Warning system for Extreme weather events, Awareness Technology for Healthcare, Equitable delivery, and Resilience (WEATHER) project: a mixed methods research study protocol

Background: Extreme weather events (EWEs) in KwaZulu-Natal province, South Africa are increasingly common causing disease outbreaks, loss of homes, damage to infrastructure, increased mortality and life as well as increasing the pressure on the health system. An Early Warning System (EWS) intervention is needed to alert communities and government increasing preparedness for floods, improving resilience of health services to predict, detect and respond to emergencies and disease outbreaks. The aim of this mixed methods study is to develop, implement and evaluate an EWS as an alert system for communities and government agencies to detect, identify and prevent disease outbreaks strengthening the health system response.

Methods: The study sites are eThekwini and Ugu, municipalities in KwaZulu-Natal province, South Africa and will comprise the selected community and health facilities in selected sites in these two health districts. This transdisciplinary project will build on prior engagement with communities/health providers (e.g., communities, professionals, policy makers) integrating a participatory, co-creation approach. To build the foundation for this study and understand the impact of climate change on disease outbreaks, a systematic review will be conducted. We will also design, develop and evaluate the performance of an EWS and will link data on the two (rural and urban) healthcare and environmental contexts and integrate EWS for change, clarify how these will be delivered for vulnerable communities, and test and adapt the EWS. Following, an assessment of the disease burden at primary health care clinics in Ugu and eThekwini will be undertaken.

Subsequently, an examination of the health needs along with community experiences, during, an EWE, as well as assessment of the health systems resilience in responding to an EWE. Finally, an evaluation will be conducted on the design, development and evaluation of the performance of an EWS intervention and an evaluation and costing of the implementation of the EWS. Ethics for the project will be sought from the relevant ethical committees and informed consent taken by voluntary participants in the study.

Discussion: Based on the study findings, recommendations will be made to the Department of Health with respect to an early warning system and health systems resilience.

Trial registration: Not applicable