TY - JOUR
AU - Montag, Doreen
AB - Abstract Despite mitigation attempts, the trajectory of climate change remains on an accelerated path, with devastating health impacts. As a response to the United Nations Framework Convention on Climate Change call for National Adaptation Plans, Peru has developed a national and decentralized regional adaptation plans. The purpose of this article is to understand the role and priority status of health within the adaptation planning and process. Peru was used as a case study to analyse the policy process in the creation of adaptation plans, encompassing the need to address climate change impacts on health with a particular focus on marginalized people. An actor, content and context policy analyses were conducted to analyse 17 out of 25 regional adaptation plans, which are available. The national adaptation plans (2002, 2015) do not include health as a priority or health adaptation strategies. In a decentralized health care system, regional plans demonstrate an increased improvement of complexity, systematization and structure over time (2009–17). In general, health has not been identified as a priority but as another area of impact. There is no cohesiveness between plans in format, content, planning and execution and only a limited consideration for marginalized populations. In conclusion, the regional departments of Peru stand on unequal footing regarding adapting the health sector to climate change. Findings in the strategies call into question how mitigation and adaption to climate change may be achieved. The lack of local research on health impacts due to climate change and a particular focus on marginalized people creates a policy vacuum. The Peruvian case study resembles global challenges to put health in the centre of national and regional adaptation plans. In-depth cross-country analysis is still missing but urgently needed to learn from other experiences. Climate change adaptation, health system, Peru, policy analysis, vulnerability Key Messages The Peruvian government needs to step up its plans for climate change. However, there are many barriers in the way. The lack of cohesion within, and amongst the departments, and lack of financial support is among them. There needs to be coherence among the different departmental plans. Health should be at the centre of departmental adaptation plans. Marginalized and vulnerable populations need to be at the centre of attention. Introduction Anthropogenic climate change is causing irreversible damage to the planetary system (Rockström et al., 2009), impacting peoples’ and population health (Watts et al., 2015; Whitmee et al., 2015; McMichael, 2017). Climate change is leading to an increasing risk of chronic and infectious diseases through extreme weather events, declining fresh water, and food insecurity, which will affect marginalized populations, such as Indigenous groups and minorities, more significantly than the general population worldwide (Ford, 2012). Marginalized populations are people who are historically, systematically, socially marginalized with limited access to quality health prevention, care and education (Stephens et al., 2005). Climate change is having direct and indirect impacts on health (McMichael et al., 2006; Frumkin et al., 2008), often defined as primary, secondary and tertiary impacts (Butler and Harley, 2010; McMichael, 2014). While direct impacts are related to weather extremes, heatwaves and increased air pollution, leading to an increased risk in chronic diseases, and infectious diseases (Watts et al., 2018), indirect impacts are related to disturbances in the ecosystem, defined by the interrelationship of climate change with other planetary boundaries, such as biodiversity loss, and their impact on chronic and infectious disease and mental health (Whitmee et al., 2015; Marselle et al., 2019). Sociocultural well-being is at risk on both individual and group levels (Berry et al., 2010; Bourque and Cunsolo Willox, 2014; Padhy et al., 2015). People will experience new challenges when it comes to the incidence and prevalence of diseases and hardships, and the social determinants of health will become exacerbated (Pickett and Wilkinson, 2015; Levy et al., 2017; Rossati, 2017). Consequently, it is necessary to reflect upon the social, economic, educational and cultural factors that create an unequal society, with social structures that serve to widen disparities under climate change (Breilh Paz y Miño, 2012). Social determination is often rooted in colonial structures, heightened by globalization as many populations are violently forced to adapt to a globalizing world (Quijano, 2000; Cadena de la, 2005, 2010; Quijano, 2007; Sulmont, 2011; Grillo and Sharon, 2012; Stetson, 2012; Shannon et al., 2017; Quijano, 2017). As a consequence, indigenous people are facing an unequal risk of mental health under climate change (Durkalec et al., 2015). Low- and middle-income countries, such as Peru will experience disproportionately poorer health outcomes (Balbus and Malina, 2009; Dulal et al., 2009; Myers and Patz, 2009; Watts et al., 2015). Peru is rich in biodiversity (Bass et al., 2010; Finer et al., 2015; Codato et al., 2019). Each member of its 32 165 485 (The World Bank, 2017) population is at risk, in addition to its unique ecosystem. In Peru, 16% identify as Indigenous, and about 3% identify as Afro-Peruvian. Indigenous and Afro-Peruvian people have been historically marginalized within society (The World Bank, 2017). As one of the few countries with Indigenous people living in voluntary isolation, in addition to the 55 recognized groups, 51 from the Amazon and 4 from the Andes, the vulnerability of these groups is heightened (INEI, 2009). Research on climate change impacts on health in Peru is in its infancies but is rapidly growing (Gonzales et al., 2014; Figueroa, 2016; Burstein Roda, 2016; Burstein-Roda, 2018), with evidence emerging about water security and public health (Burstein-Roda, 2018; Cabezas Sánchez, 2018), risks to health care establishments (Hernández-Vásquez et al., 2016), mental health (Soto-Cáceres, 2015), chronic disease, food security among marginalized populations (Sherman et al., 2015; Zavaleta et al., 2018), heatwaves and health (Aguilar-León and Solano-Zapata, 2016) and overall health system challenges (Ruiz and Smith Torres-Román, 2016). Current research focuses on the northern Peruvian and the Amazon region. The northern coast is an area that is prone to be affected by more intense El Niño phenomena, with implicated increased flooding and heatwaves, and increased risk for water- and vector-borne diseases, mental health risk and mortality (Soto-Cáceres, 2015; Aguilar-León and Solano-Zapata, 2016; Cabezas et al., 2017). Other research focuses on the Amazon region with higher risk to flooding and food insecurity, increasing the risks of chronic diseases among others (Sherman et al., 2015; Zavaleta et al., 2018). There is a need for expansion into the diverse ecological regions in Peru to inform policies, analysing the relationship of biodiversity loss, climate change and health, impacting vector-borne diseases, food security, water quality, access to medicines, chronic diseases and mental health (Montag et al., 2017). Ford et al. (2018), Sherman et al. (2015) and Zavaleta et al. (2018) emphasize the importance of specific indigenous health adaptation to climate change based on community interventions in Peru. Community adaptive interventions are a sustainable form of adaptive policies to climate change challenges, particularly for the most vulnerable with limited access to public institutions and resources (Ebi and Semenza, 2008; Ebi, 2009; Ford et al., 2018). Adaptation to climate change has become important in international climate policy alongside adaptation frameworks to climate change impact on health (Schipper, 2006; Bowen et al., 2011; Bowen and Friel, 2012). Bowen et al. (2011) present an integrative framework of climate change impact on health, on peoples’ and population vulnerability and adaptive capabilities for resilience building, addressing place and social determinants to emphasize an integral, interdisciplinary framework of governance. Avilez et al. (2016) argue that mitigation and adaptation politics centred around chronic disease prevention will have an opportunity to comply with international climate change agreements and reduce the burden of increased chronic diseases in Peru. It will be important to develop local research-based adaptation frameworks for adaptation policy. The United Nations Framework for Climate Change Convention (UNFCCC) has since 1992 led global climate policy (Ramakrishna, 2000; Schipper, 2006). Their annual intergovernmental meetings and milestone agreements to reduce greenhouse gas emissions, such as Kyoto and Paris agreement, are determining national policy-making (Falkner, 2016). Peru, following the UNFCCC agreements, published its first national communication on climate change mitigation and adaptation strategies in 2001 (CONAM, 2001), followed by its first National Strategy for Climate Change1 (NAP) in 2002 (CONAM, 2002). In 2002, the regionalization process started in Peru and with it the regional responsibility for policy development (Presidencia del Perú, 2002), which led 17 out of 25 regional departments plus Lima Metropolitan to develop their regional climate change strategies between 2009 and 2017 (MINAM, 2016). In 2010, the newly founded Ministry of Environment (2008) published its second national communication, updating on the regional development processes and national advances (MINAM, 2010a). In 2009 and 2011, the Ministry of Environment (MINAM) published guidelines for the development of regional adaptation plans to climate change, which were essential for regional planning processes. In 2014, a legal