Strengthening Primary Health Systems for Climate Resilience and Disaster Response: A Review of Community Health Practitioners’ Role
Chapter One
Objective of the study
The general objective of this study is to examine the role of community health practitioners in strengthening primary health systems for climate resilience and disaster response.
The study specifically seeks to:
- Assess the extent to which community health practitioners are involved in strengthening climate resilience within primary health systems.
- Identify the disaster preparedness and response strategies currently adopted at the primary health care level.
- Examine the challenges faced by community health practitioners in contributing to climate resilience and disaster response.
- Explore best practices and innovative approaches that enhance the capacity of community health practitioners in disaster preparedness and response.
CHAPTER TWO
REVIEW OF RELATED LITERATURE
Primary Health Care
Primary Health Care (PHC) is widely regarded as the foundation of effective health systems and the most equitable approach to achieving universal health coverage (UHC). The concept of PHC was first formally articulated at the Alma-Ata Conference in 1978, which defined it as essential health care made universally accessible to individuals and families in the community, through their full participation, and at a cost that the community and country can afford (WHO, 1978). This declaration emphasized health as a fundamental human right and positioned PHC as central to attaining “Health for All.”
Since its inception, the definition of PHC has evolved to reflect the changing dynamics of health needs, global health priorities, and the increasing burden of non-communicable diseases and climate-related challenges. The World Health Organization (WHO, 2021) reaffirms PHC as a whole-of-society approach to health that includes three main components:
- Meeting people’s health needs through comprehensive promotive, preventive, curative, rehabilitative, and palliative care throughout the life course.
- Addressing the broader determinants of health through multisectoral policy and action.
- Empowering individuals, families, and communities to take charge of their health and well-being.
PHC emphasizes equity, accessibility, affordability, and community participation, making it distinct from hospital-centered or specialist-based care models. It promotes services delivered close to where people live and work, thus bridging the gap between communities and the health system (Starfield, Shi, & Macinko, 2020).
The effectiveness of PHC lies in its preventive and promotive orientation. By focusing on disease prevention, health promotion, immunization, maternal and child health, nutrition, and sanitation, PHC reduces the burden on secondary and tertiary care facilities (Kruk et al., 2021). This is particularly relevant in low- and middle-income countries (LMICs), where access to higher-level care is often limited by geography, cost, and infrastructure.
CHAPTER THREE
METHODOLOGY
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Research Design
This study adopted a review research design, specifically a systematic literature review, to examine the role of community health practitioners (CHPs) in strengthening primary health systems for climate resilience and disaster response. The review design was appropriate as it allows for the synthesis of existing empirical evidence, policy documents, and theoretical perspectives to provide a comprehensive understanding of current practices, challenges, and strategies. By reviewing multiple studies across different geographical and socio-economic contexts, the study aimed to identify patterns, gaps, and best practices in CHP contributions to climate-resilient primary health care.
Population of the Study
The population of the study comprised published empirical studies, reports, and policy documents on community health practitioners, primary health care systems, climate resilience, and disaster response. This included peer-reviewed journal articles, WHO and UNICEF reports, government policy documents, and grey literature published between 2015 and 2025. The focus was on studies involving CHPs working in low- and middle-income countries (LMICs), where primary health systems are most vulnerable to climate-induced disasters.
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
This chapter presents and analyzes data from the reviewed literature on the role of community health practitioners (CHPs) in strengthening climate resilience and disaster preparedness at the primary health care (PHC) level. The analysis is structured around the research questions guiding this study.
CHAPTER FIVE
SUMMARY, CONCLUSION, AND RECOMMENDATIONS
Summary of Findings
This study examined the role of community health practitioners (CHPs) in strengthening primary health systems to enhance climate resilience and disaster response. The review of recent literature revealed several key findings:
- Extent of CHPs’ Involvement: Community health practitioners play a crucial role in promoting climate resilience at the primary health care (PHC) level. They are actively engaged in community mobilization, preventive health education, disease surveillance, and early warning dissemination. Quantitative evidence indicates that between 60% and 75% of CHPs participate in climate adaptation and disaster preparedness activities. However, their contribution is often constrained by limited training, inadequate resources, and insufficient institutional support.
- Disaster Preparedness and Response Strategies: Primary health care facilities implement various strategies to prepare for and respond to disasters, including community-based surveillance, health education campaigns, emergency triage and first response, distribution of essential medical supplies, digital reporting tools, and participatory preparedness planning. While these strategies enhance responsiveness, challenges such as weak infrastructure, limited funding, and poor coordination with government agencies reduce their effectiveness.
- Challenges Faced by CHPs: Despite their central role, CHPs encounter multiple obstacles, including lack of formal training in climate resilience, insufficient logistics and supplies, weak policy support, and inadequate engagement in disaster planning. These limitations hinder their ability to fully strengthen PHC systems and ensure timely responses during climate-induced disasters.
- Best Practices and Innovations: Evidence from global and regional studies highlights successful practices, such as competency-based training, use of digital health tools, multi-sectoral collaboration, and community engagement. Integrating these approaches into PHC systems improves preparedness, enhances system resilience, and optimizes CHPs’ contributions.
Conclusion
Based on the findings, it is evident that community health practitioners are indispensable for strengthening primary health systems and enhancing resilience to climate-related disasters. They serve as the first point of contact for communities during emergencies, providing essential preventive and curative services. However, systemic challenges including inadequate training, poor infrastructure, and limited institutional support constrain their effectiveness.
Therefore, for PHC systems to be genuinely resilient and capable of responding effectively to disasters, the role of CHPs must be formally recognized, adequately supported, and integrated into broader health policies and disaster management frameworks. Empowering CHPs through targeted capacity building, resource provision, and policy support is critical for achieving sustainable climate-resilient health care at the community level.
Recommendations
Based on the study, the following recommendations are proposed:
- Governments, NGOs, and health agencies should provide regular, competency-based training programs for CHPs focused on climate resilience, disaster preparedness, emergency response, and risk communication.
- Primary health care facilities should be equipped with essential supplies, emergency kits, and climate-adapted infrastructure such as resilient water and energy systems to support CHPs during disasters.
- National and local health policies should formally recognize the role of CHPs in climate resilience and disaster response. Clear guidelines, standard operating procedures, and inclusion in emergency preparedness frameworks are essential.
- CHPs should be supported to work collaboratively with community leaders, local organizations, and residents to co-develop disaster preparedness plans, identify vulnerable populations, and enhance risk communication strategies.
- Integration of mobile health technologies and digital reporting platforms should be expanded to enhance early warning systems, disease surveillance, and coordination during emergencies.
REFERENCES
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- Aitsi-Selmi, A., Egawa, S., Sasaki, H., Wannous, C., & Murray, V. (2016). The Sendai Framework for Disaster Risk Reduction: Renewing the global commitment to people’s resilience, health, and well-being. International Journal of Disaster Risk Science, 6(2), 164–176. https://doi.org/10.1007/s13753-015-0050-9
- Elmahdawy, M., Elsisi, G., Carapinha, J., Lamorde, M., Habib, A., & Doua, F. (2017). Ebola virus epidemic in West Africa: Global health economic challenges, lessons learned, and policy recommendations. Value in Health Regional Issues, 13, 67–70. https://doi.org/10.1016/j.vhri.2017.05.004
- Kruk, M. E., Ling, E. J., Bitton, A., Cammett, M., Cavanaugh, K., Chopra, M., & Van Lerberghe, W. (2018). Building resilient health systems: A proposal for a resilience index. BMJ, 357, j2323. https://doi.org/10.1136/bmj.j2323
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