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East Africa is highly affected by neglected tropical diseases (NTDs), which are projected to be exacerbated by climate change. Consequently, understanding what research has been conducted and what knowledge gaps remain regarding NTDs and climate change is crucial to informing public health interventions and climate change adaptation. We conducted a systematic scoping review to describe the extent, range, and nature of publications examining relationships between NTDs and climatic factors in East Africa. We collated all relevant English and French publications indexed in PubMed ® , Web of Science™ Core Collection, and CAB Direct © databases published prior to 2019. Ninety-six publications were included for review. Kenya, Tanzania, and Ethiopia had high rates of publication, whereas countries in the Western Indian Ocean region were underrepresented. Most publications focused on schistosomiasis ( n = 28, 29.2%), soil-transmitted helminthiases ( n = 16, 16.7%), or human African trypanosomiasis ( n = 14, 14.6%). Precipitation ( n = 91, 94.8%) and temperature ( n = 54, 56.3%) were frequently investigated climatic factors, whereas consideration of droughts ( n = 10, 10.4%) and floods ( n = 4, 4.2%) was not prominent. Publications reporting on associations between NTDs and changing climate were increasing over time. There was a decrease in the reporting of Indigenous identity and age factors over time. Overall, there were substantial knowledge gaps for several countries and for many NTDs. To better understand NTDs in the context of a changing climate, it would be helpful to increase research on underrepresented diseases and regions, consider demographic and social factors in research, and characterize how these factors modify the effects of climatic variables on NTDs in East Africa.

Background: Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women's perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. Methods: Using a community-based research approach, we conducted eight focus group discussions—four in Indigenous Batwa communities and four in non-Indigenous communities—in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. Results: Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. Conclusions: Programs promoting women's adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate. [ABSTRACT FROM AUTHOR]

Climate change adaptation is increasingly considered an urgent priority for policy action. Billions of dollars have been pledged for adaptation finance, with many donor agencies requiring that adaptation is distinct from baseline development. However, practitioners and academics continue to question what adaptation looks like on the ground, especially in a developing country. This study examines the current framing of planned adaptation amidst low socioeconomic development and considers the practical implications of this framing for adaptation planning. Three overarching approaches to planned adaptation in a developing country context emerged in a systematic review of 30 peer-reviewed articles published between 2010 and 2015, including: (1) technocratic risk management, which treats adaptation as additional to development, (2) pro-poor vulnerability reduction, which acknowledges the ability of conventional development to foster and act as adaptation, and (3) sustainable adaptation, which suggests that adaptation should only be integrated into a type of development that is socially and environmentally sustainable. Over half of 'sustainable adaptation' articles in this review took a critical adaptation approach, drawing primarily from political ecology and postdevelopment studies, and emphasizing the malleability of adaptation. The reviewed articles highlight how the different framings of the relationship between adaptation and development result in diverse and sometimes contradictory messages regarding adaptation design, implementation, funding, monitoring, and evaluation. This review illustrates the need to continually interrogate the multiple framings of adaptation and development and to foster a pragmatic and pluralistic dialogue regarding planned adaptation and transformative change in developing countries. WIREs Clim Change 2016, 7:707-726. doi: 10.1002/wcc.416 For further resources related to this article, please visit the . [ABSTRACT FROM AUTHOR]