Periodic Reporting for period 2 - HIGH Horizons (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)
Período documentado: 2024-03-01 hasta 2025-08-31
The HIGH Horizons project addresses key knowledge gaps around the quantification and monitoring of direct and indirect impacts of heat exposure on maternal, newborn and child health. Pregnant women, infants and health workers serve as sentinel populations for tracking climate change impacts, adaptations and co-benefits. Protecting these vulnerable populations is critical and ensures a healthy future for the next generations. With heat adaptation interventions such as modifications to health facilities (e.g. passive cooling systems, reflective white paint on the roofs,…) and effective messaging through smartphones to accompany heat stress notifications to pregnant and postpartum women and mothers of infants, the burden of adverse health outcomes may be reduced.
The HIGH Horizons project includes 11 partners across 10 countries in Europe and Africa and encompasses activities in both the European Union (EU) and sub-Saharan Africa. Jointly the HIGH Horizons partners 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.
IMPROVING MATERNAL AND CHILD HEALTH OUTCOMES
Using systematic reviews, analyses of heat impacts on maternal, newborn and child health outcomes, and data science predictive modelling on maternal and newborn health data from multiple countries in Europe, Africa and Latin America and the Caribbean, the HIGH Horizons partners:
• increase our understanding of the relationships between heat and maternal, newborn and child health outcomes
• inform testing and selection of global, EU and national indicators as well as cut-off thresholds for the EWS, stratified by risk groups.
Specific biomarkers are measured among pregnant women and their infants in a prospective mother-child birth cohort in Greece to better understand the role of heat exposures on adverse health effects. Through a smartphone app (MotherHeat Alert), this EWS delivers notifications and setting-specific messages, co-designed locally. The app will be evaluated among 600 mothers and infants in Sweden, South Africa and Zimbabwe, from pregnancy through 12 months of infant age.
PROTECTING HEALTH WORKERS AND IMPROVING HEALTH FACILITIES
The HIGH Horizons project will document the impact of heat exposure on health worker wellbeing, health, productivity and on the quality of care provided. Modifications to health facilities are co-designed and modelled to reduce heat exposure for health workers and to limit facility-generated carbon emissions. Health worker outcomes and facility emissions are compared before and after the mitigation and adaptation interventions of which the cost-effectiveness is evaluated.
SHAPING POLICY
Throughout HIGH Horizons partners will engage relevant stakeholders to conduct the research and to disseminate the project findings, prioritising country partners, EU, African and global policy makers.
The HIGH Horizons project includes 11 partners across 10 countries in Europe and Africa and encompasses activities in both the European Union (EU) and sub-Saharan Africa. Jointly the HIGH Horizons partners 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.
IMPROVING MATERNAL AND CHILD HEALTH OUTCOMES
Using systematic reviews, analyses of heat impacts on maternal, newborn and child health outcomes, and data science predictive modelling on maternal and newborn health data from multiple countries in Europe, Africa and Latin America and the Caribbean, the HIGH Horizons partners:
• increase our understanding of the relationships between heat and maternal, newborn and child health outcomes
• inform testing and selection of global, EU and national indicators as well as cut-off thresholds for the EWS, stratified by risk groups.
Specific biomarkers are measured among pregnant women and their infants in a prospective mother-child birth cohort in Greece to better understand the role of heat exposures on adverse health effects. Through a smartphone app (MotherHeat Alert), this EWS delivers notifications and setting-specific messages, co-designed locally. The app will be evaluated among 600 mothers and infants in Sweden, South Africa and Zimbabwe, from pregnancy through 12 months of infant age.
PROTECTING HEALTH WORKERS AND IMPROVING HEALTH FACILITIES
The HIGH Horizons project will document the impact of heat exposure on health worker wellbeing, health, productivity and on the quality of care provided. Modifications to health facilities are co-designed and modelled to reduce heat exposure for health workers and to limit facility-generated carbon emissions. Health worker outcomes and facility emissions are compared before and after the mitigation and adaptation interventions of which the cost-effectiveness is evaluated.
SHAPING POLICY
Throughout HIGH Horizons partners will engage relevant stakeholders to conduct the research and to disseminate the project findings, prioritising country partners, EU, African and global policy makers.
