management to increase adaptive capacity and build resilience. Environ Health Perspect 120:171. https://doi.org/10.1289/ehp.1103515

    Article  Google Scholar 

  • Hess JJ, Eidson M, Tlumak JE, Raab KK, Luber G (2014) An evidence-based public health approach to climate change adaptation. Environ Health Perspect 122:1177–1186. https://doi.org/10.1289/ehp.1307396

    Article  Google Scholar 

  • Homsy GC, Liu Z, Warner ME (2018) Multilevel governance: framing the integration of top-down and bottom-up policymaking. Int J Public Admin 1–11. https://doi.org/10.1080/01900692.2018.1491597

  • Huang C, Vaneckova P, Wang X, FitzGerald G, Guo Y et al (2011) Constraints and barriers to public health adaptation to climate change: a review of the literature. Am J Prev Med 40:183–190. https://doi.org/10.1016/j.amepre.2010.10.025

  • IPCC (2018) Summary for policymakers. In: Masson-Delmotte V, Zhai P, Pörtner H-O, Roberts D, Skea J et al (eds) Global warming of 1.5°C. An IPCC Special Report on the impacts of global warming of 1.5°C above pre-industrial levels and related global greenhouse gas emission pathways, in the context of strengthening the global response to the threat of climate change, sustainable development, and efforts to eradicate poverty. World Meteorological Organization, pp 32

  • Law RP (2016) Climate change adaptation and disaster risk reduction in the Philippine health sector: challenges and way forward. Philipp J Health Res Dev 20:8

  • Lesnikowski AC, Ford JD, Berrang-Ford L, Barrera M, Berry P et al (2013) National-level factors affecting planned, public adaptation to health impacts of climate change. Global Environ Change 23:1153–1163 https://doi.org/10.1016/j.gloenvcha.2013.04.008

  • Marcus H, Hanna L (2020) Understanding national barriers to climate change adaptation for public health: a mixed-methods survey of national public health representatives. Int J Health Gov. https://doi.org/10.1108/IJHG-06-2020-0061

  • MDG Achievement Fund (2012) Final MDG-F Joint Programme Narrative Report - MDG-F 1656.

  • Miles M, Huberman M, Saldana J (2014) A methods source book Qualitative data analysis. Sage

  • Nalau J, Preston BL, Maloney MC (2015) Is adaptation a local responsibility? Environ Sci Policy 48:89–98. https://doi.org/10.1016/j.envsci.2014.12.011

    Article  Google Scholar 

  • Nguyen QA, Miller F, Bowen K, Tan Sinh B (2017) Evaluating capacity for climate change adaptation in the health and water sectors in Vietnam: constraints and opportunities. Climate Dev 9:258–273. https://doi.org/10.1080/17565529.2016.1146118

    Article  Google Scholar 

  • Nightingale AJ (2017) Power and politics in climate change adaptation efforts: struggles over authority and recognition in the context of political instability. Geoforum 84:11–20. https://doi.org/10.1016/j.geoforum.2017.05.011

    Article  Google Scholar 

  • Nilsson M, Chisholm E, Griggs D, Howden-Chapman P, McCollum D et al (2018) Mapping interactions between the sustainable development goals: lessons learned and ways forward. Sustain Sci 13:1489–1503. https://doi.org/10.1007/s11625-018-0604-z

  • PAGASA (2011) Climate Change in the Philippines. Philippine Atmospheric, Geophysical and Astronomical Services Administration, Philippines, Manila

  • PCHRD-DOST (2011) National Unified Health Research Agenda 2011–2016. Department of Science and Technology, Philippines, Manila

  • PCHRD-DOST (2017a) National Unified Health Research Agenda 2017–2022. Department of Science and Technology, Philippines, Manila

  • PCHRD-DOST (2017b) Philippine Center for Health Research and Development - Call for Proposals 2018. http://www.pchrd.dost.gov.ph/index.php/news/6179-pchrd-call-for-proposals-2018. Accessed 12th February 2018

  • Piggott-McKellar AE, McNamara KE, Nunn PD, Watson JE (2019) What are the barriers to successful community-based climate change adaptation? A review of Grey literature. Local Environ 24:374–390. https://doi.org/10.1080/13549839.2019.1580688

  • Pulhin JM, Tapia MA, Perez RT (2010) Integrating disaser risk reduction and climate change adaptation: initiatives and challenges in the Philippines. In: Climate change adaptation and disaster risk reduction: an Asian perspective: an Asian perspective, vol 5. Community, Environment and Disaster Risk Management. Emerald Group Publishing. https://doi.org/10.1007/s11442-016-1304-1

  • QSR International Pty Ltd (2018) NVivo qualitative data analysis software, Version 12 edn.

  • Racioppi F, Martuzzi M, Matić S, Braubach M, Morris G et al (2020) Reaching the sustainable development goals through healthy environments: are we on track? https://doi.org/10.1093/eurpub/ckaa028

  • Shi P, Yang X, Xu W, Wang J (2016) Mapping and ranking global mortality, affected population and GDP loss risks for multiple climatic hazards. J Geogr Sci 26:878–888. https://doi.org/10.1007/s13753-016-0079-4

  • Spires M, Shackleton S, Cundill G (2014) Barriers to implementing planned community-based adaptation in developing countries: a systematic literature review. Climate Dev 6:277–287. https://doi.org/10.1080/17565529.2014.886995

    Article  Google Scholar 

  • Tong S, Ebi K (2019) Preventing and mitigating health risks of climate change. Environ Res. https://doi.org/10.1016/j.envres.2019.04.012

    Article  Google Scholar 

  • Tonmoy FN, Cooke SM, Armstrong F, Rissik D (2020) From science to policy: development of a climate change adaptation plan for the health and wellbeing sector in Queensland Australia. Environ Sci Policy 108:1–13. https://doi.org/10.1016/j.envsci.2020.03.005

