The impacts of a changing climate touch every region of the globe, but they are acutely felt by people in Uganda, where floods, droughts, and shifting rainfall patterns disrupt agricultural productivity, livelihoods, and the health and well-being of millions of people. According to the ND-GAIN index, Uganda is the 13^th most vulnerable nation in the world, and action there is urgently needed to better prepare for and adapt to climate change’s impacts.

Meanwhile, Uganda is also experiencing one of the most rapid population growth rates in the world, straining its efforts to adapt to climate change. Childhood and early marriage, limited access to family planning and reproductive health services, and high rates of unintended pregnancy underpin high fertility rates that drive population growth. Women and girls, who often experience a disproportionate burden of the impacts of climate change, have limited opportunities to go to school, enter the workforce, and exercise autonomy in multiple aspects of their lives.

These intersecting challenges have inspired stakeholders across Uganda to devise innovative, multisectoral responses. Uganda has become a world leader in advancing both policy and programmatic models that tackle the linked nature of climate, population, and health challenges. Regenerate Africa is a Uganda-based NGO that has been at the center of program innovation and policy advocacy. I recently spoke with Charles Kabiswa, executive director of Regenerate Africa, about this progress and ongoing challenges.  

Kathleen Mogelgaard: Uganda’s national climate policies and international climate commitments incorporate references to population dynamics and gender inequity and call for greater investments in the health and rights of women and girls as part of Uganda’s response. This multisectoral framework is quite rare in the world of climate policy. Can you tell us how this came to be?

Charles Kabiswa: Uganda is experiencing significant impacts of climate change manifested in prolonged droughts, floods, unreliable rainfall patterns, landslides, increased pest and disease infestations in human, crops and livestock, low crop productivity, and food and nutrition insecurity. Women and girls experience the greatest impacts of climate change, which amplifies existing gender inequalities and poses unique threats to their livelihoods, health, and safety. Some landscapes are more prone to the climate change-induced impacts and disasters, as we saw with the floods in Kasese, the prolonged drought in the Karamoja region, and the landslides in Bududa. In such communities, the health of women, girls and elderly persons is affected most by the limiting access to services and health care, as well as increasing risks related to maternal and child health.

Uganda is one of the few countries that has developed overarching policy frameworks with commitment and frequent reference to the value of and need for cross-sectoral collaboration between health, gender, family planning, reproductive health, environment and climate resilience.

Nationally Determined Contributions ((NDCs) reflect the national climate plans of countries that have ratified the Paris Agreement and indicate their voluntary commitment to meet the agreed goals. These play a key role in determining responses to climate change, including plans to build adaptive capacity and resilience. And the recently updated Nationally Determined Contribution (NDC) for Uganda is one of the few NDCs globally that draws a strong connection for integrating climate considerations into national health plans and strategies, including proposing a priority action on developing the Health National Adaptation Plan (NAP) that integrates reproductive health care. In addition to the NDC, Uganda’s Climate Change Policy, National Development Plan III, the national population policy, the National Population, Health, and Environment Strategy also contain elements that acknowledge these important links.

This integration of issues in policy frameworks is thanks to continuous, informed, and constructive multisectoral engagement between policy makers, practitioners, and actors in the country on the interconnectedness between population, gender, reproductive health, and climate. The recent Multi-stakeholder Dialogue on Population Dynamics, Health, Gender, and Climate Connection held in Kampala in February 2023, was a good example of this; it brought together more than 200 representatives from multiple ministries, academia, and civil society organizations (CSOs) to discuss these interconnections.

In addition, the National Population Council of Uganda has for some years supported and funded coordination and scale-up activities with cross-sectoral representation of line ministries and CSOs under the National PHE Network. Many organizations, like Regenerate Africa and other PHE network members across Uganda, are implementing measures and advocating for the integration of gender, family planning, and reproductive health actions with conservation and natural resource management actions.

You mentioned Uganda’s long history of community-based multisectoral projects that seek to address challenges related to population, health, and the environment. What lies ahead for implementation and scale-up of these kinds of multisectoral approaches?

Both the importance and the complexity of pursuing integrated population, health, environment and development approaches have been affirmed in Uganda and other countries as necessary to achieve the Sustainable Development Goals, climate ambition, and national and subnational development plans. Many projects that embrace this approach—such as the Health of the People and Environment in the Lake Victoria Basin (HoPELVB), which focused on improving reproductive health and environmental conservation outcomes in Uganda and Kenya–have been successfully tested in a diverse range of landscapes and settings. The practical experience and evidence gained from these endeavors has been documented to inform country programs and policies.

Whereas we are noticing a growing perception of the relevance of pursuing integrated development approaches, their sustainable expansion has been slow, mainly because practitioners continue to remain in silos. Yet families and communities experience intertwined and interconnected challenges that require adopting such strategies and approaches to make collective progress. We need to continue engaging decision makers, organizations, and funding partners, and convincing them with the evidence, good documentation, and firsthand experience that has emerged on the multiple benefits of multisectoral interventions versus single-sector approaches.

What do you see as some of the major challenges or barriers to further implementation of multisectoral climate change adaptation approaches in Uganda?

Most programming, funding streams, and budgets tend to be highly sectoral, departmentalized, and siloed, which makes the scale up of integrated and multi-sectoral climate change adaptation approaches harder. There are also still underlying policy and institutional barriers that limit effective integration and scale-up of cross-sectoral approaches into Uganda´s climate change agenda and actions at different scales.

For example, despite the growing evidence base that links women’s met needs for family planning with enhanced resilience and reduced human vulnerability to climate change, family planning and sexual and reproductive health and rights have been largely left out of climate change adaptation strategies, proposals, and projects not only in Uganda but the world over. There is an urgent need to move beyond silos and adopt integrated cross-sectoral policy and practice initiatives targeted at addressing population growth, gender, health, consumption habits, and the environment, from the individual to the sub-national and to the national and international level.

As the impacts of climate change intensify in Uganda and around the world, what gives you hope for the future?

In countries like Uganda, communities and landscapes most vulnerable to climate change are also experiencing the highest rates of population growth. According to the U.N. Population Division, the population in sub-Saharan Africa is growing at 2.5 percent per year—this is more than three times the global average. Even if strong mitigation and adaptation programs are put in place, the scale of human vulnerability in such places is likely to intensify dramatically if practitioners seeking solutions to these challenges continue to remain in silos.

We need multisectoral strategies and approaches that can be employed for collective progress in building the resilience of people and planet. And even though Uganda has registered some progress, it is now time to turn these policy commitments and plans into concrete actions. This includes:

• Decisionmakers and practitioners must recognize population, gender, health and climate connections as effective long-term climate adaptation strategies in National Adaptation Plans (NAPs), NDCs and key components of climate policies and action.
• Incorporate rights-based reproductive health, including modern voluntary family planning for adolescents and women, in an interconnected system of climate solutions to foster and generate co-benefits for maternal and child health, nutrition, economic development, climate adaptation, gender equality, resilience, and planetary health.

• Use the NDC and NAP processes to give countries like Uganda an opportunity to apply bilateral and multilateral adaptation funds to multisectoral climate adaptation projects, which can bring about transformative long-term change when they include investment in reproductive health, girls’ education, family planning, gender equality and more. Holistic climate adaptation approaches of this kind can boost the ability of vulnerable populations to adapt to climate change.

The decisions and actions we make today as individuals, communities, and institutions can affect tomorrow’s families, people, planet, and climate. It is already starting to happen here in Uganda.