Identifying research questions

How climate change adaptation are included into health policies and actions in the ASEAN health systems, with particular focus on infectious diseases control?

Sub-questions:

1. What are the characteristics of existing policies and actions for climate change adaptation in health systems among ASEAN member states and the ASEAN region, with particular focus on infectious diseases control?
2. To what extent do the current climate-related health policy documents from AMS adopt the WHO Operational Framework for Climate-Resilient Health Systems?
3. What are the indicators that have been used to assess for climate change adaptation in health systems among ASEAN member states and the ASEAN region, with particular focus on infectious diseases control?

Eligibility of the research questions

The eligibility of the primary research question was assessed using the Population, Concept, Context (PCC) framework [17].

• P-Population: Humans.
• C-Concept: Policies and actions on climate change adaptation in health systems, focusing on infectious disease outbreaks.
• C-Context: ASEAN member states (AMS) and the ASEAN.

Search strategy

We will conduct a systematic search on the ASEAN Secretariat website, government websites, Google, and six research databases (PubMed, ScienceDirect, Web of Science, Embase, WHO Institutional Repository Information Sharing (IRIS), and Google Scholar) to identify relevant policy documents and grey literature. The search will be conducted using a combination of keywords (and/or MeSH terms, if applicable): “Climate change”, “healthcare system”, “health preparedness”, “infectious diseases”, “Southeast Asia”, “ASEAN”, and the names of each ASEAN country (Brunei Darussalam, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, Vietnam). S1 Appendix shows the keywords that will be used for each database. Duplicated documents from the research databases will be filtered using Zotero application.

Study selection and eligibility criteria

The inclusion criteria of this scoping review are:

1. Policy documents and studies on climate change adaptation policies and actions, with particular focus on infectious diseases, in ASEAN health systems.
2. The documents should be published within 20 years (between January 2003 to January 2023) to allow a comprehensive analysis of the current climate change adaptation policies, particularly on infectious diseases, in ASEAN. If there are two or more policies published by a country or in ASEAN, we will only include policies that are still in effect.

No language restrictions will be imposed. Translations of original articles will only be conducted if the article is relevant. We will exclude conference proceedings, books, blogs, news articles, and articles that are not available in full-text form. Two reviewers, AVM and BWL, will independently assess the eligibility and inclusion of the studies by screening the titles and abstracts, followed by full-text assessments. Any differences will be resolved through consensus.

Data extraction, summary and reporting

To summarize our search results, we will use the PRISMA flow chart. Two reviewers will extract data from the included documents into a matrix containing information about the country, name of documents, type of documents, issuing body, and type of addressed infectious diseases-related issues (vector-borne, water-borne, and/or food-borne diseases, and their effects to health systems). We will further look into the concordance of these policies to the WHO’s ten key components for building climate-resilient health systems [14] and on whether the policies included key performance indicators to assess the climate change adaptation process among AMS health systems (Table 1). We will also collect information on whether the AMS has any policy change in the past 20 years. This data will be the basis for a summary narrative discussing the current national and regional policies on the topic, the infectious diseases that are the focus of these policies, and the remaining gaps that need to be addressed.

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Table 1. Extracted data from national policy documents.

https://doi.org/10.1371/journal.pone.0286869.t001

Analytical framework

To analyze the included policies, we will use the framework obtained from the WHO’s ten key components for building climate-resilient health systems (Table 1): leadership and governance; health workforce; vulnerability, capacity & adaptation assessment; integrated risk monitoring & early warning; health & climate research; climate resilient and sustainable technologies & infrastructure; management of environmental determinants of health; climate-informed health programs; emergency preparedness and management; climate and health financing [14].

Ethics and dissemination

This study does not require ethical approval as it is a scoping review protocol. The findings will be published in scientific journals and disseminated electronically. All relevant literature search results such as government documents, journal articles, and publications, will be made available in a public repository.

Strengths and limitations of this study

This is the first study that systematically reviews the climate-related health policies and collaborative frameworks in the ASEAN. The findings of this scoping review will provide comprehensive information on climate-related health policies and programs for AMS and ASEAN policymakers. The scoping review is guided by the Joanna Briggs Institute (JBI) methodology for scoping review, ensuring clear and replicable literature search process. In addition, our policy analysis is guided by the WHO operational framework on climate-resilient health systems, allowing for future comparative analysis. The limitations of this study are the English keywords used for the literature search, reducing the possibility of including articles in other languages, and the year criteria (20 years), although this is intended to give focus to current policies.