Heat Exposure & Adaptation Tools – Protecting vulnerable g

  • India
  • In Progress / Completed
  • October 2023 – October 2027
  • Multi-Sectoral Interventions / Empowering people & Communities / RCS / Community Engagement Initiatives


Heatwaves affect human health (Hess et al. 2018; Venugopal et al. 2021), and India is especially vulnerable to them due to its high population density, inadequate healthcare access, and climate change vulnerability. The 2022 Indian heatwaves were 30 times more likely due to climate change (World Weather Attribution 2022). Heat action plans and early warning systems are needed, especially in low- and middle-income nations where climate change is expected to increase morbidity and death (Green et al., 2019). Heat action plans are being implemented in India with the national government and stakeholders (Government of India, 2023). These HAP measures can reduce community and vulnerable working population mortality (Krisher et al., 2020, Bodin, 2016; Malima, 2020; Nutkiewicz, 2022; Hasan, 2021).


We want to co-produce, co-implement, and assess multi-sectoral, co-designed PHC-embedded adaptation interventions to prevent and manage heat stress and related illnesses in high-risk communities and workplaces in Andhra Pradesh.

Study Objective

  1. Identify sustainable, cost-effective, and adaptive solutions through a comprehensive literature review and information synthesis.
  2. Expand SMARThealth digital platform for integrated community and individual heat- and health-related data collecting.
  3. To quantify the influence of heat exposure on NCD incidence, morbidity, and mortality in vulnerable rural populations.
  4. Apply the SMARThealth digital platform to evaluate select implemented components of state-level Heat Action Plan (HAP).
  5. 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 interventions (Skivington et al., 2021) and comprises the following steps: Data synthesis and communication, intervention implementation and mixed-methods evaluation, and formative research.

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)

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.

Expected Impact

  1. Reduced heat-related symptoms, HRI episodes and kidney-related issues in communities.
  2. Reduced emergency visits and improved heat-protective behaviour.
  3. Improved heat strain in worker communities.


The present study is expected to provid the following benefits.

  1. Developed toolkits and training for at-risk communities/workplaces to safeguard workers and communities.
  2. Standardised protocols for assessing heat stress, workload, and NCDs in communities and workplaces by researchers and OSH teams.
  3. Implement water-rest-shade tool kits for MSME and outdoor workplaces, including training and evidence-based interventions.
  4. Risk reduction recommendations for heat mitigation for enhanced public health. Provide teaching materials to workers, community, healthcare, local, and state officials.