Health plans and strategies addressing climate change in Portuguese-speaking countries: a documentary analysis
Description
Climate change represents a burgeoning threat to global health, affecting populations through direct, indirect, and social mechanisms that exacerbate structural vulnerabilities. In developing Portuguese-speaking countries, these impacts are compounded by historical challenges of inequality and institutional fragility. Within this context, the integration of health actions into national adaptation and mitigation plans and strategies becomes a central element for climate governance in the health sector. To analyze the health plans and strategies of developing Portuguese-speaking countries regarding the management of climate change impacts. This is a qualitative documentary analysis study conducted according to the READ approach. National strategic documents from five countries of the Community of Portuguese Language Countries (CPLP) were included: Angola, Brazil, Cape Verde, Mozambique, and Timor-Leste. The identified health actions were thematically categorized and classified according to governance levels (macro, meso, and micro). No documents containing specific health actions were located in the public domain for Guinea-Bissau, Equatorial Guinea, or São Tomé and Príncipe; conversely, Angola, Brazil, Cape Verde, Mozambique, and Timor-Leste exhibited greater thematic diversity in their actions. Twenty-six health actions were identified, organized into 11 thematic categories. A predominance of actions focused on climate adaptation was observed, particularly regarding basic sanitation, water quality, monitoring of climate-sensitive diseases, early warning systems, and the production of epidemiological knowledge. Only Cape Verde included an explicit mention of climate financing within the health sector. The multilevel classification revealed a concentration of actions at the macro and meso levels, with a sparse presence of strategies explicitly directed at the micro level. The analyzed plans demonstrate institutional recognition by the study countries of the climate-health interface; however, they reveal an asymmetry between normative formulation and community operationalization. The limited incorporation of climate financing and the low capillary reach of actions at the micro level indicate challenges for the consolidation of a climate governance in health that is effectively integrated and territorialized across developing Portuguese-speaking countries.