decree was published to ensure the development of a Health National Adaptation Plan (HNAP) (MINSA, 2014), align with international regulations and the WHO guidelines (WHO, 2014). This is currently in development. In 2015, the updated NAP was published and a third national communication on progress in 2016 (MINAM, 2015, 2016). As per the UNFCCC, the NAP should be integrated into the Peruvian governance system, and into the health system (UNFCCC, 2014). The most distinctive feature of the Peruvian governance system, and particularly its health system, is its fragmentation and decentralization (Alcalde-Rabanal et al., 2011; Velásquez et al., 2016). The Regional and 2015 National Strategies are the latest in a series of projects with the objective of reducing adverse impacts of climate change by conducting vulnerability studies to identify zones and sectors most vulnerable to climate change in order to implement mitigation and adaptation projects (MINAM , 2015; Vieira et al., 2019). How vulnerability studies are related to analysis and particular focus on marginalized populations in each region, who are the ones at highest risk, is a leading question of this analysis. This article seeks to analyse the preparedness of the Peruvian health system for the impacts of climate change through a policy analysis based on the National Strategy for Climate Change and regional strategies for climate change using Walt and Gilson (1994) policy framework. The article argues that health for the most marginalized people is not sufficiently included in the regional strategies to assure health equity under climate change. While the Indigenous and Afro-Peruvian populations inhabit varying regions throughout the country, the accumulation of centuries of institutional and structural racism, leading to their marginalization, will remain as barriers to effective implementation of equitable climate change policies (Castro et al., 2015; Gold, 2016). Even in urban areas, which people of varying socioeconomic statuses co-inhabit, marginalized populations tend to inhabit lower-lying areas prone to flooding and are more so susceptible to poor living conditions in general (Hofmeijer et al., 2013; Francesconi et al., 2015; Sorribas et al., 2016; Bodmer et al., 2017). The article will contribute by characterizing the deficits in the climate change adaptation strategies, specifically in the health sector and identify possible avenues for including the health sector in future adaptation interventions. Materials and methods Context: health care system The Peruvian health care system is divided into various subsystems, each of them providing services to multiple subgroups. The Ministry of Health (MINSA) is the largest and offers services to the majority of the population, there is also EsSalud2, the Armed Forces Health Services, National Police Health services and the private sector (Jiménez et al., 2017). To some extent, each health subsystem in Peru operates as a separate health system, within a much lighter-touch horizontal framework, and with little co-ordination of functions between them (Vermeersch et al., 2014). Peruvians will have different ways of financing health care, depending on their socioeconomic characteristics. The poorest and most vulnerable are financially protected by the governmental Integral Health Insurance, and the Ministry of Health provides them with the care they need (Vammalle et al., 2018), but still a large sector assumes these expenses as out-of-pocket expenses. One additional characteristic of the services provided by the Ministry of Health is that they are decentralized. Regional governments manage all health services through Regional Health Directorates (DIRESA) (Francke, 2013; Vermeersch et al., 2014; Atun et al., 2015; Gold, 2016). The decentralization process, however, does not establish precise mechanisms to define priorities and policies for services (Francke, 2013). Each subsystem operates its clinics and hospitals [health care providers, Institutions of Health Services Provision (IPRESS)].3 Benefits provided are in-kind, following broad provisions set in their corresponding legal frameworks, including preventive and curative services. The types of health interventions depend on the definition of national priorities, policies, plans and financing, as well as the Regional health priorities, policies, procedures and funding, and the capabilities for responding developed by the IPRESS, regarding human resources, technology and supplies. Methodology A policy analysis was conducted to analyse actor, content and context of the 17 out of 25 regional adaptation plans. The Walt and Gilson approach to health policy analysis (Walt and Gilson, 1994; Walt et al., 2008) emphasizes the complexity of social, political and economic interactions that allow us to analyse the health policies found in the Regional Strategy for Climate Change (ERCC) and the 2002 and 2015 National Strategy for Climate Change (ENCC) to follow the decision-making process and discover efficient routes of policy implementation. In accordance with Walt et al. (2008) emphasis on declaring the authors positionality in the research process, the team is composed of senior Peruvian health system and policy experts, who have had or currently have public policy posts in the health system, an anthropologist with Peruvian research experience on environmental degradation and health among indigenous people, and a former MSc student in Global Health and Public Policy. The research has been designed by the senior experts and conducted under the supervision of the senior author by the MSc student as her dissertation project. Policies were triple reviewed by the second first author and the senior author of this article. The experts’ experience played an essential role in the contextualization and interpretation of the research data, supporting the students’ research and developing it afterwards for publication. Walt and Gilson (1994) policy approach considers content, context, process and actors as equally important. The context allows us to determine how health policy has changed, and how future strategies are best implemented. Actors were identified by their role in committees and participation in the execution of objectives as determined by the Regional Strategies for Climate Change (ERCC). Process is mostly affected by the actors and may be determined by the position of the actor, and how they impact the origins, formulation and implementation of policy (Walt and Gilson, 1994). The content analysis evaluates the body of the policy (Walt and Gilson, 1994), which allows us to identify perspective, the possibility of impact and assess the resources addressed within the policy (Araújo and Maciel Filho, 2001). The central question for the content aspect of this policy analysis is whether each plan has addressed critical points brought up in the guidelines provided by the WHO (2014), taking into account that the Peruvian ENCC and ERCC processes started long before the WHO guidelines were published. WHO recommends that for each country working on a NAP there should be a health component, an HNAP. To best align the health adaptation planning process with the national process for developing an HNAP, the WHO (2014) lays out various suggestions. HNAPs should use the best available science, which co-ordinates with the overall national climate change adaptation plan/process, in addition to promoting sustainability of health adaptation efforts. These efforts must co-ordinate regional and national processes and plan to ensure proper implementation and sustainability of health adaptation processes. Additionally, the health sector needs to organize and communicate its institutional arrangements and implement adaptation to climate change at the national level. HNAPs must be specific in ways in which the country can achieve national health adaptation, with resources currently available to them, and building on existing national efforts towards health adaptation to climate change. Essential to include in the HNAP are vulnerability assessments, development and implementation of policies, and programmes at local to national levels. In terms of actors, each plan must establish institutional participants at the national level and include ways for stakeholders to become engaged in the climate adaptation process. It is also vital for the HNAP to take into consideration the ways gender, marginalized groups and communities, and ecosystems will affect said groups concerning climate change. The WHO emphasizes to incorporate traditional and indigenous knowledge in the HNAP. Finally, the HNAP must assess climate risks, identify and plan adaptation options, prioritize health, find solutions for implementing adaptation options and monitor and evaluate adaptation options (WHO, 2014). The leading question here is, to which extend, does this exist on a regional level and what needs to be improved going forward. Data collection The regional and national plans were searched for on Google and government websites, such as the website of the Ministry of Environment, regional governmental entities and the official www.gob.pe website. Latter was particularly useful for ministerial resolutions. Seventeen out of 25 regional adaptation plans were publicly accessible. For a few, there was an updated version, which has also been analysed. For Lima, the regional and the Lima metropolitan plans were collected and analysed. Data analysis: health hazards To identify climate change health hazards, key health risks from the WHO guidelines were combined with crucial health risks found in the adaptation plans and relevant literature (OPS, 2012; Hofmeijer et al., 2013; Gonzales et al., 2014; Ebi and Villalobos Prats, 2015; Burstein Roda, 2016; Figueroa, 2016; Sánchez Zavaleta, 2016). Any natural