Building on DHIS2’s already flexible design to incorporate climate services and help break health and climate data out of silos to facilitate combined analysis and forecasting, and strengthen climate-resilient health systems
The potential effects of climate change and related ecosystem disruptions are dramatic and wide-ranging, touching every part of life on our planet, including human health. In many health programs – such as infectious disease surveillance, maternal and child health, and nutrition and food security – health outcomes can be directly and indirectly impacted by environmental factors, including local climate variation and extreme weather events linked to global climate change. Urgent action is needed to protect at-risk communities and prevent negative health effects, particularly among populations most vulnerable to the impacts of climate change and variation on population health. Planning and prioritizing that action requires accurate and actionable data on the specific correlations between climate and environmental factors and health outcomes.
To help strengthen the climate resilience of national health systems, DHIS2 for Climate & Health aims to enhance existing DHIS2 systems through the integration of climate, weather, environmental, and earth observation data; the development of Climate & Health analytical and modeling tools; and the design of data visualizations and dashboards to support effective and timely analysis and decision making in response to climate-sensitive health risks.
Are you interested in using DHIS2 for Climate & Health? Get in touch with us at climate@dhis2.org
To get involved in our technical work on predictive modeling and climate-sensitive disease forecasting, visit our CHAP wiki on GitHub.
Incorporating climate, weather, and environmental data into DHIS2 can help to close the data gap between climate and health and deploy sustainable digital systems that address local health priorities, provide evidence for national climate change adaptation and public health policies, and support effective health interventions to respond to climate-related health risks. Below are a few examples of potential Climate & Health systems supported by DHIS2, as well as DHIS2 features developed to support them. Learn more on the use cases and features page.
Early warning and response systems for climate-sensitive diseases, such as malaria, dengue, diarrhea, Zika, etc. This use case builds on existing disease surveillance systems to allow for triangulation or health and climate data to help predict outbreaks and the spread of diseases to new areas.
Early warning and response systems for weather events and seasonal variation that affect crop production and prevalence of malnutrition. This use case builds on existing nutrition and agriculture systems to help plan mitigation actions, outreach activities, and resource prioritization.
Early warning and response systems for heat waves, floods, or other extreme weather events, linked to routine and emergency health programs. This use case builds on existing DHIS2 systems for routine service delivery and can expand DHIS2 systems for new data sources (non-communicable disease data, emergency response, etc.), to help plan mitigation actions, outreach for vulnerable populations and minimize routine service disruption.
The following DHIS2 features and applications are available to support Climate & Health use cases:
DHIS2 app to explore daily and monthly temperature, precipitation and humidity data for your organisation units. Import weather and climate data into DHIS2 data elements. The data source is ERA5-Land, which is considered the most accurate and complete climate dataset available with worldwide coverage. Values are aggregated to DHIS2 organisation units on Google Earth Engine.
Pilot app for DHIS2 that provides seamless integration with CHAP core, providing a user-friendly interface within DHIS2 for selecting data to use to generate predictions in CHAP – including data from the DHIS2 Climate App – train predictive models, visualize predictions, and evaluate model accuracy.
This app is currently in testing. Visit the CHAP wiki on Github for more information.
CHAP (Climate Health Analytics Platform) is an open-source software platform for climate and health data harmonization and climate-sensitive disease forecasting that allows you to access, import, train, tune, run, assess, and share predictive models. CHAP is developed by HISP to integrate with DHIS2, but can also be used independently with other data sources.
If you are interested in learning more or getting involved in predictive modeling and disease forecasting with DHIS2, we invite you to connect with the CHAP team.
Several countries have begun to explore the potential of incorporating climate, weather, and environmental data into DHIS2 systems. Explore the map below to see recent pilots and ongoing projects.
Initial work has begun to add a Climate & Health early warning component to the Ministry of Health’s national DHIS2-based malaria information system. It uses malaria data (aggregate weekly cases at the district level) from the national DHIS2 database and weekly meteorological data (temperature, atmospheric pressure, and precipitation) from the Copernicus data set that is pulled into DHIS2 Maps via the Google Earth API. From DHIS2, this data is run through a statistical model that outputs malaria outbreak probability in 4- and 8-week predictions. These indicators are returned to DHIS2 where they are displayed on dashboards in several formats, including maps for geospatial analysis and a chart with an outbreak warning threshold (target line). The dashboards are customized at the district level to facilitate action in the form of local preventative measures. This system was initially developed through a Clinton Health Access Initiative (CHAI) project with technical support from Saudigitus (HISP Mozambique). It is currently in the development phase.
