Policy coherence for climate-related health risks : examining cross-sector policy integration across climate change, disaster management, and health—The Gambia as a case study

Abstract

A growing body of evidence demonstrates that climate change and its associated extreme events and disasters pose substantial threats to human health. Climate change, disaster management, and health institutions share a common mandate to reduce exposure and vulnerability to climate-related hazards while enhancing resilience to events such as floods, tropical cyclones, heatwaves, droughts, and bushfires, with the overarching goal of minimizing climate-related health risks. Despite this overlap, evidence on how policies across these domains align to address interconnected climate-related health risks remains limited. This study addresses this gap by examining policy coherence and identifying opportunities to strengthen cross-sectoral governance for climate-related health risk management. Using The Gambia—a low-income, climate-vulnerable country—as a case study, this study analyzed national policy documents through content analysis using both quantitative (ordinal) and qualitative coding approaches, complemented by key informant interviews. The findings indicate limited integration of climate-related health risks across the three policy domains, as evidenced by inconsistent problem framing, limited consideration of health implications and vulnerable populations, and fragmented adaptation measures. Policy content analysis also revealed misalignment among policy instruments within and across domains, with inconsistencies observed even within individual policies. Furthermore, institutional and governance mechanisms supporting policy integration were limited across the three policy domains. Overall, the evidence indicates a lack of policy coherence across the climate change, disaster management, and health policy domains in addressing climate-related health risks. This pattern of policy incoherence is not unique to The Gambia and may reflect a broader governance challenge facing other low-income, climate-vulnerable countries with similar sector-based institutional arrangements.