disasters listed in the plans that are correlated to health problems have been, listed in Table 1. The terms mentioned as health risks throughout the adaptation plans are found in Table 2. Table 1 Health policy analysis of the adaptation plans analysing the steps taken by each department in the process of climate change adaptation Regional department . Plan . Health priority . Vulnerability to climate change . Identify impacts of natural disasters on health . Health risks identified . Actors identified . Environmental health actors . References . Amazonas N/A N/A N/A N/A N/A N/A N/A Ancash Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, health infrastructure No N/A Gobierno Regional de Ancash (2017, pp. 12, 26–30, 66, 74,78) Apurímac Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Water-borne diseases, food security/malnutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure Yes DIRESA, community institutions, Regional Council for Decentraliztion and Health Co-ordination Gobierno Regional de Apurímac (2012, pp. 51–53, 59–60, 79) Arequipa Yes No Yes Heat, flooding/intense rains Water borne diseases, food security/malnutrition, air borne/respiratory infections, skin N/A N/A Gobierno Regional de Arequipa (2009, pp. 17–18) Ayacucho Yes No Yes Heat, flooding/intense rain, drought, frosts, landslides, glide, alluvium Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, occupational health, health infrastructure Yes DIRESA, Helath Networks, local governments, infrastructure management, DREA, Regional Climate Change Council Gobierno Regional de Ayacucho (2015, pp. 47–66, 163, 173, 175, 178–179, 204) Cajamarca Yes No No Flooding/intense rain, frosts, drought, ecosistem-biodiversity Food security/nutrition N/A N/A Gobierno Regional de Cajamarca (2016). Cusco Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño, ecosistema Endocrine/metabolic, food security, parasitic/zoonotic/vector-borne, air-borne/respiratory infections Yes DIRESA Gobierno Regional de Cusco (2012, pp. 24, 34, 52, 58, 60, 64, 82, 94) Huancavelica Yes No Yes Intense rain, solar radiation, strong winds, draught, snow, hail Vector-borne diseases, respiratory infections, skin diseases, ocular diseases, food insecurity, chronic under nutrition N/A DIRESA Gobierno Regional de Huancavelica (2017, pp. 51–57, 102) Huánuco Yes No Yes Flooding/intense rain, strong winds, frosts, glides, landslides vector/zoonotic diseases, respiratory infections, food insecurity, health infrastructure Yes DIRESA, DIGESA, MINSA Gobierno Regional de Huánuco (2017, pp. 48–54, 91, 94–95, 111–112) Ica Yes No Yes Heat, flooding/intense rain, drought, landslides, frosts, El Niño Food security/nutrition, air-borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Ica (2014, pp. 36–37, 57–60, 104, 110) La Libertad Yes N/A Yes Flooding/intense rain, frosts, El Niño Water borne, food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure No DIRESA Gobierno Regional de la Libertad (2011, pp. 25–26, 41) Yes N/A Yes Intense rain, strong winds, draught, snow, hail, El Niño Respiratory infectious disease, diarrheal diseases, health infrastructure Yes Health Ministry and Health Management Gobierno Regional de la Libertad (2016, pp. 19, 38) Lambayeque Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Lambayeque (2010, pp.36–37, 50, 59) Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, epidemics, health infrastructure No DIRESA Gobierno Regional de Lambayeque (2016a, pp.35–39) Lima (Metropolitano) Yes No Yes Heat, flooding/intense rain, drought, frosts, landslide, El Niño Air-borne/respiratory infections, occupational health, skin, food insecurity No Gerencia de salud, MINSA, DIGESA Gerencia del Ambiente (2015, pp. 39, 40) Lima (Regional) Yes No Yes Frost, landslides, intense rain, flooding Respiratory infectious disease, vector-borne diseases, diarrheal diseases Yes Health networks Gobierno Regional de Lima (2015, pp. 57–60) Loreto Yes N/A No Flooding/intense rain, frosts Airborne/respiratory infections No DISA, GOREL, IIAP, MINAG, DISA, MINAM, SENAMHI, UNAP Gobierno Regional de Loreto (2011, pp. 2, 4, 6, 33) Madre de Dios N/A N/A N/A N/A N/A N/A N/A Moquegua N/A N/A N/A N/A N/A N/A N/A Junín Yes No Yes Flooding/intense rain, drought, frosts Water-borne diseases, food security/malnutrition, air-borne/respiratory infections, health infrastructure N/A DIRESA Gobierno Regional Junín (2015, pp. 23, 52, 54–60, 98, 107, 110–111) Pasco N/A N/A N/A N/A N/A N/A N/A Piura Yes No No Heat, flooding/intense rain, drought, frosts, El Niño N/A Yes, but vague DIRESA Gobierno Regional de Piura (2013, p. 23) Puno Yes No Yes Frost, snow, inundation, strong winds, landslides, UV radiation Respiratory, vector-borne, diarrheal diseases N/A DIRESA Gobierno Regional de Puno (2016, pp. 56–64, 123, 128) San Martín N/A N/A N/A N/A N/A N/A N/A Tacna N/A N/A N/A N/A N/A N/A N/A Tumbes N/A N/A N/A N/A N/A N/A N/A Ucayali Yes No Yes Heat, flooding/intense rain, drought, disasters Water-borne diseases, food security/malnutrition, parasitic/zoonotic/ vector-borne, air-borne/respiratory infections, health infrastructure No DIRESA, DESA Gobierno Regional de Ucayali (2013, pp. 74–80, 114) National Adaptation Plan Yes No Yes Flooding/intense rain, drought Parasitic/zoonotic/ vector borne No MINSA MINAM (2015, p. 47) National Adaptation Plan Yes No No N/A No No No CONAM (2002). Regional department . Plan . Health priority . Vulnerability to climate change . Identify impacts of natural disasters on health . Health risks identified . Actors identified . Environmental health actors . References . Amazonas N/A N/A N/A N/A N/A N/A N/A Ancash Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, health infrastructure No N/A Gobierno Regional de Ancash (2017, pp. 12, 26–30, 66, 74,78) Apurímac Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Water-borne diseases, food security/malnutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure Yes DIRESA, community institutions, Regional Council for Decentraliztion and Health Co-ordination Gobierno Regional de Apurímac (2012, pp. 51–53, 59–60, 79) Arequipa Yes No Yes Heat, flooding/intense rains Water borne diseases, food security/malnutrition, air borne/respiratory infections, skin N/A N/A Gobierno Regional de Arequipa (2009, pp. 17–18) Ayacucho Yes No Yes Heat, flooding/intense rain, drought, frosts, landslides, glide, alluvium Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, occupational health, health infrastructure Yes DIRESA, Helath Networks, local governments, infrastructure management, DREA, Regional Climate Change Council Gobierno Regional de Ayacucho (2015, pp. 47–66, 163, 173, 175, 178–179, 204) Cajamarca Yes No No Flooding/intense rain, frosts, drought, ecosistem-biodiversity Food security/nutrition N/A N/A Gobierno Regional de Cajamarca (2016). Cusco Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño, ecosistema Endocrine/metabolic, food security, parasitic/zoonotic/vector-borne, air-borne/respiratory infections Yes DIRESA Gobierno Regional de Cusco (2012, pp. 24, 34, 52, 58, 60, 64, 82, 94) Huancavelica Yes No Yes Intense rain, solar radiation, strong winds, draught, snow, hail Vector-borne diseases, respiratory infections, skin diseases, ocular diseases, food insecurity, chronic under nutrition N/A DIRESA Gobierno Regional de Huancavelica (2017, pp. 51–57, 102) Huánuco Yes No Yes Flooding/intense rain, strong winds, frosts, glides, landslides vector/zoonotic diseases, respiratory infections, food insecurity, health infrastructure Yes DIRESA, DIGESA, MINSA Gobierno Regional de Huánuco (2017, pp. 48–54, 91, 94–95, 111–112) Ica Yes No Yes Heat, flooding/intense rain, drought, landslides, frosts, El Niño Food security/nutrition, air-borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Ica (2014, pp. 36–37, 57–60, 104, 110) La Libertad Yes N/A Yes Flooding/intense rain, frosts, El Niño Water borne, food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure No DIRESA Gobierno Regional de la Libertad (2011, pp. 25–26, 41) Yes N/A Yes Intense rain, strong winds, draught, snow, hail, El Niño Respiratory infectious disease, diarrheal diseases, health infrastructure Yes Health Ministry and Health Management Gobierno Regional de la Libertad (2016, pp. 19, 38) Lambayeque Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Lambayeque (2010, pp.36–37, 50, 59) Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, epidemics, health infrastructure No DIRESA Gobierno Regional de Lambayeque (2016a, pp.35–39) Lima (Metropolitano) Yes No Yes Heat, flooding/intense rain, drought, frosts, landslide, El Niño Air-borne/respiratory infections, occupational health, skin, food insecurity No Gerencia de salud, MINSA, DIGESA Gerencia del Ambiente (2015, pp. 39, 40) Lima (Regional) Yes No Yes Frost, landslides, intense rain, flooding Respiratory infectious disease, vector-borne diseases, diarrheal diseases Yes Health networks Gobierno Regional de Lima (2015, pp. 57–60) Loreto Yes N/A No Flooding/intense rain, frosts Airborne/respiratory infections No DISA, GOREL, IIAP, MINAG, DISA, MINAM, SENAMHI, UNAP Gobierno Regional de Loreto (2011, pp. 2, 4, 6, 33) Madre de Dios N/A N/A N/A N/A N/A N/A N/A Moquegua N/A N/A N/A N/A N/A N/A N/A Junín Yes No Yes Flooding/intense rain, drought, frosts Water-borne diseases, food security/malnutrition, air-borne/respiratory infections, health infrastructure N/A DIRESA Gobierno Regional Junín (2015, pp. 23, 52, 54–60, 98, 107, 110–111) Pasco N/A N/A N/A N/A N/A N/A N/A Piura Yes No No Heat, flooding/intense rain, drought, frosts, El Niño N/A Yes, but vague DIRESA Gobierno Regional de Piura (2013, p. 23) Puno Yes No Yes Frost, snow, inundation, strong winds, landslides, UV radiation Respiratory, vector-borne, diarrheal diseases N/A DIRESA Gobierno Regional de Puno (2016, pp. 56–64, 123, 128) San Martín N/A N/A N/A