Integrating health in ecosystem-based adaptation initiatives across the Pacific Islands region: A policy analysis of Fiji, Solomon Islands, and Vanuatu

Ecosystem-based Adaptation (EbA) is an adaptation approach that focuses on the management of ecosystem services to reduce vulnerabilities of communities to the adverse impacts of climate change. There are various EbA projects implemented across the Pacific Islands region; however, health outcomes have not been comprehensively addressed in relevant national policies and EbA projects to date. The region is facing a ‘triple burden’ of disease and further efforts are required to integrate health outcomes in policy and EbA project development to fully understand the impacts of EbA on health. Fiji, Solomon Islands, and Vanuatu were chosen as the study sites for the policy analysis and key national policies and plans relating to climate change, health, and adaptation/sustainable development, along with three case studies, were analysed using the Intersectionality-Based Policy Analysis (IBPA) framework. While most policies included information and recommendations around climate change-related health outcomes, this was often presented separately to any environmental, gender- or human rights-related, or traditional knowledge analysis or indicators. Similarly, the case studies did not include comprehensive information on the studied themes. To overcome the current lack of integration between health outcomes and EbA approaches, we recommend the following: the integration of health-related performance-based indicators in monitoring and evaluation (M&E) methods to measure adaptation capacity; the use of health impact assessments (HIAs) in policy development and project planning; and capacity building to increase awareness of climate-related risks through inclusive planning, development, implementation, and M&E processes. • EbA can build social and economic resilience to the effects of climate change. • Regional EbA projects and climate change policies don’t suitably address health outcomes. • EbA projects must focus on health, traditional knowledge and gender for effective adaptation.