This study presents a comparative review of health system resilience in Mauritius and Madagascar amid growing environmental stressors driven by climate change. As small island developing states in sub-Saharan Africa, both countries face increased health risks from extreme weather events, shifting disease patterns, and food insecurity. This review highlights the disproportionate impact on vulnerable populations, particularly women and girls, emphasising the need for anticipatory and flexible health systems to manage these challenges effectively.
Methodologically, the study synthesises evidence from government and international agency assessments, peer-reviewed literature, and recent policy reports focused on health system adaptation frameworks. Special attention was paid to the World Health Organisation’s Vulnerability and Adaptation Assessment applied in Mauritius and the Climate-Smart Public Health model piloted in Madagascar. Thematic document analysis was conducted to assess governance, surveillance, infrastructure, community engagement, and equity. The results reveal contrasting yet complementary approaches.
- Mauritius benefits from robust institutional capacity, universal health coverage, and an advanced Early Warning Alert and Response System anchored in an equally robust multi-sectoral partnership framework.
- Despite resource limitations, Madagascar has demonstrated innovation through data-driven surveillance, artificial intelligence, and targeted infrastructure upgrades, supported by international cooperation. However, both countries share key lessons on the importance of predictive surveillance, multi-sectoral governance, and community participation in building resilient health systems.
In conclusion, this review highlights that effective adaptation requires context-specific, equity-focused strategies that merge strong governance with technological innovation. Additionally, sustained financing, gender-responsive policies, and enhanced inter-sectoral collaboration are critical for future resilience. These insights offer valuable guidance for health systems in vulnerable settings that face escalating climate hazards.
Keywords: Climate-resilient health systems, Environmental stress, Mauritius, Madagascar, Early warning systems, Health system adaptation
Citation: Segale, J.N., Magadza, M.E.D., Juglall, P.R., & Tofa M. Sekgoma, B., (2025). Resilient Health Systems under Environmental Stress: Policy Lessons from Mauritius and Madagascar. Adv Earth & Env Sci; 6(4):1-8. DOI : https://doi.org/10.47485/2766-2624.1082