NIHR RIGHT 5: Strengthening responsiveness of health services provision to extreme weather events for urban marginalised people A UK and low-and-middle-income-country (LMIC) partnership between the Liverpool School of Tropical Medicine and the George Institute for Global Health in India which aims to collaboratively design, implement and evaluate context sensitive interventions to improve the preparedness and responsiveness of health service delivery in the context of extreme weather events for urban marginalised people. Commencing in January 2024, this three-year research will be undertaken through equitable partnerships with urban marginalised people, and identified health system and governance actors in ten urban informal settlements across seven cities between India, Kenya and Sierra Leone. 

The research consists of five phases, with capacity strengthening of all actors including the research team built into phases two through five. 

Phase one will bring together all stakeholders to collaboratively finalise the research design and plans for capacity strengthening, ethics, and safeguarding. 

Phase two will involve assessments aimed at bridging existing data gaps regarding health impacts, community vulnerabilities and capacities, as well as health service preparedness in each setting. 

Phase three will use these assessments to focus on collaboratively designing packages of interventions to improve health service provision in extreme weather events. 

Phase four will implement and evaluate the intervention packages, which are likely to include utilisation of existing technologies such as mobile phone applications and two-way information systems. Learning within and across settings will be monitored and evaluated throughout the project. 

Phase five focuses on knowledge uptake at local, national and global levels. This phase will create and communicate evidence-based models to improve the responsiveness of health systems and service delivery to extreme weather events. The project has six objectives:

1. To retrospectively assess the health and social vulnerabilities and health service impacts of specific recent extreme weather events for urban marginalised people.

2. To assess the preparedness and capacities of health systems for health service delivery during and following extreme weather events based on existing frameworks, policies, tools and mechanisms.

3. To work with communities, health system and governance actors to co-produce and implement a package of research-informed interventions to strengthen health service preparedness and delivery for urban marginalised people during and following extreme weather events.

4. To assess and strengthen the capacities of researchers, community groups, health system and governance actors, their relationships and processes for working together equitably to improve responsiveness of health services to the health consequences of extreme weather events. 

5. To collaboratively monitor and evaluate implementation of the intervention package within and across city and country contexts for feasibility, fidelity, costs and enabling/constraining factors across diverse contexts.

6. To promote uptake of project learning by health system actors, communities, other stakeholders and global health researchers by integrating communication within all phases to ensure timely sharing of actionable information.