This World Bank report ‘The Cost of Inaction: Quantifying the Impact of Climate Change on Health in Low- and Middle-Income Countries’ presents new analysis of climate change impacts on health systems and outcomes in the regions that are bearing the brunt of these impacts. Key analytical insights to quantify climate change impacts on health The report makes three contributions to our understanding of climate-health interactions: First, it quantifies the massive scale of climate change impacts on health, projecting 4.1-5.2 billion climate-related disease cases and 14.5-15.6 million deaths in LMICs by 2050. This represents a significant advancement over previous estimates, which the report demonstrates were substantial underestimates. Second, it illuminates the profound economic consequences, calculating costs of $8.6-20.8 trillion by 2050 (0.7-1.3% of LMIC GDP). The report employs both Value of Statistical Life and Years of Life Lost approaches to provide a range of economic impact estimates. Third, it reveals stark …
How do we reframe health performance management within complex adaptive systems?
We need a conceptual framework that situates health performance management within complex adaptive systems. This is a summary of an important paper by Tom Newton-Lewis et al. It describes such a conceptual framework that identifies the factors that determine the appropriate balance between directive and enabling approaches to performance management in a given context. Existing performance management approaches in many low- and middle-income country health systems are largely directive, aiming to control behaviour using targets, performance monitoring, incentives, and answerability to hierarchies. Health systems are complex and adaptive: performance outcomes arise from interactions between many interconnected system actors and their ability to adapt to pressures for change. In my view, this important paper mends an important broken link in theories of change that try to consider learning beyond training. The complex, dynamic, multilevel nature of health systems makes outcomes difficult to control, so directive approaches to performance management need to …