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

98%的儿童死亡发生在贫穷国家。这些死亡的主要原因是新生儿疾病（即发生在新生儿身上或在其生命的头28天内）。这些死亡主要与早产（新生儿早产）、分娩过程中的问题（由于出生窒息和创伤造成的新生儿脑病）以及分娩时和分娩前后的感染和疾病（例如新生儿败血症和溶血性疾病）有关。在这些情况下，儿童还面临死于下呼吸道感染、腹泻病、先天性先天缺陷、疟疾和营养不良的风险。高影响天气事件以各种方式增加了儿童死于这些原因的风险，包括中断保健服务的提供、增加儿童的脆弱性和增加病媒的流行。然而，其中许多死亡是可以预防的。天气和基于气候的预报使人们能够提前采取行动，减少儿童面临的健康风险。这些预期行为可以采取多种形式，包括减轻在高影响天气事件期间可能发生的对儿童基本保健服务（例如疫苗、儿童疾病综合管理、儿童健康探访）的任何中断，在事件发生之前采取措施提高和保护家庭收入和营养状况（例如确保提供营养食品），以及促进围产期保健（例如孕产妇和新生儿护理）。然而，按照预测行事存在诸多问题。其中最重要的是，这些预测是不确定的，以极端事件的概率（例如，热浪的概率为50%）产生。它们也不是完美的，例如，有时它们无法预测热浪（或者在应该更高的情况下以低概率预测），而热浪发生了。或者，他们可以预测一个高影响的天气事件，但它没有发生。另一个问题是如何将对高影响天气事件的预报转化为对其对儿童健康影响的预报。这些特点给决策者知道什么时候采取行动，什么时候不采取行动带来了困难。该研究员资助的NERC研究既帮助开发了基于影响的预测，也促进了预测的使用。这项工作的一个重要部分是与那些必须决定如何使用这类信息并以符合其资源和责任的方式进行决策的人合作。在这项奖学金中，研究员将与拯救儿童基金会合作，帮助确保预测在他们的工作中经常使用。特别是，这将涉及了解高影响天气如何影响萨赫勒地区（高影响天气事件频繁发生的地区）儿童的健康，并促进可实施的减少这些影响的协议和程序。最终，该项目的目的是通过延长可采取预防行动的时间框架，帮助增加拯救和支持儿童生命的人数。提前期的延长对于采取行动减少死亡风险和减少死亡费用，从而使更多的儿童得到支持，具有重要意义。拯救儿童基金会目前在100多个国家开展工作，已经存在了一个世纪。该组织在全球约有24 000名工作人员，仅在2021年，就通过其保健和营养方案为2 650万儿童提供了服务。

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.