Navigating Uncertain Futures: Dilemmas and Opportunities in Climate and Health in LMICs
Abstract
Climate-health planning in Low- and Middle-Income Countries (LMICs) is constrained by structural health-system vulnerabilities, cross-sectoral coordination challenges, and trade-offs that remain invisible within sectoral planning processes. This study addresses three methodological gaps: the scarcity of multi-regional, LMIC-led climate-health futures; the absence of methods that translate foresight into decision-making dilemmas; and the lack of approaches that integrate participatory foresight with structured intersectoral perspective-taking. A participatory futures workshop with 29 climate, health and funding experts drawn from five regional research locations across Africa, Asia, Latin America and the Caribbean, and the Middle East used the serious game ‘Future Care Force’ to negotiate intersectoral responses across divergent ten-year scenarios. To our knowledge, this was a first-of-its-kind gathering of Global South expertise in climate and health. The consensus between experts on climate and health trajectories underlies fundamental uncertainties and the need to examine alternative futures. A serious game provides a platform to imagine divergent climate and health futures, participants worked through epistemic complexity to reveal dilemmas and opportunities. The analysis identifies four cross-cutting structural dilemmas: technology deployment, knowledge authority, system architecture, and pace of change. The study positions serious games a method for making cross-sectoral trade-offs visible, an epistemic precondition for adaptive pathway development.
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BibTeX
@misc{priday2026navigating,
title = {{Navigating Uncertain Futures: Dilemmas and Opportunities in Climate and Health in LMICs}},
author = {Gareth Priday and Jose Ramos and Frederick Ato Armah and Mey Jurdi and Martin Muchangi and Gina Polo-Infante and Tin Tin Su and Yaser Abunnasr and Nazia Ahmad and Lauren Brown and David Teye Doku and Melina Galdos and Rima Habib and Simon Hearn and Rawya Khodor and Adelaide Lusambili and Stephen J. McCall and Samuel Muhula and Walter Mukwana and David Olaya and Vincent Pagiwa and Hussein Mohammad Rizal and Aminath Shazly and Tan Pei Jean and Anita Villacis and Anya Gopfert and Holly Gray and Montasser Kamal and Natacha Lecours and Samuel Oji Oti and Robert McLean},
howpublished = {EarthArXiv},
year = {2026},
month = oct,
doi = {10.31223/x50v4j},
url = {https://eartharxiv.org/repository/view/15604/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Navigating Uncertain Futures: Dilemmas and Opportunities in Climate and Health in LMICs
AU - Gareth Priday
AU - Jose Ramos
AU - Frederick Ato Armah
AU - Mey Jurdi
AU - Martin Muchangi
AU - Gina Polo-Infante
AU - Tin Tin Su
AU - Yaser Abunnasr
AU - Nazia Ahmad
AU - Lauren Brown
AU - David Teye Doku
AU - Melina Galdos
AU - Rima Habib
AU - Simon Hearn
AU - Rawya Khodor
AU - Adelaide Lusambili
AU - Stephen J. McCall
AU - Samuel Muhula
AU - Walter Mukwana
AU - David Olaya
AU - Vincent Pagiwa
AU - Hussein Mohammad Rizal
AU - Aminath Shazly
AU - Tan Pei Jean
AU - Anita Villacis
AU - Anya Gopfert
AU - Holly Gray
AU - Montasser Kamal
AU - Natacha Lecours
AU - Samuel Oji Oti
AU - Robert McLean
PY - 2026
DA - 2026/10/20
PB - EarthArXiv
DO - 10.31223/x50v4j
UR - https://eartharxiv.org/repository/view/15604/
AB - Climate-health planning in Low- and Middle-Income Countries (LMICs) is constrained by structural health-system vulnerabilities, cross-sectoral coordination challenges, and trade-offs that remain invisible within sectoral planning processes. This study addresses three methodological gaps: the scarcity of multi-regional, LMIC-led climate-health futures; the absence of methods that translate foresight into decision-making dilemmas; and the lack of approaches that integrate participatory foresight with structured intersectoral perspective-taking. A participatory futures workshop with 29 climate, health and funding experts drawn from five regional research locations across Africa, Asia, Latin America and the Caribbean, and the Middle East used the serious game ‘Future Care Force’ to negotiate intersectoral responses across divergent ten-year scenarios. To our knowledge, this was a first-of-its-kind gathering of Global South expertise in climate and health. The consensus between experts on climate and health trajectories underlies fundamental uncertainties and the need to examine alternative futures. A serious game provides a platform to imagine divergent climate and health futures, participants worked through epistemic complexity to reveal dilemmas and opportunities. The analysis identifies four cross-cutting structural dilemmas: technology deployment, knowledge authority, system architecture, and pace of change. The study positions serious games a method for making cross-sectoral trade-offs visible, an epistemic precondition for adaptive pathway development.
ER -