Developing an indicator set for monitoring climate change-related health aspects in Germany

Abstract Background Climate change poses an increasing threat to public health. However, Germany still lacks a system for monitoring climate change-related health aspects. The MOCCHA project (Monitoring of Climate Change-related Health Aspects) addresses this gap by developing an indicator set tailored to the needs and context in Germany, drawing on national and international expertise. Methods The indicator set was developed through a systematic approach, which included: (1) a comprehensive literature search; (2) expert interviews with representatives from countries that have established climate change-related health indicators; and (3) a participatory process consisting of two online surveys and a consensus workshop, in which national stakeholders ranked indicators based on predefined criteria. The final indicator set will be published in an open-access manual and integrated into the national health reporting system. Its practical application will be discussed in a final workshop. Results Over 350 potential indicators were identified and categorised using an adapted version of the Integrated Climate Change and Health Indicator System (ICCHIS) framework, covering areas such as health outcomes, vulnerability and health-relevant climate action. Preliminary findings from the literature search and expert interviews highlight the complexity of developing such a monitoring system. An iterative and interdisciplinary approach is needed to balance scientific validity with policy and practice relevance. An initial indicator set is expected by end of 2025. Conclusions By developing a context-specific indicator set, the MOCCHA project takes an important step in closing this gap in Germany. The applied methodological approach supports the development of a robust system to identify and respond to climate-related health risks. The resulting framework is transferable and can inform similar efforts in other countries. Key messages • The iterative while systematic approach creates a transferable methodological framework for monitoring climate-related health aspects. • Participatory stakeholder involvement supports the development of country-specific indicators and sustainable implementation.