In April 2026, the Observatory convened an ‘evidence capitalization workshop’ with partners to synthesize insights and key messages on issues and opportunities that can advance early action for dryland resilience and prosperity in the Horn of Africa. This policy brief and accompanying short video are products of this exercise.
Summary
In marginalized dryland areas of East Africa, environmental shocks and disease can create surges in needs for health care. These can often overwhelm health systems leaving people without access to adequate care.
The challenge is most acute when ‘upstream’ factors that increase demands for health services are compounded by ‘downstream’ constraints that limit system capacities to deliver necessary services.
Since many surges can be forecasted or identified early, ‘anticipatory’ health systems can help reinforce wider societal efforts to manage risks and shocks.
Such ‘anticipatory’ systems must intervene upstream – through preventive and responsive actions – while also building ‘downstream’ systems and capacities that can reliably anticipate coming needs and quickly adjust and apply resources to meet those needs.
Achieving the necessary results benefits from holistic approaches built on integrated community and formal health structures as well as integrated approaches that span human, animal and environmental health.
Key messages
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Holistic approaches that incorporate human, animal and environmental health (One Health) offer a robust and valuable framework to model and anticipate ‘upstream’ drivers of surges in demand for health services in the drylands of East Africa.
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Community health actors – such as Community Health Promoters (CHPs), Community Disease Reporters (CDRs) and traditional health experts – play essential roles in monitoring upstream causes and they provide important capacities for response, reporting and health education.
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Greater integration of One Health approaches and interconnections with community health actors can improve practitioners’ abilities to anticipate stressors on health systems, allocate resources efficiently to mitigate health system demand surges and build capacities across the health system.
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This integration can also connect broad geographical areas, include marginalized or low resource health settings and help take preventative actions that reduce stress on healthcare systems.