Community health worker contributions to climate resilient health systems: A qualitative study of how community health workers navigate extreme weather events in the Philippines

Community health workers (CHWs) are an important source of health-related support and care across many resource-constrained settings. However, amid the increasing frequency and intensity of extreme weather events globally, there is a need to understand how CHWs may experience and navigate these events, and consider potential opportunities to strengthen their contributions to climate resilient health systems. This study explored the experiences of CHWs before, during, and after extreme weather events to examine how their identities, existing responsibilities, and perceived capacity shaped their ability to contribute towards preparedness, response, and recovery efforts in their communities. In collaboration with a Philippines-based non-governmental organization (NGO), we conducted 51 semi-structured interviews with CHWs affiliated with an NGO-led CHW program across four municipalities in Negros Oriental, Philippines. All interviews were audio-recorded, transcribed, and thematically analyzed using a hybrid deductive-inductive approach. Participants described how the various roles and responsibilities they held within and outside of their household shaped their engagement with preparedness, response, and recovery to extreme weather events. Importantly, participants highlighted opportunities to enhance their contributions to preparedness, response, and recovery efforts in their communities. Further, participants discussed how additional training and material resources could be leveraged to enhance preparedness to and recovery from extreme weather events in their communities. Overall, this study provides insight into how CHWs may contribute to climate resilient health systems amid extreme weather events, and underscores the complexities of recognizing CHWs as both health leaders and community members in disaster risk management practices. • Community health workers are a key source of support amid extreme weather events. • Community health workers demonstrated a motivation and capacity to provide support. • Community health workers are both health leaders and community members themselves. • Capacity to provide support was shaped by roles and responsibilities in communities.