
Project Advisory: Strengthening Climate Resilience of the Lao People’s Democratic Republic (PDR) Health System
Overview
The Strengthening Climate Resilience of the Lao People’s Democratic Republic (PDR) Health System project was initiated by the Lao Ministry of Health in 2021 to strengthen the Government of Lao’s delivery of its national climate change and health priorities by investing in more resilient infrastructure in the health sector.
Lao PDR faces significant vulnerability to climate change. Projections indicate that the country will be exposed to more frequent climate extremes and experience a 2–3°C increase in temperature by 2050. There is also a potential 10–30% rise in rainfall combined with changes in seasonal patterns. The impacts of these changes are expected to directly affect the healthcare sector by causing damage to critical health infrastructure, notably the water, sanitation, and hygiene (WASH) services required by health centres. This is exacerbated by increasing demand for health services, as climate change will also contribute to the proliferation of diseases such as dengue and diarrheal illnesses. The pressure of damage to infrastructure and increasing demand is likely to significantly add to the burden of an already struggling healthcare system in a least-developed country.

The Response
To address these challenges through a mix of investment and increased capacity for managing diseases, the project was conceived by Save the Children in close cooperation with WHO and under the direction of the Ministry of Health. The project successfully secured USD 25 million of Green Climate Fund (GCF) funding in October 2023, as SAP030. The approval of this funding proposal signified a groundbreaking development, as it was the first-ever GCF-funded climate and health initiative.
The key objective of the project is to enhance the climate resilience of the Lao PDR health system and strengthen the communities’ capacity to manage current and anticipated health impacts resulting from climate change. The main activities include:
- Strengthening health system leadership and governance at national and subnational levels;
- Expanding health facility access to climate information and key WASH indicators to help track, prepare for, and manage climate-related risks to health; and
- Strengthening health system capacity in 25 climate-vulnerable rural districts.
Globalfields was contracted by Save The Children Laos to design the project’s funding proposal package for the GCF.
Globalfields produced the following deliverables in support of the assignment:
An overview and analysis report:
Globalfields reviewed the existing baseline and secondary data available on the potential to develop climate resilience and adaptive capacity, including a gap analysis. Globalfields then gathered relevant background information on the target sites, including their vulnerability and exposure to local climate hazards, as well as gaps and needs for addressing the adaptive capacity of health systems. This included visits to sample sites by combined technical teams, including architects, WASH and health specialists, amongst others.
Based on the information collected, Globalfields collaborated with technical experts to design specific adaptation activities and identified all governance and capacity issues relevant to implementing the project. Globalfields then designed the project’s theory of change and logical framework, incorporating anticipated outputs and outcomes.
StakeholderConsultation and Validation:
Working closely with Save the Children, Globalfields supported securing the validation for the proposed approaches from key government and civil society stakeholders at the national and sub-national levels by conducting a detailed activity development exercise with all internal and external stakeholders to the necessary level of detail for the proposal and budget.
Feasibility Study Report:
Globalfields delivered an in-depth report on the proposed project including contextual information on the country, a climate rationale for the projects and all project approaches, activities and anticipated outcomes.
Health Care Facility Infrastructure and Supply Chain Assessment
Globalfields conducted desk reviews of all national construction policies and standards which relate to the construction of healthcare facilities, as well as water, sanitation, hygiene, waste management, ventilation and cooling, and electrical services. A desk review of available data on district and provincial-level water resources, including current availability, trends, and variability was also conducted. Additionally, Globalfields conducted site assessments at 19 healthcare facilities (3 provincial hospitals, 6 district hospitals, and 10 rural health centres), as well as supply chain assessments in three districts, identified by the implementing partners.
Based on these assessments, a technical package was developed to implement the proposed rehabilitation and retrofitting activities, which aim to rehabilitate health facilities with climate-resilient and climate-efficient infrastructure, WASH services, ventilation/cooling, and electrical services tailored to each site's climate vulnerabilities.
Detailed costing and procurement summary
Globalfields provided details for unit costs of all activities included in the logical framework and compiled the relevant operational and maintenance information for any assets and or equipment suggested to be purchased as part of the project for use in the Operation and Maintenance plan.
Project monitoring and evaluation plan
Finally, Globalfields designed a detailed monitoring and evaluation plan in accordance with GCF requirements. This plan included all indicators identified in the logical framework and ensured its complementarity with the Gender Equality and Social Inclusion (GESI) plan and environmental and social safeguards requirements. Globalfields also developed a budget for the cost of the monitoring and evaluation plan.
Funding proposal
Based on the above documents, Globalfields provided the full Funding Proposal package for submission to the GCF.
Want to know more?
This case study was written by Marta Simonetti, Founder and Managing Director of Globalfields. Visit Marta's bio or contact us today to discuss this project.