Heat Indicators for Global Health: Surveillance, Early Warning Systems and adaptation-mitigation actions to reduce heat impacts in pregnant women, infants and health workers in the EU and Africa (HIGH Horizons)

欧盟和全球在监测气候变化和健康方面存在重大差距，因此难以追踪健康负担和政策成果。全球健康热指标（高视界）：对孕妇和产后妇女、婴幼儿和卫生工作者的监测、早期预警系统和卫生设施干预（高视界）项目将进行四年，涉及一个联合王国伙伴、六个欧盟伙伴、三个非洲伙伴和一个国际组织（世卫组织）。它以受气候变化影响的弱势群体为中心：受气候变化严重影响的孕妇和产后妇女、婴儿和卫生工作者。我们将量化和监测极端高温对健康的直接和间接影响；测试个性化预警系统（EWS）；并在卫生设施中实施综合适应-缓解行动。热影响分析和使用瑞典数据的数据科学预测模型；意大利拉齐奥、希腊以及肯尼亚和南非的卫生设施是所有活动的基础。在希腊的一个准母亲分娩队列中，将在怀孕期间和婴儿中测量特定的生物标志物，以解释热暴露对不利健康影响的作用。这些分析和系统审查为全球、欧盟和国家指标的测试和选择提供了信息。分析还为ews的截止阈值提供信息，并按风险群体分层。一个智能手机应用程序（ClimApp-MCH）将提供警告和特定设置的信息，由当地共同设计。该应用程序将在瑞典、南非和津巴布韦的200名母亲和婴儿中进行评估，从产前到婴儿年龄的12个月。同时，我们将记录热暴露对卫生工作者福祉、健康、生产力和护理质量的影响，包括通过时间运动研究。将共同设计和模拟对卫生设施的改造，以减少卫生工作者的热暴露并限制设施的碳排放。将比较干预前后卫生工作者的结果和设施排放。权衡成本和收益的分析是所有活动的核心。在整个过程中，我们将向相关利益相关者传播项目结果，优先考虑欧盟和全球政策制定者，并利用现有网络。关于气候变化与孕产妇、新生儿和儿童健康的最后一套指标将在卫生组织、儿童基金会、气象组织和人口基金的指导文件中公布。为了优化协同效应，避免重叠并增加从Horizon - hlth - 2020 - envhlth -02-03（气候变化对健康的影响，行动和不作为的成本和效益）中选择资助的项目的影响，地平线欧洲项目101057843 HIGH Horizons、101057131 CATALYSE、101057764 BlueAdapt、101057690 CLIMOS、101057554 IDAlert和101057739 TRIGGER)将形成一个气候和健康集群。共同分组活动将包括分组年度会议和联合活动的定期报告；共同的传播和沟通活动，包括集群的共同传播和沟通策略、集群门户网站和视觉识别、集群小册子、集群通讯、利益相关者名单、集群合作伙伴之间共享的个人数据管理计划、集群的政策战略，包括联合政策简报和集群的科学战略。在集群的科学战略范围内确定关于共同关心的问题的专题讲习班/培训；共同关心的议题工作组

There are major gaps in surveillance of climate change and health in the EU and globally, making it difficult to track health burdens and policy outcomes. The Heat Indicators for Global Health (HIGH Horizons): monitoring, Early Warning Systems and health facility interventions for pregnant and postpartum women, infants and young children and health workers (HIGH Horizons) project, to be conducted over four years, involves one UK partner along with six partners in the EU, three in Africa and one international organisations (WHO). It centres on vulnerable groups affected by climate change: pregnant and postpartum women, infants, and health workers, groups heavily affected by climate change. We will quantify and monitor direct and indirect health impacts of extreme heat; test a personalised Early Warning System (EWS); and implement integrated adaptation-mitigation actions in health facilities. Analyses of heat impacts and data science predictive modelling using data from Sweden; Lazio Italy, Greece and health facilities in Kenya and South Africa underpin all activities. Specific biomarkers will be measured during pregnancy and in infants in a prospective mother-childbirth cohort in Greece to explain the role of heat exposures on adverse health effects. These analyses and systematic reviews inform testing and selection of global, EU and national indicators. Analyses also inform cut-off thresholds for EWSs, stratified by risk groups. A smartphone app (ClimApp-MCH) will deliver warnings and setting-specific messages, co-designed locally. The app will be evaluated among 200 mothers and infants in Sweden, South Africa and Zimbabwe, from antepartum through 12 months of infant age. Simultaneously, we will document impacts of heat exposure on health worker wellbeing, health, productivity and quality of care, including through time-motion studies. Modifications to health facilities will be co-designed and modelled to reduce heat exposure for health workers and to limit facilities carbon emissions. Health worker outcomes and facility emissions will be compared pre- and postintervention. Analyses weighing costs and benefits are central to all activities. Throughout we will disseminate project findings to relevant stakeholders, prioritising EU and global policy makers and leveraging existing networks. The final set of indicators on climate change and maternal, newborn and child health will be released in a WHO, UNICEF, WMO and UNFPA guidance document.In order to optimise synergies, avoid overlaps and increase the impact of the projects selected for funding from the call HORIZON-HLTH-2021-ENVHLTH-02-03 (Health impacts of climate change, costs and benefits of action and inaction), Horizon Europe projects 101057843 HIGH Horizons, 101057131 CATALYSE, 101057764 BlueAdapt, 101057690 CLIMOS, 101057554 IDAlert and 101057739 TRIGGER) will form a Climate and Health cluster. Common cluster activities will include Annual cluster meetings and periodic report of joint activities; Common dissemination and communication activities, including a common dissemination and communication strategy for the cluster, cluster web portal and visual identity, cluster brochure, cluster newsletters, stakeholder list, Shared individual Data Management Plans between cluster partners, Policy Strategy of the cluster, including joint policy briefs and Scientific strategy of the cluster. Thematic workshops/trainings on issues of common interest be defined in the context of the scientific strategy of the cluster; Working groups on topics of common interest