A pilot project between the Ministry of Health and the WHO country office has developed a pilot solution that combines climate and disease surveillance data in DHIS2 to give early warning of likely outbreaks of diarrhea and dengue. As part of this project, in 2021, Laos integrated its previous Access-based, parallel EWS called EWARS into DHIS2 to capitalize on the possibility for facilities to enact immediate electronic notification for suspected cases of notifiable diseases. Data used includes historical and current daily weather data (temperature, rainfall, humidity) from the national meteorological office that has been formatted to allow for correlation with aggregate notifiable disease data, which is collected daily and aggregated by week at the district level. The combined data is run through a statistical model in an external software package that returns outbreak prediction indicators to DHIS2 dashboards. HISP Vietnam has provided technical support for integrating these systems, and has helped facilitate a bilateral data sharing agreement between the Laos MoH and the Meteorology and Hydrology Department. This project is currently in the development phase.
Malawi has deployed a DHIS2 system for climate-resilient food security. This DHIS2-based National Agriculture Management Information System (NAMIS) relies on partnership and data sharing between the MoH, Ministry of Agriculture, and Department of Climate Change and Meteorological Services (DCCMS). It involves collection of local weather data into DHIS2 by Agricultural Extension Development Officers using tablets running a custom app. This local data is combined with weather station and satellite data and used by DCCMS to make short-term and seasonal projections and forecasts, which the NAMIS system uses to generate early warnings to farmers about localized weather events such as floods or droughts so that they can take action to safeguard their crops. The data also helps the government plan special safety interventions like evacuations or large-scale irrigation which are beyond the capacities of individual households.
Pakistan used DHIS2 for flood-related infectious disease response in 2022, which is an example of how existing DHIS2 systems can be leveraged for extreme weather events. This system helped provide a clearer picture of the impact of the flood on population health, and to inform investments in response activities and the distribution of hundreds of thousands of insecticidal nets, test kits, medicines, and other vital supplies. While this system did not include a predictive component, it could serve as the foundation for a climate-informed early warning system, assuming availability of relevant hydrology and climate data and stakeholder buy-in.
Explore these resources for more information about Climate & Health:
An overview presentation from 2023 on using DHIS2 for climate and health.
Fact sheet and additional resources on climate change and health from WHO.
Combining climate and health data: Challenges and opportunities for longitudinal population studies.
Highlighting the need for tailored climate information and services to support the health sector in the face of more extreme weather and poor air quality, shifting infectious disease patterns and food and water insecurity.
Global Knowledge for Climate and Public Health – Informing action to protect populations from the health risks of climate change.
Landscape mapping of software tools for climate-sensitive infectious disease modeling.
Our work on DHIS2 for Climate & Health is organized through participatory action research projects. These projects feature collaborations between the global DHIS2 team at HISP Centre at the University of Oslo, our network of local HISP groups, national Ministries of Health and Meteorological Institutes and other local stakeholders, and an international network of academic institutions, research institutes, and global organizations. Our current research projects include:
The DHIS2 Community of Practice (CoP) is an online forum for DHIS2 discussion, support and innovation sharing. The use of climate data in DHIS2 is a rapidly developing field, and the CoP offers a platform for experts from around the world to share innovative approaches, ideas, and needs. You can also use the CoP to ask questions, get support for technical issues, participate in webinars and other informational events, as well as connect with other members of the global DHIS2 implementer community working on climate-related projects.
Join the discussion in these two categories:
Our work on developing a Climate and Health toolkit for DHIS2 is funded by a grant from Wellcome, and builds on investments into DHIS2 as a platform for health information management from our network of global public health partners. The HISP Centre collaborates on this work with a global network of partners, including national Ministries of Health, Meteorological Institutes, and other local stakeholders; the HISP network; subject matter experts from the Global Health Resilience group at the Barcelona Supercomputing Center, the International Research Institute for Climate and Society (IRI) at the Columbia Climate School, and the CICERO Center for International Climate Research; and an interdisciplinary working group at the University of Oslo, with input and guidance from Climate & Health experts at the World Health Organization and World Meteorological Organization.
