亚开行-利用传统生态知识进行气候适应性初级卫生保健

Supporting Investments that Reach ScaleWhile Ensuring No One Is Left Behind Using Traditional Ecological Knowledgefor Climate-Resilient Primary Health Care PROJECT NAMEPreparing the Green Primary Care Project COUNTRYLao People’s Democratic Republic SECTORHealth PROJECT OFFICERAlexo Esperato MartinezSenior Health Specialist, Human and SocialDevelopment Sector Office, Sectors Department 3,Asian Development Bank IMPLEMENTATION PERIOD10 September 2025 to 31 December 2030 2Community Resilience Partnership Program Project Brief No. 3 CLIMATE RISK AND RESILIENCE PROFILE The Lao People’s Democratic Republic (Lao PDR) ranks 92nd in the 2022 Climate Risk Indexaand 140th in theND-GAIN Country Index.b The country is increasingly exposed to climate change as incidence of extreme heat poses a major threat to humanhealth while floods and landslides often hamper access to and cause damages to critical infrastructure like health Climate change has increased the prevalence of malaria, dengue, and diarrheal diseases and through its impacts onlivelihoods and agriculture, it has increased the rates of malnutrition. The country’s health system shows critical gaps in climate preparedness. The health workforce is poorly trained inmanaging climate-related diseases, 25% of the 1,232 health facilities lack essential water and/or electricity, and early aClimate Risk Index: The annualClimate Risk Indexanalyzes to what extent countries have been affected by the impacts of weather-related loss events (storms,floods, heat waves, etc.).bTheND-GAIN Country Index(accessed 16 July 2025) summarizes a country’s vulnerability to climate change and other global challenges in combinationwith its readiness to improve resilience, with higher rankings signifying greater vulnerabilities (i.e., 192 is the most vulnerable and 1 least vulnerable). A total of192 countries are ranked from low vulnerability and high readiness to high vulnerability and low readiness. CHALLENGES IN THE HEALTH SYSTEM �Limited community preparedness.Weak institutionalcapacity and lack of support for community-based The Lao PDR is among the high risk countries fromclimate-related hazards such as flooding, droughts, storms,and landslides, leading to frequent disruptions of healthservices and infrastructure. Climate change has led to higherprevalence and outbreaks of malaria, dengue, and diarrhealdiseases, especially in rural and ethnic minority communities. �Gender and social inequities.Women and ethnicminorities are disproportionately affected by The Lao PDR faces a complex set of health challenges,primarily driven by climate change, inadequate health systemcapacity, and social inequities, resulting in a high burdenof both communicable and noncommunicable diseases, �Lack of training on climate change impacts on health.Critical gaps exist in the health workforce’s ability tomanage climate-related diseases, with many health care However, it is noteworthy that the Lao PDR was one of thefirst countries to have aHealth Sector National AdaptationPlan (H-NAP), which now guides the country’s efforts inbuilding a climate-resilient health system. It outlines strategies, �Inadequate infrastructure.About 25% of health facilitieslack essential water and electricity, and many communities �Poor early warning and risk communication systems.Early warning systems for climate-related health risksare often absent or underfunded, particularly in ethnic Using Traditional Ecological Knowledge for Climate-Resilient Primary Health Care CRPP TRUST FUND SUPPORT decision to work with the Lao Front for National Development(LFND)—the country’s largest mass government organization.Given LFND’s strong connections across all villages in theLao PDR, the project aims to develop activities such as buildinglocal climate ambassadors and health promotion activities thatcould be channeled through existing village health committee. Financing from the Community Resilience PartnershipProgram Trust Fund (CRPPTF) was used to further (i) developand design theGreen Primary Care Project, includingcommunity-informed Climate Risk Vulnerability Assessment;(ii) develop a community resilience technical assistance (TA) “From the outset, we adopted ahealth equity lens and anchoredthe work on understandingclimate vulnerabilities throughintersectional approaches, sohow do race, class, age, gender FINDINGS Communities experience climate impacts firsthand.1At theoutset, theGreen Primary Care Projectdesign adopted ahealth equity lens and anchored its work on understandinga community’s climate vulnerabilities through intersectionalapproaches—how race and ethnicity, class, age, and genderintersect to determine vulnerability to climate and disasterrisks. Communities in the five target provinces of Champasak,Louangphabang, Oudomxay, Savannakhet, and Xiangkhouang Natasha KuruppuClimate Change Specialist Communities also access health services through theprimary care subsystem.2Hence, health for all, including th