Climate Care India: A protocol for digital transformation of health systems for non-communicable disease management and climate change adaptation

Background and objectiveNon-communicable diseases (NCDs) account for 74% of global deaths, disproportionately affecting low-resource settings in the global south. The increasing frequency and severity of climate change-related events worsen the NCD burden - particularly in low-resource settings - thereby necessitating health system transformation. This longitudinal trial aims to transform the current response to climate change and NCDs among affected communities via a customized digital health platform. MethodologyBuilding on the intergenerational Youth Adolescents behaViour, musculoskeletAl heAlth, Growth & Nutrition (YUVAAN) prospective cohort study - which has enrolled 1070 rural households as of November 2024 in Western India - a digital platform will be tailored to monitor and address evolving climate change and NCD-related risks. The three-phase methodology includes: 1) adaptation: co-developing the platform with a Citizen Scientist Advisory Council for local use, integrating culturally relevant features and languages; 2) implementation: pilot testing the platform and step-wedge deployment within the YUVAAN cohort; 3) evaluation: conducting mixed-method analyses of the platform, climate change, and health outcome associations. A sample size of 978 families was calculated to detect an effect size of 0.3 (90% power, 0.05 , 15% attrition). DiscussionThrough access to real-time data, the digital platform will provide rural households with personalized support for NCD prevention and management, while enabling climate change preparedness and adaptation strategies in participating communities. ConclusionIntegrating digital platforms into local decision-making will strengthen health systems capacity to manage NCDs in rural and low-resource settings impacted by climate change. These platforms can enable real-time data access for personalized care and evidence-based decision-making.