Vulnerability to the health effects of climate variability in rural southwestern Uganda

Abstract

Vulnerability to the health impacts of climate change will be shaped by the existing burden of ill- health and is expected to be highest in poor and socio-economically marginalized populations. Sub-Saharan Africa, in particular, is considered a highly vulnerable region. This paper analyses the vulnerability and adaptive capacity of rural Bakiga communities in southwestern Uganda to climate-sensitive health risks. The objectives were threefold: i) identify key climate-sensitive, community-identified health priorities; ii) describe and characterize determinants of sensitivity to these health priorities at the individual, community and regional levels; and iii) assess the adaptive capacity of Bakiga. Data collection employed a combination of individual and key informant interviews, biographies, future storylines, and Photovoice. Three key health risks were identified by the study communities (malaria, food insecurity, and gastrointestinal illnesses) – all affected by local climatic and environmental conditions, livelihoods, land use changes, and socio-economic conditions. Adaptation within these communities is dependent on their capacity to reduce sensitivities to identified health challenges among the potential of increasing exposures. Crop diversification, reducing deforestation, expanding of livestock rearing, transfer of traditional knowledge, and access to affordable health services are among potential strategies identified. We demonstrate significant existing vulnerabilities to present day climate-related health risks and highlight the importance of non-climatic processes and local conditions in creating sensitivity to health risks. Our place-based understanding is useful to inform interventions or policies aimed to reduce exposure and sensitivity and support adaptive capacity as the conditions these communities face are consistent with many other sub-Saharan African countries.

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Fig. 1
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Notes

  1. 1.

    Local Council 1 is the first unit of administration in the country.

  2. 2.

    eQuality insurance is a private health insurance programme run by the Bwindi Community Hospital. In this programme, individuals pay a small amount (10,200 Ugandan Shillings = ~4 US dollars) annually and are subsequently able to access basic healthcare services, other than coverage for some chronic diseases, at Bwindi Community Hospital when needed.

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Acknowledgments

This work was carried out with support from the International Development Research Centre, the Canadian Institute of Health Research, the Natural Sciences and Engineering Research Council of Canada, and the Social Sciences and Humanities Research Council of Canada.

We kindly thank the communities of Kihembe and Mukongoro, all other participants in the research, the Ugandan colleagues on the Indigenous Health Adaptation to Climate Change project (http://www.ihacc.ca), and our local field assistants and translators who made this research possible. We also thank Scott McEwen who helped provide the comments on the earlier drafts of this article. Finally, thank you to the editor and to three anonymous reviewers for their comments.

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Correspondence to Jolène Labbé.

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Labbé, J., Ford, J.D., Berrang-Ford, L. et al. Vulnerability to the health effects of climate variability in rural southwestern Uganda. Mitig Adapt Strateg Glob Change 21, 931–953 (2016). https://doi.org/10.1007/s11027-015-9635-2

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Keywords

  • Adaptation
  • Bakiga
  • Climate change
  • East Africa
  • Health
  • Kanungu
  • Uganda
  • Sub-Saharan Africa
  • Vulnerability