N/A N/A N/A N/A Tacna N/A N/A N/A N/A N/A N/A N/A Tumbes N/A N/A N/A N/A N/A N/A N/A Ucayali Yes No Yes Heat, flooding/intense rain, drought, disasters Water-borne diseases, food security/malnutrition, parasitic/zoonotic/ vector-borne, air-borne/respiratory infections, health infrastructure No DIRESA, DESA Gobierno Regional de Ucayali (2013, pp. 74–80, 114) National Adaptation Plan Yes No Yes Flooding/intense rain, drought Parasitic/zoonotic/ vector borne No MINSA MINAM (2015, p. 47) National Adaptation Plan Yes No No N/A No No No CONAM (2002). Open in new tab Table 1 Health policy analysis of the adaptation plans analysing the steps taken by each department in the process of climate change adaptation Regional department . Plan . Health priority . Vulnerability to climate change . Identify impacts of natural disasters on health . Health risks identified . Actors identified . Environmental health actors . References . Amazonas N/A N/A N/A N/A N/A N/A N/A Ancash Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, health infrastructure No N/A Gobierno Regional de Ancash (2017, pp. 12, 26–30, 66, 74,78) Apurímac Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Water-borne diseases, food security/malnutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure Yes DIRESA, community institutions, Regional Council for Decentraliztion and Health Co-ordination Gobierno Regional de Apurímac (2012, pp. 51–53, 59–60, 79) Arequipa Yes No Yes Heat, flooding/intense rains Water borne diseases, food security/malnutrition, air borne/respiratory infections, skin N/A N/A Gobierno Regional de Arequipa (2009, pp. 17–18) Ayacucho Yes No Yes Heat, flooding/intense rain, drought, frosts, landslides, glide, alluvium Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, occupational health, health infrastructure Yes DIRESA, Helath Networks, local governments, infrastructure management, DREA, Regional Climate Change Council Gobierno Regional de Ayacucho (2015, pp. 47–66, 163, 173, 175, 178–179, 204) Cajamarca Yes No No Flooding/intense rain, frosts, drought, ecosistem-biodiversity Food security/nutrition N/A N/A Gobierno Regional de Cajamarca (2016). Cusco Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño, ecosistema Endocrine/metabolic, food security, parasitic/zoonotic/vector-borne, air-borne/respiratory infections Yes DIRESA Gobierno Regional de Cusco (2012, pp. 24, 34, 52, 58, 60, 64, 82, 94) Huancavelica Yes No Yes Intense rain, solar radiation, strong winds, draught, snow, hail Vector-borne diseases, respiratory infections, skin diseases, ocular diseases, food insecurity, chronic under nutrition N/A DIRESA Gobierno Regional de Huancavelica (2017, pp. 51–57, 102) Huánuco Yes No Yes Flooding/intense rain, strong winds, frosts, glides, landslides vector/zoonotic diseases, respiratory infections, food insecurity, health infrastructure Yes DIRESA, DIGESA, MINSA Gobierno Regional de Huánuco (2017, pp. 48–54, 91, 94–95, 111–112) Ica Yes No Yes Heat, flooding/intense rain, drought, landslides, frosts, El Niño Food security/nutrition, air-borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Ica (2014, pp. 36–37, 57–60, 104, 110) La Libertad Yes N/A Yes Flooding/intense rain, frosts, El Niño Water borne, food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure No DIRESA Gobierno Regional de la Libertad (2011, pp. 25–26, 41) Yes N/A Yes Intense rain, strong winds, draught, snow, hail, El Niño Respiratory infectious disease, diarrheal diseases, health infrastructure Yes Health Ministry and Health Management Gobierno Regional de la Libertad (2016, pp. 19, 38) Lambayeque Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Lambayeque (2010, pp.36–37, 50, 59) Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, epidemics, health infrastructure No DIRESA Gobierno Regional de Lambayeque (2016a, pp.35–39) Lima (Metropolitano) Yes No Yes Heat, flooding/intense rain, drought, frosts, landslide, El Niño Air-borne/respiratory infections, occupational health, skin, food insecurity No Gerencia de salud, MINSA, DIGESA Gerencia del Ambiente (2015, pp. 39, 40) Lima (Regional) Yes No Yes Frost, landslides, intense rain, flooding Respiratory infectious disease, vector-borne diseases, diarrheal diseases Yes Health networks Gobierno Regional de Lima (2015, pp. 57–60) Loreto Yes N/A No Flooding/intense rain, frosts Airborne/respiratory infections No DISA, GOREL, IIAP, MINAG, DISA, MINAM, SENAMHI, UNAP Gobierno Regional de Loreto (2011, pp. 2, 4, 6, 33) Madre de Dios N/A N/A N/A N/A N/A N/A N/A Moquegua N/A N/A N/A N/A N/A N/A N/A Junín Yes No Yes Flooding/intense rain, drought, frosts Water-borne diseases, food security/malnutrition, air-borne/respiratory infections, health infrastructure N/A DIRESA Gobierno Regional Junín (2015, pp. 23, 52, 54–60, 98, 107, 110–111) Pasco N/A N/A N/A N/A N/A N/A N/A Piura Yes No No Heat, flooding/intense rain, drought, frosts, El Niño N/A Yes, but vague DIRESA Gobierno Regional de Piura (2013, p. 23) Puno Yes No Yes Frost, snow, inundation, strong winds, landslides, UV radiation Respiratory, vector-borne, diarrheal diseases N/A DIRESA Gobierno Regional de Puno (2016, pp. 56–64, 123, 128) San Martín N/A N/A N/A N/A N/A N/A N/A Tacna N/A N/A N/A N/A N/A N/A N/A Tumbes N/A N/A N/A N/A N/A N/A N/A Ucayali Yes No Yes Heat, flooding/intense rain, drought, disasters Water-borne diseases, food security/malnutrition, parasitic/zoonotic/ vector-borne, air-borne/respiratory infections, health infrastructure No DIRESA, DESA Gobierno Regional de Ucayali (2013, pp. 74–80, 114) National Adaptation Plan Yes No Yes Flooding/intense rain, drought Parasitic/zoonotic/ vector borne No MINSA MINAM (2015, p. 47) National Adaptation Plan Yes No No N/A No No No CONAM (2002). Regional department . Plan . Health priority . Vulnerability to climate change . Identify impacts of natural disasters on health . Health risks identified . Actors identified . Environmental health actors . References . Amazonas N/A N/A N/A N/A N/A N/A N/A Ancash Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, health infrastructure No N/A Gobierno Regional de Ancash (2017, pp. 12, 26–30, 66, 74,78) Apurímac Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño Water-borne diseases, food security/malnutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure Yes DIRESA, community institutions, Regional Council for Decentraliztion and Health Co-ordination Gobierno Regional de Apurímac (2012, pp. 51–53, 59–60, 79) Arequipa Yes No Yes Heat, flooding/intense rains Water borne diseases, food security/malnutrition, air borne/respiratory infections, skin N/A N/A Gobierno Regional de Arequipa (2009, pp. 17–18) Ayacucho Yes No Yes Heat, flooding/intense rain, drought, frosts, landslides, glide, alluvium Food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, occupational health, health infrastructure Yes DIRESA, Helath Networks, local governments, infrastructure management, DREA, Regional Climate Change Council Gobierno Regional de Ayacucho (2015, pp. 47–66, 163, 173, 175, 178–179, 204) Cajamarca Yes No No Flooding/intense rain, frosts, drought, ecosistem-biodiversity Food security/nutrition N/A N/A Gobierno Regional de Cajamarca (2016). Cusco Yes No Yes Heat, flooding/intense rain, drought, frosts, El Niño, ecosistema Endocrine/metabolic, food security, parasitic/zoonotic/vector-borne, air-borne/respiratory infections Yes DIRESA Gobierno Regional de Cusco (2012, pp. 24, 34, 52, 58, 60, 64, 82, 94) Huancavelica Yes No Yes Intense rain, solar radiation, strong winds, draught, snow, hail Vector-borne diseases, respiratory infections, skin diseases, ocular diseases, food insecurity, chronic under nutrition N/A DIRESA Gobierno Regional de Huancavelica (2017, pp. 51–57, 102) Huánuco Yes No Yes Flooding/intense rain, strong winds, frosts, glides, landslides vector/zoonotic diseases, respiratory infections, food insecurity, health infrastructure Yes DIRESA, DIGESA, MINSA Gobierno Regional de Huánuco (2017, pp. 48–54, 91, 94–95, 111–112) Ica Yes No Yes Heat, flooding/intense rain, drought, landslides, frosts, El Niño Food security/nutrition, air-borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Ica (2014, pp. 36–37, 57–60, 104, 110) La Libertad Yes N/A Yes Flooding/intense rain, frosts, El Niño Water borne, food security/nutrition, parasitic/zoonotic/vector-borne, air-borne/respiratory infections, skin, health infrastructure No DIRESA Gobierno Regional de la Libertad (2011, pp. 25–26, 41) Yes N/A Yes Intense rain, strong winds, draught, snow, hail, El Niño Respiratory infectious disease, diarrheal diseases, health infrastructure Yes Health Ministry and Health Management Gobierno Regional de la Libertad (2016, pp. 19, 38) Lambayeque Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, health infrastructure Yes DIRESA Gobierno Regional de Lambayeque (2010, pp.36–37, 50, 59) Yes No Yes Flooding/intense rain, drought, El Niño Water borne diseases, food security/malnutrition, parasitic/zoonotic/vector borne, air borne/respiratory infections, epidemics, health infrastructure No DIRESA Gobierno Regional de Lambayeque (2016a, pp.35–39) Lima (Metropolitano) Yes No Yes Heat, flooding/intense rain, drought, frosts, landslide, El Niño Air-borne/respiratory infections, occupational health, skin, food insecurity No Gerencia de salud, MINSA, DIGESA Gerencia del Ambiente (2015, pp. 39, 40) Lima (Regional) Yes No Yes Frost, landslides, intense rain, flooding Respiratory infectious disease, vector-borne diseases, diarrheal diseases Yes Health networks Gobierno Regional de Lima (2015, pp. 57–60) Loreto Yes N/A No Flooding/intense rain, frosts Airborne/respiratory infections No DISA, GOREL, IIAP, MINAG, DISA, MINAM, SENAMHI, UNAP Gobierno Regional de Loreto (2011, pp. 2, 4, 6, 33) Madre de Dios N/A N/A N/A N/A N/A N/A N/A Moquegua N/A N/A N/A N/A N/A N/A N/A Junín