Stakeholder mapping: regional comparisons in adaptation implementation

BACKGROUND: Health adaptation planning is rapidly progressing but implementing actions on key health and climate change priorities is slow. We summarise and compare findings on progress in health adaptation in Europe and East and Southern African regions. METHODS: A desk-review of national health adaptation plans and strategies (NAPs) was conducted in 20 European countries and 14 East and Southern African countries to identify adaptation priorities. Key informant interviews were conducted with government representatives, non-governmental organizations, development partners, and civil society organisations. Participants were identified through partner networks and snowballing. The WHO framework was followed in mapping stakeholders’ interests, knowledge, and influence on health adaptation. Interview responses were transcribed and analysed in Nvivo to identify key themes. RESULTS: 34 NAPs were reviewed (20 in Europe, 14 in Africa). Interviews were conducted with 48 stakeholders (32 in Europe, 16 in Africa). Across Europe, more than half of the countries have policies addressing infectious diseases (12) and heat-related risks (14). In Africa, infectious diseases were a national priority for all countries, but heat management plans were largely absent (only one nation had a heat management plan). In both regions, adaptation action was driven by national policies, high stakeholder interest and knowledge, and the presence of focal points or joint working groups. Key barriers included: limited interagency or institutional collaborations, a need for evidence-based practice-oriented research, and funding for health adaptation activities. CONCLUSIONS: There are similarities in drivers and barriers to health adaptation in Europe and Africa. Progress on implementation is uneven, with heat-health planning largely lacking in East and Southern Africa.