Over the past several years, community-based adaptation has emerged alongside national and regional climate change initiatives as a strategic, localized approach to building resilience and adaptive capacity in areas vulnerable to climate change.

Similarly, over the last decade, communities across the globe have engaged in initiatives that recognize and address the complex linkages between human population, health, and the environment. These diverse efforts – often referred to as CBA and PHE, respectively – aim to meet development needs of remote underserved communities while sustaining the natural resources and environmental services upon which they depend.

In both theory and practice, these approaches bear striking similarities, yet the two communities of practice rarely overlap. Given the new energy around CBA, and the depth of experience in PHE, what could these communities share with each other to strengthen both approaches?

Seeking to Thrive Amidst Change

Community-based adaptation has arisen as a means of meaningfully engaging the poorest communities that are highly reliant on natural resources for their livelihoods and who live in countries most vulnerable to the effects of changing climate. While multilateral organizations and national governments grapple with large-scale strategies and initiatives for climate change adaptation, CBA brings the practice of adaptation down to the local level and aims to be responsive to localized conditions. The hallmark of CBA is that it is a community-led process based on communities’ priorities, needs, knowledge, and capabilities.

CBA has been embraced by non-governmental organizations such as CARE, Practical Action, and Oxfam, and the UN Development Program supports projects in 10 pilot countries with funding from the Global Environment Facility. These projects recognize that adaptation requires management of ecosystems so that they can continue to provide critical services that support human communities even as the climate changes.

If I were to ask you to think of a country that is highly vulnerable to the impacts of climate change, you might envision a country like Bangladesh. Not only does Bangladesh have hundreds of miles of coastline, but in addition, most of the country is one huge low-lying delta, making it particularly vulnerable to sea level rise and storm surge. Seasonal flooding and cyclones have always been part of people’s lives, but climate change is decreasing the predictability and increasing the severity of these events.

With over 1,000 people per square kilometer, Bangladesh is one of the most densely populated countries in the world, and these kinds of disruptions affect a lot of people – especially in areas where infrastructure is weak and livelihoods are tightly linked to natural resources (close to half of the population is employed in agriculture). As a result, it has been a country of focus for CBA.

In March 2011, I traveled to the capital, Dhaka, for the 5th International CBA Conference (there has since been a 6th conference since, which took place in April in Hanoi). In addition to hearing diverse and enlightening presentations from CBA practitioners from around the world, I visited a CBA project in Kunderpara, a village several hours’ drive from the city. Residents were working together to diversify livelihood strategies, packaging together activities like fish farming, livestock raising, and vegetable farming in ways that would provide more options for income in their changing environment. They were also working together on disaster preparedness and early-warning systems for floods, which had been increasing in the area in recent years.

During my visit to Kunderpara, I had the opportunity to listen in on a women’s group as they talked about the effects of the increasingly erratic and intense flooding in the village. More than anything, these women voiced concerns for their children, and spoke of the challenges and stresses they face when they are pregnant or caring for young ones.

Though this was the first time I’d visited a CBA project, I was struck by how this conversation mirrored themes I’d heard before, visiting PHE projects in the Philippines, Madagascar, and Ethiopia. In all of these places, women spoke of their concerns for the health and well-being of their families in the context of changing environmental conditions.

PHE in Action

While CBA is relatively new, many conservation and health organizations have been engaging communities in local initiatives that address the linkages among population, health and environment for more than a decade. PHE projects supported by USAID have focused on areas of high biodiversity, but other PHE projects have addressed wider environmental concerns, such as food security in coastal and agricultural contexts.

A key component of the integrated PHE approach has been the explicit focus on addressing women’s unmet need for reproductive health care, including family planning. In PHE project areas, communities have specifically identified lack of access to family planning services as a priority, due to the impact that unintended pregnancies and larger-than-desired family size have on women, their families, their communities, and the local environment.

While the CBA project I visited in Kunderpara did not incorporate reproductive health care or family planning, the women’s discussion revealed the importance of these issues in the context of daily life. While pockets of deep need remain, Bangladesh has witnessed significant progress in meeting women’s needs for family planning in recent decades, with resulting declines in fertility. In many vulnerable countries around the world, however, women remain woefully underserved.

PHE projects aim to address these needs with an integrated approach. For example, the Philippine non-profit organization PATH Foundation Philippines, Inc., implemented PHE approaches in coastal areas through its Integrated Population and Coastal Resource Management (IPOPCORM) initiative. IPOPCORM sought to improve food security and overall quality of life in communities that depend on aquatic resources. Having identified high fertility and population growth among the factors straining increasingly at-risk coastal fisheries, the IPOPCORM project partnered with the local government to employ a community-based approach that included reproductive health service delivery; education and outreach on population, environment, and food security relationships; environmentally-friendly livelihood development; and efforts to restore coastal resources, including mangrove reforestation and coral reef protection.

There is growing evidence that this kind of integration can produce promising synergies: Research on the IPOPCORM project comparing integrated PHE sites with single sector sites found PHE sites performed better than or equivalent to their single sector counterparts for all health and ecological indicators examined.

Opportunities to Share and Learn

Could PHE be considered a special case of CBA in which particular attention is paid to an often-overlooked aspect of women’s vulnerability? Comparing CBA and PHE approaches, one finds that they have several common elements, including:

• Community engagement in participatory processes to identify their needs and priorities, and to select and implement appropriate interventions
• Prioritization of communities that are underserved and highly dependent on natural resources
• Support for community stewardship and sustainable use of forests, soils, watersheds, coastal areas, and other climate-sensitive resources
• Grounding in multi-sectoral assessment, planning, and implementation

Some institutions implementing PHE projects are just beginning to assess the impacts of climate change on health, livelihoods, and ecosystems, and this provides an opportunity for more intentional incorporation of CBA approaches and techniques into these projects.

For example, western Tanzania’s Tuungane PHE project, supported by the Nature Conservancy, Pathfinder International, the Jane Goodall Institute, Frankfurt Zoological Society, Tanzania National Parks, and the Government of Tanzania, is reviewing the results of a regional climate change vulnerability assessment to determine how to integrate meaningful adaptation strategies into PHE project activities. The growing body of CBA tools and assessment techniques can help PHE practitioners better incorporate climate information and strategies in their efforts.

Conversely, lessons learned from more than a decade of PHE implementation could also strengthen CBA projects, particularly in areas experiencing high fertility and rapid population growth, and where women have an unmet need for family planning. PHE approaches have experienced success in:

• Building local awareness of the connections between environmental conditions, human health, and behavior
• Strengthening community capacity to plan and manage resources in the context of those connections
• Engaging communities in assessing ecosystem values and function that could provide a useful bridge between CBA and ecosystem-based adaptation approaches

Likewise, there is a wealth of tools, project documentation, and lessons learned from PHE experience that has been packaged in ways that can help to directly inform and strengthen the practice of CBA.

Finding a Place for Population and Women’s Health in Adaptation

A growing body of evidence, such as the recently-released People and the Planet report by the U.K.’s Royal Society, resoundingly confirms that population growth and other demographic trends have important implications for the human and physical systems vulnerable to climate change. A full understanding of this vulnerability requires assessment of the ways in which these trends affect climate change exposure, sensitivity, and adaptive capacity.

Key determinants of population growth, including fertility, access to health services, and gender equity therefore warrant consideration in the development of strategies to reduce vulnerability to climate change impacts. The depth of experience and practice of population, health, and environment projects, and the emerging attention and resources for community-based adaptation, can and should be blended to produce the best possible outcomes for human and environmental well-being.