Yes No Yes Flooding/intense rain, drought, frosts Water-borne diseases, food security/malnutrition, air-borne/respiratory infections, health infrastructure N/A DIRESA Gobierno Regional Junín (2015, pp. 23, 52, 54–60, 98, 107, 110–111) Pasco N/A N/A N/A N/A N/A N/A N/A Piura Yes No No Heat, flooding/intense rain, drought, frosts, El Niño N/A Yes, but vague DIRESA Gobierno Regional de Piura (2013, p. 23) Puno Yes No Yes Frost, snow, inundation, strong winds, landslides, UV radiation Respiratory, vector-borne, diarrheal diseases N/A DIRESA Gobierno Regional de Puno (2016, pp. 56–64, 123, 128) San Martín N/A N/A N/A N/A N/A N/A N/A Tacna N/A N/A N/A N/A N/A N/A N/A Tumbes N/A N/A N/A N/A N/A N/A N/A Ucayali Yes No Yes Heat, flooding/intense rain, drought, disasters Water-borne diseases, food security/malnutrition, parasitic/zoonotic/ vector-borne, air-borne/respiratory infections, health infrastructure No DIRESA, DESA Gobierno Regional de Ucayali (2013, pp. 74–80, 114) National Adaptation Plan Yes No Yes Flooding/intense rain, drought Parasitic/zoonotic/ vector borne No MINSA MINAM (2015, p. 47) National Adaptation Plan Yes No No N/A No No No CONAM (2002). Open in new tab Table 2 Terms mentioned as health risks throughout the adaptation plans (Gobierno Regional de Arequipa, 2009; MINAM, 2010a; Gobierno Regional de la Libertad, 2011; Gobierno Regional de Loreto, 2011; Gobierno Regional de Cusco, 2012; Gobierno Regional de Apurímac, 2012; Gobierno Regional de Piura, 2013; Gobierno Regional de Ica, 2014; Gobierno Regional de Lambayeque, 2014; Gobierno Regional de Ucayali , 2014; Gerencia del Ambiente, 2015; Gobierno Regional de Ayacucho, 2015; MINAM , 2015; Gobierno Regional de Ancash , 2017). Health risk . Translation . Metaxenica Vector-transmitted diseases Dengue Dengue Malaria Malaria Desnutrición Malnutrition IRA (infección respiratoria aguda) Acute respiratory infection Diarrea Diarrhoea EDA (enfermedades diarreicas agudas) Acute diarrheal infection Infecciosa Infectious Vectores Vector Eventos extremos Extreme events Eventos climáticos Climatic events Health risk . Translation . Metaxenica Vector-transmitted diseases Dengue Dengue Malaria Malaria Desnutrición Malnutrition IRA (infección respiratoria aguda) Acute respiratory infection Diarrea Diarrhoea EDA (enfermedades diarreicas agudas) Acute diarrheal infection Infecciosa Infectious Vectores Vector Eventos extremos Extreme events Eventos climáticos Climatic events Open in new tab Table 2 Terms mentioned as health risks throughout the adaptation plans (Gobierno Regional de Arequipa, 2009; MINAM, 2010a; Gobierno Regional de la Libertad, 2011; Gobierno Regional de Loreto, 2011; Gobierno Regional de Cusco, 2012; Gobierno Regional de Apurímac, 2012; Gobierno Regional de Piura, 2013; Gobierno Regional de Ica, 2014; Gobierno Regional de Lambayeque, 2014; Gobierno Regional de Ucayali , 2014; Gerencia del Ambiente, 2015; Gobierno Regional de Ayacucho, 2015; MINAM , 2015; Gobierno Regional de Ancash , 2017). Health risk . Translation . Metaxenica Vector-transmitted diseases Dengue Dengue Malaria Malaria Desnutrición Malnutrition IRA (infección respiratoria aguda) Acute respiratory infection Diarrea Diarrhoea EDA (enfermedades diarreicas agudas) Acute diarrheal infection Infecciosa Infectious Vectores Vector Eventos extremos Extreme events Eventos climáticos Climatic events Health risk . Translation . Metaxenica Vector-transmitted diseases Dengue Dengue Malaria Malaria Desnutrición Malnutrition IRA (infección respiratoria aguda) Acute respiratory infection Diarrea Diarrhoea EDA (enfermedades diarreicas agudas) Acute diarrheal infection Infecciosa Infectious Vectores Vector Eventos extremos Extreme events Eventos climáticos Climatic events Open in new tab Although mental health was not mentioned in any of the Regional Climate Change Strategies (ERCC) or the WHO guidance, it was included in the analysis. Inclusion in the study highlights the erasure of mental health from the climate change conversation, despite research explaining that mental health disorders such as anxiety, PTSD, aggression and depression will increase with climate change variability (Berry et al., 2010; Padhy et al., 2015; Levy et al., 2017; Rossati, 2017). The ‘WHO Guidance’ (WHO, 2014) informs the content analysis. The WHO (2014) recommends that for each country working on an NAP, there should be a health component, which entitled HNAP. In order to best align the health adaptation planning process with the national process for developing an HNAP, the WHO presents 11 steps, covering groundwork and knowledge assessment, preparatory elements, implementation and monitoring. Ebi and Villalobos Prats (2015) present a detailed analysis of the steps and challenges for national governments. The WHO guidelines are designed very generally to allow for individual countries to adapt to their own contexts within a participatory process. However, for countries which do not have strong research evidence, quality of health data and frameworks for adaptation on climate change impact on health, the guidelines provide a challenge (Ebi and Villalobos Prats, 2015). Results Actors As part of the NAP process, the government released a document detailing workshops held to monitor advances in the NAP process, and ways in which different actors have been working and can work together in its planification and implementation (Cancino, 2016). The Guide for the Building of the Regional Strategy for Climate Change (MINAM, 2011, 2009) gives insight into the proposed composition of actors to be involved in the process. Although climate change will significantly impact health, the health sector is often left out of climate change discussions. Numerous plans laid out the composition of the Regional Technical Group for Climate Change (RTGCG). This included details for how the duties would be divided into proposing the plan, co-ordination, approval and execution. The institutional mapping in Table 3 details the ways in which regional departments organized the RTGCCs, and ways in which the responsibilities have been divided between government and non-governmental organizations. Table 3 List of actors for each step of the Regional Climate Change Strategies implementation Region . Propose plan . Co-ordinate plan . Approve plan . Execute plan . References . Amazonas GTRCC-Regional Technical Groups for Climate Change Regional agency for natural resources and environmental management CAR-Regional Environmental Commission Regional Government Regional Council Regional Agency for Natural Resources and Environmental Management Regional Co-ordination Council Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ancash Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Natural Resource Commission and Regional Environmental Council Projects ‘Asegurando el agua y los medios de vida en las montañas (Instituto de Montaña/USAID), “Glaciares” (CARE/Universidad de Zurich/ Cosude), “IMAAC” (Minam/BID)’. CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Ancash (2017) Apurímac CAR-Regional Environmental Commission Regional Technical Group on Vulnerability and Climate Change Adaptation CAR-Technical Groups and Thematic Groups ERCC-Driving Committee Regional Operational Unit of Climate Change Programmes and Projects Climate Change Adaptation Programme CAR-Regional Environmental Commission Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Operational Unit of Climate Change Programmes and Projects PACC-Climate Change Adaptation Programme Regional Government Regional Council Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Governments and Regional Directors Regional Directorate of Education Regional Directorate of Health Regional Directorate of Housing, Construction, and Sanitation Regional Directorate of Transport and Communication Regional Directorate of Energy and Mining Regional Directorate of Production Regional Directorate of Agriculture Local governments Peasant communities NGOs Climate Change Adaptation Programme Universities Water providers Private companies (mining) Gobierno Regional de Apurímac (2012) Arequipa Regional Environmental Authority Development Management of the Special Project COPASA AUTODEMA Project Majes Siguas II Regional Agricultural Management Regional Energy and Mining Management Regional Government Provincial Municipalities NGO’s Universities Regional Environmental Council Regional Government Regional Council Regional Environmental Authority- ARMA Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ayacucho GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional Government of Ayacucho Gobierno Regional de Ayacucho (2015) Cajamarca GTRCC-Regional Technical Groups for Climate Change and Risk Management RENAMA-Regional Management of Natural Resources and Environmental Management Regional Environmental Commission Regional Government Regional Council Management and Regional Directorates of the Regional Government of Cajamarca Provincial and district municipalities Public decentralized sectorial institutions Universities Business associations and private enterprises Civil society Gobierno Regional de Cajamarca (2016) Cusco GTRCC-Regional Technical Groups for Climate Change Working groups for: Climate and risk management Biodiversity Governance Food security Water Energy Education Health Regional Government Regional Council Regional Government of Cusco Gobierno Regional de Cusco (2012) Huánuco GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huanuco Gobierno Regional de Huánuco (2017) Huancavelica GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huancavelica Gobierno Regional de Huancavelica (2017) Ica Call for institutions and local actors Formalization, presentation and installation of GTRCC—Regional Technical Groups for Climate Change Elaboration for the work plan of the GTRCC Diagnosis