Local research evidence for public health interventions against climate change in Vietnam

Perspectives of Local Community Leaders, Health Care Workers, Volunteers, Policy Makers and Academia on Climate Change Related Health Risks in Mukuru Informal Settlement in Nairobi, Kenya-A Qualitative Study

Sub-Saharan Africa has been identified as one of the most vulnerable regions to climate change. The objective of this study was to explore knowledge and perspectives on climate change and health-related issues, with a particular focus on non-communicable diseases, in the informal settlement (urban slum) of Mukuru in Nairobi, Kenya. Three focus group discussions and five in-depth interviews were conducted with total of 28 participants representing local community leaders, health care workers, volunteers, policy makers and academia. Data were collected using semi-structured interview guides and analyzed using grounded theory. Seven main themes emerged: climate change related diseases, nutrition and access to clean water, environmental risk factors, urban planning and public infrastructure, economic risk factors, vulnerable groups, and adaptation strategies. All participants were conscious of a link between climate change and health. This is the first qualitative study on climate change and health in an informal settlement in Africa. The study provides important information on perceived health risks, risk factors and adaptation strategies related to climate change. This can inform policy making, urban planning and health care, and guide future research. One important strategy to adapt to climate change-associated health risks is to provide training of local communities, thus ensuring adaptation strategies and climate change advocacy.

Gaps in awareness of climate variability and its impacts on society among health professionals and community workers in Vietnam: Implications for COVID-19 and other epidemic response systems

The study presents a cross-sectional analysis via a web-based survey to assess the awareness and experiences of Vietnamese health professionals and community workers on climate and epidemic changes and their impacts on society. Health professionals, medical students, and community workers were included in the survey. Factor analysis was used to explore the construct validity of measures, and Multivariable Tobit regression models were used to examine associated factors with awareness about climate and epidemic changes and impacts on society. Results showed that the awareness of participants about climate and epidemic changes was moderately-low, while the awareness about the impacts on society were moderately high. Community workers show higher awareness of climate and epidemic changes compared to health professionals. People working in provincial levels had a lower score (Coef. = -0.64, 95%CI = -1.19 to -0.09) than those working in central level. Compared to Northern participants, those living in Central and Southern regions have lower awareness scores regarding "Changes in weather and epidemics" and "Changes in the environment" compared to Northern people. The higher awareness about climate and epidemic changes were found to be correlated with the higher awareness of "Impacts on health, society and economy" and "Impact on individuals and families". Community workers scored lower in "Impact on individuals and families" compared to health professionals (Coef.-0.75; 95%CI = -1.34 to -0.16). This study emphasized the vulnerabilities of Vietnamese communities to epidemics and climate change. It suggests the involvements of intersectoral taskforces in the preparedness and responses to climate change and epidemics.

Heatwave and risk of hospitalization: A multi-province study in Vietnam

The effects of heatwaves on morbidity in developing and tropical countries have not been well explored. The purpose of this study was to examine the relationship between heatwaves and hospitalization and the potential influence of socio-economic factors on this relationship in Vietnam. Generalized Linear Models (GLM) with Poisson family and Distributed Lag Models (DLM) were applied to evaluate the effect of heatwaves for each province (province-level effect). A random-effects meta-analysis was applied to calculate the pooled estimates (country-level effects) for 'all causes', infectious, cardiovascular, and respiratory admissions queried by lag days, regions, sex, and ages. We used random-effects meta-regression to explore the potential influence of socio-economic factors on the relationship between heatwaves and hospitalization. The size of province-level effects varied across provinces. The pooled estimates show that heatwaves were significantly associated with a 2.5% (95%CI: 0.8-4.3) and 3.8% (95%CI, 1.5-6.2) increase in all causes and infectious admissions at lag 0. Cardiovascular and respiratory admissions (0.8%, 95%CI: -1.6-3.3; 2.2%, 95%CI: -0.7-5.2) were not significantly increased after a heatwave event. The risk of hospitalization due to heatwaves was higher in the North than in the South for all causes (5.4%, 95%CI: -0.1-11.5 versus 1.3%, 95%CI: 0.1-2.6), infectious (11.2%, 95%CI: 3.1-19.9 versus 3.2%, 95%CI: 0.7-5.7), cardiovascular (7.5%, 95%CI: 1.1-14.4 versus -1.2%, 95%CI: -2.6-2.3), and respiratory diseases (2.7%, 95%CI: -5.4-11.5 versus 2.1%, 95%CI: -0.8-1.2). A non-significant influence of socio-economic factors on the relationship between heatwave and hospitalization was observed. This study provides important evidence and suggests implications for the projected impacts of climate change related extreme weather. Climate change adaptation programs of the health sector should be developed to protect residents from the effects of extreme weather events such as heatwaves in Vietnam.