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Zwei Männer impfen Kinder in Pakistan

Assessing heat adaptation in informal settlements in LMIC urban areas using a disaster justice informed theory: a rapid review

Lira Ramadani, Katharina Förster, Juliana Lenz, Melanie Böckmann

Climate change poses critical risks to urban areas due to their dense populations and infrastructures that are sensitive to climatic conditions (1). As cities grow rapidly, their exposure to climate and disaster risks increases, highlighting their critical role in climate change adaptation (2). Urban heat disproportionately impacts informal settlements in low- and middle-income countries (LMICs). These communities often lack essential infrastructure, adequate housing, and green spaces, further increasing their vulnerability during extreme heat events (3). Despite their heightened risk, the voices and needs of at-risk populations are frequently excluded from urban heat adaptation strategies. The drive for quick solutions often overshadows the principles of distributive, procedural, and recognition justice, resulting in inequitable outcomes. This exclusion of vulnerable groups often reflects systemic inequities, as environmental and economic goals are prioritized over addressing social vulnerabilities(4). The planned rapid review investigates the current state of knowledge about ethical considerations regarding the participation of at-risk groups in urban heat adaptation in LMIC, with a particular focus on informal settlements. 

We conducted a rapid review to synthesize evidence from peer-reviewed studies on urban heat adaptation in LMICs. Cochrane rapid review guidelines are followed, with searches performed in Web of Science, PubMed, and SCOPUS. Studies are included if they address urban resilience strategies for heat adaptation in LMICs and are published in English between January 1, 2000, and the search date. Non-peer-reviewed and non-English articles are excluded. Thematic analysis guided by a disaster justice theory framework is then be applied to identify key findings related to ethical considerations and the inclusion of vulnerable groups in adaptation planning.

For the purposes of this review, the PAC (Platform–Agent–Conviction) framework, as outlined in the context of disaster justice in Nepal's earthquake recovery (5) provides a structured approach to assess and address justice-related issues by focusing on three domains: accountability, representation, and recognition of diverse knowledge systems (Figure 1). In addition, the PAC framework emphasizes the need for specific structures, actors, and values that can actively challenge power imbalances and drive transformative change in disaster governance. Platform refers to inclusive spaces where diverse forms of knowledge such as scientific, local, and indigenous are acknowledged and integrated. Agents are individuals or groups who work to promote justice by navigating power dynamics and advocating for marginalized voices. Whereas conviction is their commitment to prioritizing the needs of the most disadvantaged. Essentially, the PAC framework is a practical and analytical tool used to address injustices that often arise during disaster recovery, with a particular focus on the three interconnected domains of accountability, representation, and recognition of diverse knowledge systems. Each domain reflects the three PAC elements. For example, accountability may require platforms that ensure transparency, agents who demand answers, and a conviction to hold power to account. By approaching these domains holistically, the PAC framework helps identify where structures, actors, and values can align to challenge injustice and support more just outcomes in disaster recovery.

 

Grafik Conceptual Framework
Conceptual Framework to Analyze Ethical Considerations in Urban Heat Adaptation adapted from Shrestha et al. 2019 (p.208)

The included studies indicate a limited or entirely absent equitable distribution of resources for climate change adaptation in informal settlements. Shortcomings in climate adaptation efforts are evident in the deficiency of long-term planning, limited official interventions and a prevalent lack of accountability mechanisms in governance (6–8). Only one study reports a collaborative effort between community leaders and legal advocates aimed at contesting policy decisions (9). Moreover, the reviewed studies highlight the limited inclusion of marginalized groups, especially women, in climate adaptation decision-making, despite recognition of their heightened vulnerability (8,10,11). Several studies identify challenges in participatory processes and emphasize the need for local inclusion and transparent governance (6,12,13).

Our findings show that local and culturally rooted knowledge is often present and relied upon by residents in informal settlements (14). In formal adaptation planning this knowledge is still rarely recognized. A couple of studies underline the exclusion of marginalized perspectives and the lack of community-derived strategies in decision-making spaces(6,9).Additionally, several studies highlight the lack of shared spaces for meaningful collaboration among diverse stakeholders, including informal settlers, while emphasizing the importance of establishing platforms that enable dialogue, knowledge exchange, and collaborative decision-making (6,11,14). Among the reviewed studies, only one reports on a successfully implemented platform mechanism in practice (9).

The reviewed studies highlight the role of diverse actors as agents of change in promoting the inclusion of marginalized groups and ensuring fair access to heat adaptation resources. Recommendations include recognizing women’s roles in adaptation (8), fostering collaboration among stakeholders (11), and empowering local residents with technical knowledge (15). Finally, the included studies support a paradigm shift in climate adaptation towards prioritizing the most vulnerable, especially residents of informal settlements (8,11). These communities are consistently identified as being disproportionately affected by extreme heat and as having limited adaptive capacity (9,10,13,14).

This research is part of the WHO Climate Change, Health, and Ethics Initiative, supported by Wellcome Trust Grant 306679/Z/23/Z. It represents a collaborative effort between the Global South and Global North and is co-led by Prof. Rumana Huque from the University of Dhaka and ARK Foundation, Bangladesh, and Prof. Melanie Boeckmann from IPP. The one-year project officially commenced in November 2024.

More information is available on the OSF registration: https://osf.io/shke2


Lira Ramadani, Katharina Förster, Juliana Lenz, Prof. Dr. Melanie Böckmann

Universität Bremen, Institut für Public Health und Pflegeforschung (IPP) | Abt. Global Health

melanie.boeckmannprotect me ?!uni-bremenprotect me ?!.de

www.uni-bremen.de/institut-fuer-public-health-und-pflegeforschung/abteilungen-arbeitsgruppen/public-health-forschung/global-health


Literatur

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Zitierweise

Ramadani L, Förster K, Lenz J, Böckmann M. Assessing heat adaption in informal settlements in LMIC urban areas using a disaster justice informed theory: a rapid review. IPPinfo [Internet]. 2026;19(22):17-18. Available from: https://www.uni-bremen.de/institut-fuer-public-health-und-pflegeforschung/ippinfo. https://doi.org/10.26092/elib/5876

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