elaboration, development of the proposal (GTRCC) General working for the ERCC document for approval Public presentation of the ERCC Decentralized provincial consultation Regional Government Regional Council Regional Government of Ica Regional Environmental Council GTRCC Provincial and district municipalities Civil society Gobierno Regional de Ica(2014) La Libertad GTRCC-Regional Technical Groups for Climate Change Regional Government Regional Environmental Council Regional Government Regional Council Regional Government Universities CONCYTEC-National Council for Science and Technology Municipalities Gobierno Regional de la Libertad (2011) Regional Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Management Gobierno Regional de la Libertad (2016) Lambayeque GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Government Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2010) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Management for Natural Resources and Environmental Management Regional Council General Regional Management Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2016a) Lima (Metropolitan) GTRCC-Regional Technical Groups for Climate Change Technical Metropolitan Group of the Environmental Municipality Council Submanagement of Natural Resources and Environmental Programme of the Regional Government of Metropolitan Lima Environmental Management Metropolitan Municipality of Lima Metropolitan Municipality of Lima Gerencia Ambiental de Lima (2015) Lima Provincias GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Council Regional Management of Natural Resources and Environmental Management Regional Management for Planning, Budget and Territorial Conditioning Gerencia del Ambiente (2016) Loreto GTRCC-Regional Technical Groups for Climate Change UIAP-Research Institute for Peruvian Amazon INIA-National Institute for Agricultural Innovation UNAP-Universidad Nacional de la Amazonía Peruana UCP-Universidad Científica del Perú UPO-Universidad Peruana del Oriente GOREL-Loreto Regional Government Regional Municipalities Regional Government Regional Council GOREL-Loreto Regional Government IIAP-Research Institute for Peruvian Amazon MINAGRI-Ministry of Agriculture and Irrigation MINAM-Ministry of Environment UNAP-Universidad Nacional de la Amazonía Peruana MINEM-Ministry of Energy and Mining Gobierno Regional de Loreto (2011) Madre de Dios N/A N/A N/A N/A Moquegua N/A N/A N/A N/A Junín GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change DGCCDRH—MINAM PNUD EbA Montaña Regional Government of Junín Local governments Private organizations Universities Civil society Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Gobierno Regional Junín (2015) Pasco N/A N/A N/A N/A Piura GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change Regional Management of Natural Resources and Environmental Governance Regional Directorate of Agriculture Piura SENAMHI Administrative Water Authority Rural Sustainable Development Programme of the Regional Government of Piura Departmental Council for the Fight Against Desertification and Draught National University of Piura Private institutions Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Regional Management of Planning Budget and Territorial Conditioning Gobierno Regional de Piura (2013) Puno Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Puno (2016) San Martín N/A N/A N/A N/A Tacna N/A N/A N/A N/A Tumbes N/A N/A N/A N/A Ucayali GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Authority Regional Management of Natural Resources and Environmental Management Gobierno Regional de Ucayali (2014) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Comisión Ambiental Regional Convention for Biological Diversity Regional Management Group for Planning and Budget Regional Social Development Management Regional Economic Development Management Regional Infrastructure Management Regional directorates of the Regional Ucayali Governement Gobierno Regional de Ucayali (2014) and Gobierno Regional de Ucayali (2019) National Adaptation Plan National Commission for Climate Change Ad-hoc technical groups National Commission for Climate Change General Directorate of Climate Change, Desertification and Hydraulic Resources at MINAM MINAM National Commission for Climate Change MINAM (2015) National Adaptation Plan National Environmental Council–CONAM National Commission for Climate Change National Commission for Climate Change CONAM National Commission for Climate Change (CONCYTEC, Ministry of Foreign Affairs, Confiep, FONAM, IMARPE, INRENA, MEF, Ministry of Transport and Communication, Ministry of Energy and Mines, PCM, PRODUCE, SENAMHI) CONAM (2002) Region . Propose plan . Co-ordinate plan . Approve plan . Execute plan . References . Amazonas GTRCC-Regional Technical Groups for Climate Change Regional agency for natural resources and environmental management CAR-Regional Environmental Commission Regional Government Regional Council Regional Agency for Natural Resources and Environmental Management Regional Co-ordination Council Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ancash Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Natural Resource Commission and Regional Environmental Council Projects ‘Asegurando el agua y los medios de vida en las montañas (Instituto de Montaña/USAID), “Glaciares” (CARE/Universidad de Zurich/ Cosude), “IMAAC” (Minam/BID)’. CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Ancash (2017) Apurímac CAR-Regional Environmental Commission Regional Technical Group on Vulnerability and Climate Change Adaptation CAR-Technical Groups and Thematic Groups ERCC-Driving Committee Regional Operational Unit of Climate Change Programmes and Projects Climate Change Adaptation Programme CAR-Regional Environmental Commission Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Operational Unit of Climate Change Programmes and Projects PACC-Climate Change Adaptation Programme Regional Government Regional Council Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Governments and Regional Directors Regional Directorate of Education Regional Directorate of Health Regional Directorate of Housing, Construction, and Sanitation Regional Directorate of Transport and Communication Regional Directorate of Energy and Mining Regional Directorate of Production Regional Directorate of Agriculture Local governments Peasant communities NGOs Climate Change Adaptation Programme Universities Water providers Private companies (mining) Gobierno Regional de Apurímac (2012) Arequipa Regional Environmental Authority Development Management of the Special Project COPASA AUTODEMA Project Majes Siguas II Regional Agricultural Management Regional Energy and Mining Management Regional Government Provincial Municipalities NGO’s Universities Regional Environmental Council Regional Government Regional Council Regional Environmental Authority- ARMA Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ayacucho GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional Government of Ayacucho Gobierno Regional de Ayacucho (2015) Cajamarca GTRCC-Regional Technical Groups for Climate Change and Risk Management RENAMA-Regional Management of Natural Resources and Environmental Management Regional Environmental Commission Regional Government Regional Council Management and Regional Directorates of the Regional Government of Cajamarca Provincial and district municipalities Public decentralized sectorial institutions Universities Business associations and private enterprises Civil society Gobierno Regional de Cajamarca (2016) Cusco GTRCC-Regional Technical Groups for Climate Change Working groups for: Climate and risk management Biodiversity Governance Food security Water Energy Education Health Regional Government Regional Council Regional Government of Cusco Gobierno Regional de Cusco (2012) Huánuco GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huanuco Gobierno Regional de Huánuco (2017) Huancavelica GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huancavelica Gobierno Regional de Huancavelica (2017) Ica Call for institutions and local actors Formalization, presentation and installation of GTRCC—Regional Technical Groups for Climate Change Elaboration for the work plan of the GTRCC Diagnosis elaboration, development of the proposal (GTRCC) General working for the ERCC document for approval Public presentation of the ERCC Decentralized provincial consultation Regional Government Regional Council Regional Government of Ica Regional Environmental Council GTRCC Provincial and district municipalities Civil society Gobierno Regional de Ica(2014) La Libertad GTRCC-Regional Technical Groups for Climate Change Regional Government Regional Environmental Council Regional Government Regional Council Regional Government Universities CONCYTEC-National Council for Science and Technology Municipalities Gobierno Regional de la Libertad (2011) Regional Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Management Gobierno Regional de la Libertad (2016) Lambayeque GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Government Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2010) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Management for Natural Resources and Environmental Management Regional Council General Regional Management Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2016a) Lima (Metropolitan) GTRCC-Regional Technical Groups for Climate Change Technical Metropolitan Group of the Environmental Municipality Council Submanagement of Natural Resources and Environmental Programme of the Regional Government of Metropolitan Lima Environmental Management Metropolitan Municipality of Lima Metropolitan Municipality of Lima Gerencia Ambiental de Lima (2015) Lima Provincias GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Council Regional Management