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 facilities carbon emissions. Health worker outcomes and facility emissions will be compared pre- and postintervention. Analyses weighing costs and benefits are central to all activities. Throughout we will disseminate project findings to relevant stakeholders, prioritising EU and global policy makers and leveraging existing networks. The final set of indicators on climate change and maternal, newborn and child health will be released in a WHO, UNICEF, WMO and UNFPA guidance document. In order to optimise synergies, avoid overlaps and increase the impact of the projects selected for funding from the call HORIZON-HLTH-2021-ENVHLTH-02-03 (Health impacts of climate change, costs and benefits of action and inaction), Horizon Europe projects 101057843 HIGH Horizons, 101057131 CATALYSE, 101057764 BlueAdapt, 101057690 CLIMOS, 101057554 IDAlert and 101057739 TRIGGER) will form a Climate and Health cluster. Common cluster activities will include Annual cluster meetings and periodic report of joint activities; Common dissemination and communication activities, including a common dissemination and communication strategy for the cluster, cluster web portal and visual identity, cluster brochure, cluster newsletters, stakeholder list, Shared individual Data Management Plans between cluster partners, Policy Strategy of the cluster, including joint policy briefs and Scientific strategy of the cluster. Thematic workshops/trainings on issues of common interest be defined in the context of the scientific strategy of the cluster; Working groups on topics of common interest