Heat Exposure & Adaptation Tools – Protecting vulnerable groups
- India
- In Progress
- October 2023 – September 2027
- Multi-Sectoral Interventions / Empowering people & Communities / RCS / Community Engagement Initiatives
Background
Climate change is intensifying heatwaves globally, with low- and middle-income countries bearing the greatest burden. Heat-related mortality has risen sharply worldwide, claiming hundreds of thousands of lives annually. India is among the worst affected1. Temperatures above 40°C drive significant increases in mortality, and the 2022 heatwaves were estimated to be 30 times more likely due to climate change2. Beyond deaths, extreme heat fuels a rising burden of non-communicable diseases, cardiovascular, renal, pulmonary, and mental health conditions, with older adults, children, pregnant women, outdoor workers, and rural and peri-urban communities facing the highest risks.
India has responded with Heat Action Plans (HAPs)3 across 20 states, including 100+ cities and districts now have implemented localized heat action strategies led by early warning systems, public awareness, and healthcare preparedness. While Ahmedabad’s pioneering HAP demonstrated measurable reductions in mortality, most state-level interventions remain reactive rather than preventive. In Andhra Pradesh, one of India’s most heat-vulnerable states, a HAP exists, but its current implementation status, reach, and effectiveness remain largely unknown.
The HEAT-PROTECT Project (Heat Exposure & Adaptation Tools PROtection via intervention TEchniques to Combat hoT temperatures), was designed to address this gap assessing the HAP’s current status in Srikakulam district, Andhra Pradesh, India, evaluating health impacts, identifying primary care gaps, and co-designing community-driven interventions to protect the general & vulnerable population.
Aim
This study aims to co-produce, co-implement, and assess multi-sectoral, co-designed Primary Health Care (PHC)-embedded adaptation interventions to prevent and manage heat stress and related illnesses in high-risk communities and workplaces in Andhra Pradesh.
Study Objective
- Identify sustainable, cost-effective, and adaptive solutions through a comprehensive literature review and information synthesis.
- Expand SMARThealth digital platform for integrated community and individual heat- and health-related data collecting.
- To quantify the influence of heat exposure on NCD incidence, morbidity, and mortality in vulnerable rural populations.
- Apply the SMARThealth digital platform to evaluate select implemented components of state-level Heat Action Plan (HAP).
- Co-design a PHC-embedded heat adaptation intervention plan that integrates user perspectives, health system assessments, and current local heat action plans and guidelines.
Research Methodology
Our transdisciplinary research follows the 2021 Medical Research Council (MRC) guidance for creating and evaluating complex interventions4 and comprises the following steps:
Formative research:
This phase will examine community-level Heat Action Plans (HAP) intervention technologies, expand SMARThealth (Systematic Medical Appraisal, Referral, and Treatment) to collect HEAT-PROTECT data in India, and quantify the impact of heat exposure on NCD incidence, morbidity, and mortality in vulnerable rural populations.
Intervention, implementation and mixed-methods evaluation:
Interventions will be co-designed, baseline data collected, feasible, effective, adoptable, and acceptable interventions identified using UK MRC guidelines, and decision- makers consulted before piloting them using a “Plan-Do-Study-Act” (PDSA)
process.
Communication and data synthesis:
The synthesis of data involves analysis. The population prevalence component of the study will use descriptive statistics, reporting categorical variables as proportions and continuous variables as means and standard deviations. Participatory methods and experiential knowledge sharing are planned.
The study is structured across three sequential phases, each building on and informing the next following the pathway:
Expected Impact
- Reduced heat-related symptoms, HRI episodes and kidney-related issues in communities.
- Reduced emergency visits and improved heat-protective behaviour.
- Improved heat strain in worker communities.
Conclusion
Extreme heat is no longer a distant threat, it is a present and escalating public health emergency, and its harshest consequences fall on those least equipped to cope.
The HEAT-PROTECT Project represents a critical step toward building heat resilience where it matters most, at the community level, in the workplace, and within primary healthcare systems. By moving beyond reactive measures and embracing a structured, evidence-driven, and people-centred approach, the project seeks to transform how heat-health risks are understood, planned for, and responded to in rural and peri-urban Andhra Pradesh.
From assessing the ground reality of HAP implementation, to co-designing interventions with communities themselves, to rigorously testing and scaling what works, HEAT-PROTECT is committed to generating actionable evidence that is locally owned, contextually relevant, and sustainable.
The findings from Srikakulam have the potential to inform heat-health policy and practice across Andhra Pradesh and serve as a replicable model for other heat-vulnerable states across India.