of Natural Resources and Environmental Management Regional Management for Planning, Budget and Territorial Conditioning Gerencia del Ambiente (2016) Loreto GTRCC-Regional Technical Groups for Climate Change UIAP-Research Institute for Peruvian Amazon INIA-National Institute for Agricultural Innovation UNAP-Universidad Nacional de la Amazonía Peruana UCP-Universidad Científica del Perú UPO-Universidad Peruana del Oriente GOREL-Loreto Regional Government Regional Municipalities Regional Government Regional Council GOREL-Loreto Regional Government IIAP-Research Institute for Peruvian Amazon MINAGRI-Ministry of Agriculture and Irrigation MINAM-Ministry of Environment UNAP-Universidad Nacional de la Amazonía Peruana MINEM-Ministry of Energy and Mining Gobierno Regional de Loreto (2011) Madre de Dios N/A N/A N/A N/A Moquegua N/A N/A N/A N/A Junín GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change DGCCDRH—MINAM PNUD EbA Montaña Regional Government of Junín Local governments Private organizations Universities Civil society Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Gobierno Regional Junín (2015) Pasco N/A N/A N/A N/A Piura GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change Regional Management of Natural Resources and Environmental Governance Regional Directorate of Agriculture Piura SENAMHI Administrative Water Authority Rural Sustainable Development Programme of the Regional Government of Piura Departmental Council for the Fight Against Desertification and Draught National University of Piura Private institutions Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Regional Management of Planning Budget and Territorial Conditioning Gobierno Regional de Piura (2013) Puno Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Puno (2016) San Martín N/A N/A N/A N/A Tacna N/A N/A N/A N/A Tumbes N/A N/A N/A N/A Ucayali GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Authority Regional Management of Natural Resources and Environmental Management Gobierno Regional de Ucayali (2014) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Comisión Ambiental Regional Convention for Biological Diversity Regional Management Group for Planning and Budget Regional Social Development Management Regional Economic Development Management Regional Infrastructure Management Regional directorates of the Regional Ucayali Governement Gobierno Regional de Ucayali (2014) and Gobierno Regional de Ucayali (2019) National Adaptation Plan National Commission for Climate Change Ad-hoc technical groups National Commission for Climate Change General Directorate of Climate Change, Desertification and Hydraulic Resources at MINAM MINAM National Commission for Climate Change MINAM (2015) National Adaptation Plan National Environmental Council–CONAM National Commission for Climate Change National Commission for Climate Change CONAM National Commission for Climate Change (CONCYTEC, Ministry of Foreign Affairs, Confiep, FONAM, IMARPE, INRENA, MEF, Ministry of Transport and Communication, Ministry of Energy and Mines, PCM, PRODUCE, SENAMHI) CONAM (2002) Open in new tab Table 3 List of actors for each step of the Regional Climate Change Strategies implementation Region . Propose plan . Co-ordinate plan . Approve plan . Execute plan . References . Amazonas GTRCC-Regional Technical Groups for Climate Change Regional agency for natural resources and environmental management CAR-Regional Environmental Commission Regional Government Regional Council Regional Agency for Natural Resources and Environmental Management Regional Co-ordination Council Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ancash Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Natural Resource Commission and Regional Environmental Council Projects ‘Asegurando el agua y los medios de vida en las montañas (Instituto de Montaña/USAID), “Glaciares” (CARE/Universidad de Zurich/ Cosude), “IMAAC” (Minam/BID)’. CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Ancash (2017) Apurímac CAR-Regional Environmental Commission Regional Technical Group on Vulnerability and Climate Change Adaptation CAR-Technical Groups and Thematic Groups ERCC-Driving Committee Regional Operational Unit of Climate Change Programmes and Projects Climate Change Adaptation Programme CAR-Regional Environmental Commission Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Operational Unit of Climate Change Programmes and Projects PACC-Climate Change Adaptation Programme Regional Government Regional Council Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Governments and Regional Directors Regional Directorate of Education Regional Directorate of Health Regional Directorate of Housing, Construction, and Sanitation Regional Directorate of Transport and Communication Regional Directorate of Energy and Mining Regional Directorate of Production Regional Directorate of Agriculture Local governments Peasant communities NGOs Climate Change Adaptation Programme Universities Water providers Private companies (mining) Gobierno Regional de Apurímac (2012) Arequipa Regional Environmental Authority Development Management of the Special Project COPASA AUTODEMA Project Majes Siguas II Regional Agricultural Management Regional Energy and Mining Management Regional Government Provincial Municipalities NGO’s Universities Regional Environmental Council Regional Government Regional Council Regional Environmental Authority- ARMA Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ayacucho GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional Government of Ayacucho Gobierno Regional de Ayacucho (2015) Cajamarca GTRCC-Regional Technical Groups for Climate Change and Risk Management RENAMA-Regional Management of Natural Resources and Environmental Management Regional Environmental Commission Regional Government Regional Council Management and Regional Directorates of the Regional Government of Cajamarca Provincial and district municipalities Public decentralized sectorial institutions Universities Business associations and private enterprises Civil society Gobierno Regional de Cajamarca (2016) Cusco GTRCC-Regional Technical Groups for Climate Change Working groups for: Climate and risk management Biodiversity Governance Food security Water Energy Education Health Regional Government Regional Council Regional Government of Cusco Gobierno Regional de Cusco (2012) Huánuco GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huanuco Gobierno Regional de Huánuco (2017) Huancavelica GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huancavelica Gobierno Regional de Huancavelica (2017) Ica Call for institutions and local actors Formalization, presentation and installation of GTRCC—Regional Technical Groups for Climate Change Elaboration for the work plan of the GTRCC Diagnosis elaboration, development of the proposal (GTRCC) General working for the ERCC document for approval Public presentation of the ERCC Decentralized provincial consultation Regional Government Regional Council Regional Government of Ica Regional Environmental Council GTRCC Provincial and district municipalities Civil society Gobierno Regional de Ica(2014) La Libertad GTRCC-Regional Technical Groups for Climate Change Regional Government Regional Environmental Council Regional Government Regional Council Regional Government Universities CONCYTEC-National Council for Science and Technology Municipalities Gobierno Regional de la Libertad (2011) Regional Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Management Gobierno Regional de la Libertad (2016) Lambayeque GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Government Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2010) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Management for Natural Resources and Environmental Management Regional Council General Regional Management Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2016a) Lima (Metropolitan) GTRCC-Regional Technical Groups for Climate Change Technical Metropolitan Group of the Environmental Municipality Council Submanagement of Natural Resources and Environmental Programme of the Regional Government of Metropolitan Lima Environmental Management Metropolitan Municipality of Lima Metropolitan Municipality of Lima Gerencia Ambiental de Lima (2015) Lima Provincias GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Council Regional Management of Natural Resources and Environmental Management Regional Management for Planning, Budget and Territorial Conditioning Gerencia del Ambiente (2016) Loreto GTRCC-Regional Technical Groups for Climate Change UIAP-Research Institute for Peruvian Amazon INIA-National Institute for Agricultural Innovation UNAP-Universidad Nacional de la Amazonía Peruana UCP-Universidad Científica del Perú UPO-Universidad Peruana del Oriente GOREL-Loreto Regional Government Regional Municipalities Regional Government Regional Council GOREL-Loreto Regional Government IIAP-Research Institute for Peruvian Amazon MINAGRI-Ministry of Agriculture and Irrigation MINAM-Ministry of Environment UNAP-Universidad Nacional de la Amazonía Peruana MINEM-Ministry of Energy and Mining Gobierno Regional de Loreto (2011) Madre de Dios N/A N/A N/A N/A Moquegua N/A N/A N/A N/A Junín GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change DGCCDRH—MINAM PNUD EbA Montaña Regional Government of Junín Local governments Private organizations Universities Civil society Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Gobierno Regional Junín (2015) Pasco N/A N/A N/A N/A Piura GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change Regional Management of Natural Resources and Environmental Governance Regional Directorate of Agriculture Piura SENAMHI Administrative Water Authority Rural Sustainable Development Programme of the Regional Government of Piura Departmental Council for the