Protecting children's health through forecast based anticipatory action (PROCHAIN)

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Ninety eight percent of child deaths occur in poor country contexts. The leading cause of these deaths are neonatal disorders (i.e. happening to the newborn, or within the first 28 days of their life). These deaths are mainly associated with premature birth (neonatal preterm birth), problems during birth (neonatal encephalopathy due to birth asphyxia and trauma), and infections and disease at and around birth (e.g. neonatal sepsis and hemolytic disease). Children in these contexts also risk death from lower respiratory infections, diarrhoeal diseases, congenital birth defects, malaria and malnutrition. The risk of a child dying of these causes is increased by high impact weather events, in a variety of ways, including interrupting health service provision, increasing the vulnerability of children and increasing the prevalence of disease vectors. However many of these deaths are preventable. Weather and climate-based forecasts allow actions to be taken ahead of time, that reduce health risks to children. These anticipatory acts can take many forms including mitigating any disruptions in basic childhood health services (e.g. vaccines, integrated management of childhood illness, well-child visits) that might occur during the high impact weather event, interventions to boost and protect household income and nutritional status before the event occurs (e.g. ensuring the supply of nutritional food) and the promotion of perinatal health (e.g. maternal and neonatal care). However, acting on forecasts is beset with problems. Foremost of these is that these forecasts are uncertain, produced as the probability of an extreme event (e.g. 50% probability of a heatwave). They are also not perfect e.g. sometimes they fail to predict a heatwave (or do so with a low probability when it should have been higher) and one occurs. Alternatively, they can predict a high impact weather event and it doesn't happen. Another problem is translating forecasts of high impact weather events into forecasts of their impacts on children's health. These characteristics present difficulties to decision-makers knowing when to act and when to not. NERC funded research by the fellow has both helped developed impact-based forecasts and facilitated the use of forecasts. An important part of this work has been working with the people who have to make decisions on how to make them with this type of information and does so in a way that fits with their resources and responsibilities. In this fellowship the fellow will work with Save the Children fund to help make sure that forecasts are routinely used in their work. In particular, this will involve understanding how high impact weather effects the health of children in the Sahel (where high impact weather events are frequent) and facilitating protocols and procedures that can be implemented to reduce these impacts. Ultimately the project aims to help increase the number of children's lives saved and supported by extending the time frame over which preventative actions can be taken. This extension of lead time is important to allow actions to be taken that reduce the risk of death and the costs of doing so, so that more children can be supported. Save the Children fund current works in over 100 countries, and has been in existence for a century. It has a worldwide staff of around 24,000 and in 2021 alone reached 26.5 million children through its health and nutrition programmes.