Population-level heat-health indicators (objective 1)
* Cross-country data analyses conducted of the association between heat exposure and maternal and newborn health outcomes using several heat metrics
* Ongoing process to identify population-level indicators to track and monitor the impacts of extreme heat on maternal, newborn and child health, through scoping meetings with the Expert Group
Early Warning System (objective 2)
* Testing of the usability, feasibility and effectiveness of the MotherHeat Alert app in pregnant and postpartum women and in health workers in South Africa, Sweden and Zimbabwe
Integrated adaptation-mitigation interventions (objective 3)
* Thermal exposure assessed in maternity wards and health worker baseline assessment conducted in the hot season in South Africa, Sweden and Zimbabwe
* Carbon emissions measured in health facilities in Kenya, South Africa and Zimbabwe and CARBOMICA tool developed, a resource optimisation tool for modelling of alternative mitigation interventions
* Co-design and implementation of adaptation and mitigation interventions
Shaping policy ((objective 4): Relevant stakeholders at global, country and local level identified and engaged with outreach and networking ongoing
Biological and thermal physiological pathways of heat effects ((objective 5): Mother-child cohort study protocol developed and recruitment of cohort ongoing in Greece
* Cross-country data analyses conducted of the association between heat exposure and maternal and newborn health outcomes using several heat metrics
* Ongoing process to identify population-level indicators to track and monitor the impacts of extreme heat on maternal, newborn and child health, through scoping meetings with the Expert Group
Early Warning System (objective 2)
* Testing of the usability, feasibility and effectiveness of the MotherHeat Alert app in pregnant and postpartum women and in health workers in South Africa, Sweden and Zimbabwe
Integrated adaptation-mitigation interventions (objective 3)
* Thermal exposure assessed in maternity wards and health worker baseline assessment conducted in the hot season in South Africa, Sweden and Zimbabwe
* Carbon emissions measured in health facilities in Kenya, South Africa and Zimbabwe and CARBOMICA tool developed, a resource optimisation tool for modelling of alternative mitigation interventions
* Co-design and implementation of adaptation and mitigation interventions
Shaping policy ((objective 4): Relevant stakeholders at global, country and local level identified and engaged with outreach and networking ongoing
Biological and thermal physiological pathways of heat effects ((objective 5): Mother-child cohort study protocol developed and recruitment of cohort ongoing in Greece
Although still work in progress HIGH Horizons has already obtained results which may have potential impact on end users and policy makers. Assessing the impact of these methods, products and policy recommendations is part of our work in the last stage of HIGH Horizons.
1. Population-level heat-health indicators. The process on selection of potential indicators to track and monitor the effects of heat exposure on maternal, newborn and child health outcomes has started. The Expert Group was convened several times by WHO and discussed evidence-based findings. Their recommendations are taken forward by the HIGH Horizons team, and a final face-to-face Expert Group meeting is planned in January 2026 to reach consensus on the MNCH indicators, heat metrics, and heat-health messages.
2. Prototype of MotherHeat Alert app, the personalised and context-specific early warning system, was tested in pregnant and postpartum women and in health workers in South Africa, Sweden and Zimbabwe. Heat health risk thresholds have been preliminarily identified. The usability, feasibility and effectiveness of the app are being assessed.
3. CARBOMICA tool. This resource allocation tool supports health managers to improve health facilities’ carbon management efficacy and informs decision-makers in the strategic distribution of scarce resources towards decarbonizing health facilities. This tool has been tested in real-world to exemplify its utility and was finetuned and used to identify the resource optimal package of mitigation interventions in the selected health facilities in Kenya, South Africa and Zimbabwe.
4. User-friendly tool for heat-related risk assessment of the working environment in health facilities. This tool/checklist provides a practical and systematic procedure to identify and assess risks caused by working in high temperatures in health facilities, with the goal to prevent or reduce heat-related health risks, improve workers’ health and well-being, and ultimately the quality of care.
1. Population-level heat-health indicators. The process on selection of potential indicators to track and monitor the effects of heat exposure on maternal, newborn and child health outcomes has started. The Expert Group was convened several times by WHO and discussed evidence-based findings. Their recommendations are taken forward by the HIGH Horizons team, and a final face-to-face Expert Group meeting is planned in January 2026 to reach consensus on the MNCH indicators, heat metrics, and heat-health messages.
2. Prototype of MotherHeat Alert app, the personalised and context-specific early warning system, was tested in pregnant and postpartum women and in health workers in South Africa, Sweden and Zimbabwe. Heat health risk thresholds have been preliminarily identified. The usability, feasibility and effectiveness of the app are being assessed.
3. CARBOMICA tool. This resource allocation tool supports health managers to improve health facilities’ carbon management efficacy and informs decision-makers in the strategic distribution of scarce resources towards decarbonizing health facilities. This tool has been tested in real-world to exemplify its utility and was finetuned and used to identify the resource optimal package of mitigation interventions in the selected health facilities in Kenya, South Africa and Zimbabwe.
4. User-friendly tool for heat-related risk assessment of the working environment in health facilities. This tool/checklist provides a practical and systematic procedure to identify and assess risks caused by working in high temperatures in health facilities, with the goal to prevent or reduce heat-related health risks, improve workers’ health and well-being, and ultimately the quality of care.