Background This paper focuses on the impacts of climate change on vulnerable ecosystems and its implications for the health and well-being of populations. It specifically examines the Semi-arid region of Brazil, where the introduction of a social climate adaptation tool, cisterns, has brought about significant positive changes. Cisterns, a low-cost climate adaptation technology, can be replicated globally, reducing the negative health impacts of frequent droughts, especially for vulnerable groups in remote rural areas.

Objective We analyze the impact of the “One Million Cisterns Program” (P1MC) on health by synthesizing the literature and modeling its interactions with climatic and environmental factors with the DPSEEA framework.

Methods Our case study employs a multidisciplinary approach, focusing on two key objectives: (i) synthesizing the literature on the implementation of the P1MC and its association with health outcomes; and (ii) developing a conceptual framework to model the relationship between climatic and environmental factors, adaptive ecosystems, and health outcomes. The Driving Force–Pressure–State–Exposure–Effect–Action (DPSEEA) framework evaluates the structural connections between climate change and human health.

Findings The study found a significant gap in the literature concerning the relationship between P1MC and health outcomes. Cisterns target the pressure/state linkages related to contextual factors and health effects, addressing the root causes of drought-related health issues. This framework also provides a foundation for collaboration among health, environmental, and policy sectors to address shared challenges, such as water security and health outcomes.

Conclusion We offer a multidisciplinary analytical framework that can be used to explore various perspectives – environmental, social, and health-related – with experts and stakeholders to develop and improve adaptive social technology strategies for living in the emergence of climate change. This framework also facilitates the implementation of qualitative and quantitative well-being and health assessments.

The authors have declared no competing interest.

This manuscript is part of a supplement titled Lessons from the Field: Case Studies to advance research on climate adaptation strategies and their impact on public health. This writing project was supported by the National Institutes of Health (NIH) Climate Change and Health Initiative (https://climateandhealth.nih.gov) and coordinated by the Center for Global Health Studies at the Fogarty International Center of NIH. A steering committee of global experts on health and climate change led the activity. More information is available at https://go.nih.gov/ClimateAdaptationStudies. This research was also funded by the NIHR (NIHR134801), using UK aid from the UK Government to support global health research. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the UK government.

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