Madagascar is an ideal location to launch CSPH because of its unique vulnerability and ongoing preparedness efforts. Madagascar is prone to frequent exposure to cyclonic events and their accompanying floods, major heatwaves, and drought. In Madagascar, more than 80% of people live in poverty, there are 66 deaths for children less than 5 per 1,000 live births, malnutrition stunts the growth of nearly half the population, and maternal mortality rates are among the highest in the world with 392 women dying per 100,000 live births. These conditions, among many others, will only be exacerbated by future climate and environmental change. Our team’s past research has linked climate-related stressors to decreased nutrition and food security through ocean warming altering fisheries and changes in atmospheric circulation increasing agricultural water stress. In addition, deforestation causes increased diarrheal and vector-borne diseases.

Madagascar has a centralized data collection system to monitor public health and disease, collating data from more than 2,770 public clinics that were managed by local data platforms between 2010 - 2019 and then migrated in 2019 to District Health Information Software 2 (DHIS2), a free and open source health management data platform used by more than 100 countries worldwide. Still, there has been little ability to actively monitor spatial and temporal trends in health that may be affected by climate stressors due to data infrastructure and limited capacity. Moreover, the research platform that houses the public health statistics could not directly speak to environmental, climate, or agricultural information to understand how changes in these systems may affect human health. To solve this, we created a georeferenced and temporally explicit clinic health database integrated with in situ climate data, remote sensing observations and reanalysis products related to climate and environmental exposures, enabling health research, rapid prediction, and public health planning. The generation and collation of an interoperable climate and environmental exposure database for the health database form what is often called climate services for health (WMO 2023). Our current health database includes monthly incidence data for over 60 health outcomes (infectious, non-communicable, and nutritional conditions) sourced from over 2,770 geographically distributed and geospatially referenced public healthcare clinics between 2010 - present.

Projects