Institutional governance and climate–health–economic resilience in Africa: Multisectoral coordination, policy integration, and adaptation implementation
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Daniel Chigudu 1 *
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1 University of South Africa, SOUTH AFRICA* Corresponding Author

Abstract

Climate change is a systemic threat to Africa’s health systems, economies, and development trajectory, with the continent projected to bear the highest climate-related disease burden by 2030. This systematic review examines institutional governance frameworks for climate–health–economic resilience in Africa, with a focus on multisectoral coordination, policy integration, and adaptation implementation. The review synthesises 30 peer-reviewed studies (2015–2025) identified through a structured search of Scopus, Web of Science, Google Scholar, and African Journals OnLine, screened against pre-specified inclusion criteria and analysed through framework-based thematic synthesis (coded in Microsoft Excel) across three domains: governance mechanisms, the climate–health–economic nexus, and implementation barriers and enablers. The synthesis reveals that coordination failures across sectors and levels of government are the dominant barrier (~80% of studies; 24 of 30), followed by inadequate climate finance (~73%; 22 of 30) and institutional capacity deficits (~67%; 20 of 30). Health departments were excluded from National Adaptation Plans in 40% of the SADC countries reviewed (2 of 5). The review’s theoretical contribution is to position governance as an endogenous mediator across the climate–health–economic nexus rather than as exogenous context, and to translate the resulting evidence into 15 operational recommendations, each specifying the level, instrument, lead actor, and monitoring vehicle required to advance reform. This is among the first systematic reviews to synthesise institutional governance arrangements at the climate–health–economic nexus across multiple African regions.

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Review Article

EUR J SUSTAIN DEV RES, Volume 10, Issue 4, 2026, Article No: em0437

https://doi.org/10.29333/ejosdr/19261

Publication date: 01 Oct 2026

Online publication date: 16 Sep 2026

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