  • Turner LR, Alderman K, Connell D, Tong S (2013) Motivators and barriers to incorporating climate change-related health risks in environmental health impact assessment. Int J Environ Res Public Health 10:1139–1151. https://doi.org/10.3390/ijerph10031139

    Article  Google Scholar 

  • UNEP (2018) Adaptation Gap Report 2018. United Nations Environment Programme. Kenya, Nairobi. Retrieved from: https://www.unep.org/resources/adaptation-gap-report-2018

  • UNEP (2020) Emissions Gap Report 2020. United Nations Environment Programme Kenya, Nairobi. Retrieved from: https://www.unep.org/emissions-gap-report-2020

  • UNFCCC (2017) Human health and adaptation: understanding climate impacts on health and opportunities for action. Synthesis paper by the secretariat. vol Forty-sixth session. Retrieved from: https://unfccc.int/documents/9661

  • Villarin JR, Algo JL, Cinco TA, Cruz FA, de Guzman RG et al (2016) Philippine Climate Change Assessment: Working Group I, The Physical Science Basis. Oscar M. Lopez Center for Climate Change Adaptation and Disaster Risk Management Foundation Inc, Climate Change Commission, Manila, Philippines. Retrieved from: https://niccdies.climate.gov.ph/climate-reports/philippine-climate-change-assessment-report

  • Watts N, Adger WN, Agnolucci P, Blackstock J, Byass P et al (2015) Health and climate change: policy responses to protect public health. The Lancet 386(10006):1861–1914. https://doi.org/10.1016/S0140-6736(15)60854-6

    Article  Google Scholar 

  • Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K et al (2018a) The 2018 report of the Lancet Countdown on health and climate change: shaping the health of nations for centuries to come. The Lancet 392:2479–2514. https://doi.org/10.1016/S0140-6736(18)32594-7

  • Watts N, Amann M, Ayeb-Karlsson S, Belesova K, Bouley T et al (2018b) The Lancet Countdown on health and climate change: from 25 years of inaction to a global transformation for public health. The Lancet 391:589–630. https://doi.org/10.1016/S0140-6736(17)32464-9

  • Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Belesova K et al (2019) The 2019 report of The Lancet Countdown on health and climate change: ensuring that the health of a child born today is not defined by a changing climate. The Lancet 394:1836–1878. https://doi.org/10.1016/S0140-6736(19)32596-6

  • Watts N, Amann M, Arnell N, Ayeb-Karlsson S, Beagley J et al (2020) The 2020 report of the lancet countdown on health and climate change: responding to converging crises. The Lancet 10269:129–170. https://doi.org/10.1016/S0140-6736(20)32290-X

  • Wheeler N, Watts N (2018) Climate change: from science to practice. Curr Environ Health Rep 5:170–178. https://doi.org/10.1007/s40572-018-0187-y

  • WHO (2014) WHO guidance to protect health from climate change through health adaptation planning. WHO, Department of Public Health Environment and Social determinants of health, Geneva, Switzerland. Retrieved from: http://apps.who.int/iris/bitstream/handle/10665/137383/9789241508001_eng.pdf?sequence=1

  • WHO (2015a) Lessons learned on health adaptation to climate variability and change experiences across low- and middle-income countries. Retrieved from: https://apps.who.int/iris/handle/10665/176009

  • WHO (2015b) Operational framework for building climate resilient health systems. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/189951/9789241565073_eng.pdf

  • WHO (2019) Health and Climate Change Survey Report. Retrieved from: https://apps.who.int/iris/handle/10665/329972

  • Workman A, Blashki G, Bowen KJ, Karoly DJ, Wiseman J (2018) The political economy of health co-benefits: embedding health in the climate change agenda. Int J Environ Res Public Health 15:1–18. https://doi.org/10.3390/ijerph15040674

    Article  Google Scholar 

  • Yin R (2016) Qualitative research from start to finish (2nd Eds.) New York: GuilPress

  • Yumul GP, Cruz NA, Servando NT, Dimalanta CB (2011) Extreme weather events and related disasters in the Philippines, 2004–08: a sign of what climate change will mean? Disasters 35:362–382. https://doi.org/10.1111/j.1467-7717.2010.01216.x

    Article  Google Scholar 

Download references

Acknowledgements

The authors would like to acknowledge Professor Cordia Chu for her role supervising the PhD research of Nicola Banwell.

Funding

This research was partially funded by the Australian Government Endeavour Post Graduate Scholarship. The authors would like to thank the Health Emergency Management Bureau, Philippines Department of Health for their collaboration and support with data collection.

Author information

Authors and Affiliations

  1. Centre for Environment and Population Health, School of Environment, Griffith University, Brisbane, 4111, Australia

    Nicola Banwell

  2. Health Emergency Management Bureau, Department of Health, Manila, Philippines

    Ronald Law

  3. Griffith Climate Action Beacon, Griffith University, Gold Coast City, 4222, Australia

    Brendan Mackey

  4. School of Medicine, Griffith University, Brisbane, 4111, Australia

    Shannon Rutherford

Authors
  1. Nicola Banwell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald Law
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brendan Mackey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shannon Rutherford
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicola Banwell.

Ethics declarations

Conflict of interest

Co-author of this manuscript, Ronald Law, is employed by the Department of Health in the Philippines.

Additional information

Communicated by Stacy-ann Robinson

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Banwell, N., Law, R., Mackey, B. et al. Implementation of national health adaptation policy: a case study of policy principles and implementation barriers in the Philippines. Reg Environ Change 21, 93 (2021). https://doi.org/10.1007/s10113-021-01817-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10113-021-01817-8

Keywords

Search

Navigation