HIGH Horizons - Selection and implementation of adaptation interventions in South Africa and Zimbabwe

Global temperatures are rising, with Africa emerging as one of the most vulnerable regions to climate change and extreme heat events. Healthcare workers faceheightened risks from heat exposure due to poor working environments, including inadequate ventilation and lack of cooling systems in many public health facilities.Their work is often physically demanding, requiring long hours with the use of heavy protective clothing further exacerbating heat stress. As a result, heat exposure can strain both physical and emotional coping capacities, leading to impaired performance, compromised quality of care, increased absenteeism, and lower job satisfaction. Thus, the urgent need for targeted contextual heat adaptation and mitigation interventions. Co-design, an effective collaborative approach, was used to identify and prioritize targeted context-specific heat adaptation interventions. The process brought together researchers, community members, facility managers, policymakers, and other stakeholders, and facilitated equal participation to share knowledge and refine multi-component heat adaptation interventions in South Africa and Zimbabwe. The approach consisted of workshops in South Africa and Zimbabwe. The findings from the baseline research (deliverable D2.10) were shared with participants to guide discussions and enable identification and prioritisation of heat adaptation interventions for health facilities. All outputs were refined, leading to the agreement on approximately 20 context-specific heat adaptation interventions across four domains in both countries. This document, deliverable D4.8, outlines the selection and implementation of adaptation interventions co-designed in South Africa and Zimbabwe in July 2024 and January2025, respectively. It provides insights into the co-production process, presents the Theory of Change (ToC) for both countries, highlights progress to date, and outlines the timeline for full implementation.