By Christopher Golden

A healthcare worker in a red jacket uses a stethoscope and blood pressure cuff to check the blood pressure of a woman who is sitting down, wearing a floral-patterned top and dark clothing. The setting appears modest and dimly lit, suggesting a rural or remote environment. Both women look focused and serious during the examination.
A healthcare worker in Nepal checking a woman's blood pressure during an outreach visit. Photo credit: Rebecca Gaal

Addressing Climate Change and Public Health in Nepal

South Asia faces significant public health challenges, with Nepal standing out as a country severely affected by poverty-related health issues. Infectious diseases, malnutrition, and high infant mortality rates are widespread in Nepal, largely due to poor sanitation, failures in the food system, and limited healthcare access. As climate change intensifies, these health issues are expected to worsen, making it crucial to address the interconnectedness of environmental and health systems.

The Need for Climate-Smart Public Health Solutions

The Government of Nepal has identified integrated climate-health surveillance and the forecasting of climate-sensitive health risks as a key national priority. However, Nepal’s health data infrastructure has two main limitations:

  1. Fragmented data systems prevent comprehensive long-term analysis.
  2. Gaps in integrating spatial and temporal environmental data inhibit climate-health analysis.

To develop climate-smart public health interventions in Nepal, it is essential to build systems that connect climate, environmental, and health data for meaningful insights.

Building the Foundation: Research and Collaboration

Third Image: A group photo of eight people standing indoors, shoulder-to-shoulder and smiling at the camera. Three of the people in the center are wearing traditional Nepali hats and scarves. A presentation screen with text is partially visible on the right side of the photo.
The research team with Nepalese government collaborators. 

Our project focused on strengthening Nepal’s health data infrastructure by organizing a robust repository and developing innovative data science methodologies to analyze the human health impacts of climate-related diseases.

In partnership with the Government of Nepal, the Ministry of Health, and the Planetary Health Research Centre, our team completed the following milestones:

  • Established a Health Database: Collected and georeferenced monthly health clinic data from 2018 to the present, covering all 753 municipalities in Nepal.
  • Developed an Integrated Data Platform: Built a data warehouse combining satellite data, ground-based environmental observations, health incidence data, and socioeconomic indicators. This platform measures local exposure to variables like temperature, humidity, precipitation, land cover change, water stress, and extreme weather events.

This collaborative effort, including site visits and joint research between Nepalese and international experts, was made possible with grant funding, ensuring equitable benefit sharing. The climate and environmental data collected follows FAIR (Findable, Accessible, Interoperable, Reusable) principles, using open science standards. This ensures the public health data platform in Nepal is accessible and reusable by researchers, policymakers, and the public.

Global Impact Through DHIS2 Integration

Four people standing outside in front of the Harvard T.H. Chan School of Public Health building. The sign behind them reads, "Powerful ideas for a healthier world." The group consists of three men and one woman, smiling for the camera, with the building’s large windows and banner in the background.
The research team in front of the Harvard T.H. Chan School of Public Health

A standout feature of this project is its compatibility with DHIS2, the world’s largest health data management system used in over 76 countries. By developing tools and algorithms to connect climate and health data within DHIS2, we offer a scalable solution for climate-health surveillance globally—potentially benefitting up to 3.2 billion people (40% of the world’s population).

While raw health data from Nepal remains secure, the analytical methods and data-linking algorithms developed are publicly available and adaptable for other countries using DHIS2.

A Vision for the Future: Data-Driven Policy and Resilience

Our long-term goal is to enable Nepal—and other DHIS2-using countries—to operationalize integrated climate-health analysis for proactive public health policies. By identifying vulnerable regions and linking environmental data with health trends, we can support data-driven decisions that address and prevent worsening public health crises caused by climate change.

Through ongoing engagement with Nepal’s government and other stakeholders, we are committed to translating research into actionable policy, supporting both human and ecosystem health. This project establishes the critical groundwork for a climate-smart public health platform in Nepal, leveraging data integration, open access, and international collaboration. Our approach provides a scalable model for other countries, empowering governments to make informed decisions and build resilience against the growing threats of climate change.

 

In November 2023, the Harvard Center for International Development (CID) announced the award recipients of the inaugural GEM Incubation Fund, designed to support research that strives to find solutions to pressing development challenges. The recipients of the 2023 GEM Incubation Fund are pursuing research around the theme of climate change and international development, in line with the theme of CID's annual Global Empowerment Meeting. 

Dr. Christopher Golden headshot

Dr. Christopher Golden

CID Faculty Affiliate Dr. Christopher Golden is an Associate Professor of Planetary Health and Nutrition at the Harvard T.H. Chan School of Public Health. As an ecologist and epidemiologist, his research investigates the human health impacts of global environmental change, with a focus on food systems.

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