BACKGROUND:
Uganda’s urban health systems are increasingly strained by climate change, rapid urbanization, environmental degradation, and the expansion of informal settlements. In Kampala, recurrent floods, heat stress, air pollution, and erratic rainfall are altering disease patterns, intensifying outbreaks of malaria and cholera, and increasing respiratory and heat-related illnesses. Climate-driven changes in vector ecology and heightened human–animal–environment interactions further elevate zoonotic risks, underscoring the need for a One Health approach. Although Uganda has adopted a National Plan for Health and strengthened routine surveillance through DHIS2, health data remain weakly integrated with climate, environmental, and ecosystem indicators. Existing early warning mechanisms are largely confined to technical platforms and policymakers, with limited linkage to community structures, creating critical last-mile gaps that undermine timely and equitable public health action.

METHODS:
We propose a mixed-methods study using a hybrid effectiveness–implementation design in Kampala. The intervention will integrate meteorological, air quality, ecosystem, and urban indicators, as well as vector surveillance data, into DHIS2, with automated alerts triggered by predefined climate–health thresholds. Alerts will be disseminated through a multi-tier pathway, including DHIS2 dashboards for decision-makers, SMS/USSD alerts to Community and Extended Health Workers (CHEWS), and simplified, locally translated community risk messages. Implementation strategies include multi-sectoral co-design workshops, training CHEWs in climate–health risk communication, development of community-facing response protocols, and feedback loops from communities to the health system. Outcomes will assess implementation and effectiveness, including timeliness of detection, response time, and community preparedness actions. Expected Results The integrated system is expected to improve early detection of climate-sensitive health events, reduce response times, enhance last-mile dissemination of alerts, and strengthen One Health surveillance and coordination across sectors.

CONCLUSIONS:
Implementing a climate-sensitive, community-linked health information and early warning system offers a scalable, equity-focused model to strengthen urban health resilience in Kampala and similar low- and middle-income urban settings.