Fight Against Desertification and Draught National University of Piura Private institutions Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Regional Management of Planning Budget and Territorial Conditioning Gobierno Regional de Piura (2013) Puno Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Puno (2016) San Martín N/A N/A N/A N/A Tacna N/A N/A N/A N/A Tumbes N/A N/A N/A N/A Ucayali GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Authority Regional Management of Natural Resources and Environmental Management Gobierno Regional de Ucayali (2014) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Comisión Ambiental Regional Convention for Biological Diversity Regional Management Group for Planning and Budget Regional Social Development Management Regional Economic Development Management Regional Infrastructure Management Regional directorates of the Regional Ucayali Governement Gobierno Regional de Ucayali (2014) and Gobierno Regional de Ucayali (2019) National Adaptation Plan National Commission for Climate Change Ad-hoc technical groups National Commission for Climate Change General Directorate of Climate Change, Desertification and Hydraulic Resources at MINAM MINAM National Commission for Climate Change MINAM (2015) National Adaptation Plan National Environmental Council–CONAM National Commission for Climate Change National Commission for Climate Change CONAM National Commission for Climate Change (CONCYTEC, Ministry of Foreign Affairs, Confiep, FONAM, IMARPE, INRENA, MEF, Ministry of Transport and Communication, Ministry of Energy and Mines, PCM, PRODUCE, SENAMHI) CONAM (2002) Region . Propose plan . Co-ordinate plan . Approve plan . Execute plan . References . Amazonas GTRCC-Regional Technical Groups for Climate Change Regional agency for natural resources and environmental management CAR-Regional Environmental Commission Regional Government Regional Council Regional Agency for Natural Resources and Environmental Management Regional Co-ordination Council Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ancash Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Natural Resource Commission and Regional Environmental Council Projects ‘Asegurando el agua y los medios de vida en las montañas (Instituto de Montaña/USAID), “Glaciares” (CARE/Universidad de Zurich/ Cosude), “IMAAC” (Minam/BID)’. CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Ancash (2017) Apurímac CAR-Regional Environmental Commission Regional Technical Group on Vulnerability and Climate Change Adaptation CAR-Technical Groups and Thematic Groups ERCC-Driving Committee Regional Operational Unit of Climate Change Programmes and Projects Climate Change Adaptation Programme CAR-Regional Environmental Commission Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Operational Unit of Climate Change Programmes and Projects PACC-Climate Change Adaptation Programme Regional Government Regional Council Natural Resources and Environmental Management Regional Technical Group on Vulnerability and Climate Change Adaptation Regional Governments and Regional Directors Regional Directorate of Education Regional Directorate of Health Regional Directorate of Housing, Construction, and Sanitation Regional Directorate of Transport and Communication Regional Directorate of Energy and Mining Regional Directorate of Production Regional Directorate of Agriculture Local governments Peasant communities NGOs Climate Change Adaptation Programme Universities Water providers Private companies (mining) Gobierno Regional de Apurímac (2012) Arequipa Regional Environmental Authority Development Management of the Special Project COPASA AUTODEMA Project Majes Siguas II Regional Agricultural Management Regional Energy and Mining Management Regional Government Provincial Municipalities NGO’s Universities Regional Environmental Council Regional Government Regional Council Regional Environmental Authority- ARMA Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014) Ayacucho GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional Government of Ayacucho Gobierno Regional de Ayacucho (2015) Cajamarca GTRCC-Regional Technical Groups for Climate Change and Risk Management RENAMA-Regional Management of Natural Resources and Environmental Management Regional Environmental Commission Regional Government Regional Council Management and Regional Directorates of the Regional Government of Cajamarca Provincial and district municipalities Public decentralized sectorial institutions Universities Business associations and private enterprises Civil society Gobierno Regional de Cajamarca (2016) Cusco GTRCC-Regional Technical Groups for Climate Change Working groups for: Climate and risk management Biodiversity Governance Food security Water Energy Education Health Regional Government Regional Council Regional Government of Cusco Gobierno Regional de Cusco (2012) Huánuco GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huanuco Gobierno Regional de Huánuco (2017) Huancavelica GTRCC-Regional Technical Groups for Climate Change Regional Agency for Natural Resources and Environmental Management GTRCC Regional Government Regional Council Regional Government of Huancavelica Gobierno Regional de Huancavelica (2017) Ica Call for institutions and local actors Formalization, presentation and installation of GTRCC—Regional Technical Groups for Climate Change Elaboration for the work plan of the GTRCC Diagnosis elaboration, development of the proposal (GTRCC) General working for the ERCC document for approval Public presentation of the ERCC Decentralized provincial consultation Regional Government Regional Council Regional Government of Ica Regional Environmental Council GTRCC Provincial and district municipalities Civil society Gobierno Regional de Ica(2014) La Libertad GTRCC-Regional Technical Groups for Climate Change Regional Government Regional Environmental Council Regional Government Regional Council Regional Government Universities CONCYTEC-National Council for Science and Technology Municipalities Gobierno Regional de la Libertad (2011) Regional Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Management Gobierno Regional de la Libertad (2016) Lambayeque GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Government Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2010) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Management for Natural Resources and Environmental Management Regional Council General Regional Management Regional Management of Natural Resources and Environmental Management Gobierno Regional de Lambayeque (2016a) Lima (Metropolitan) GTRCC-Regional Technical Groups for Climate Change Technical Metropolitan Group of the Environmental Municipality Council Submanagement of Natural Resources and Environmental Programme of the Regional Government of Metropolitan Lima Environmental Management Metropolitan Municipality of Lima Metropolitan Municipality of Lima Gerencia Ambiental de Lima (2015) Lima Provincias GTRCC-Regional Technical Groups for Climate Change Regional Management for Natural Resources and Environmental Management Regional Council Regional Management of Natural Resources and Environmental Management Regional Management for Planning, Budget and Territorial Conditioning Gerencia del Ambiente (2016) Loreto GTRCC-Regional Technical Groups for Climate Change UIAP-Research Institute for Peruvian Amazon INIA-National Institute for Agricultural Innovation UNAP-Universidad Nacional de la Amazonía Peruana UCP-Universidad Científica del Perú UPO-Universidad Peruana del Oriente GOREL-Loreto Regional Government Regional Municipalities Regional Government Regional Council GOREL-Loreto Regional Government IIAP-Research Institute for Peruvian Amazon MINAGRI-Ministry of Agriculture and Irrigation MINAM-Ministry of Environment UNAP-Universidad Nacional de la Amazonía Peruana MINEM-Ministry of Energy and Mining Gobierno Regional de Loreto (2011) Madre de Dios N/A N/A N/A N/A Moquegua N/A N/A N/A N/A Junín GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change DGCCDRH—MINAM PNUD EbA Montaña Regional Government of Junín Local governments Private organizations Universities Civil society Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Gobierno Regional Junín (2015) Pasco N/A N/A N/A N/A Piura GTRCC-Regional Technical Groups for Climate Change GTRCC-Regional Technical Groups for Climate Change Regional Management of Natural Resources and Environmental Governance Regional Directorate of Agriculture Piura SENAMHI Administrative Water Authority Rural Sustainable Development Programme of the Regional Government of Piura Departmental Council for the Fight Against Desertification and Draught National University of Piura Private institutions Regional Government Regional Council Regional Management of Natural Resources and Environmental Governance Regional Management of Planning Budget and Territorial Conditioning Gobierno Regional de Piura (2013) Puno Regional Agency for Natural Resources and Environmental Management GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Agency for Natural Resources and Environmental Management Regional Government Regional Council Regional, local, and provincial governments Civil society-Environment and development NGOs, community organizations Private institutions, research and educational institutions Other public institutions Gobierno Regional de Puno (2016) San Martín N/A N/A N/A N/A Tacna N/A N/A N/A N/A Tumbes N/A N/A N/A N/A Ucayali GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Regional Environmental Authority Regional Management of Natural Resources and Environmental Management Gobierno Regional de Ucayali (2014) GTRCC-Regional Technical Groups for Climate Change CAR-Regional Environmental Commission Regional Council Comisión Ambiental Regional Convention for Biological Diversity Regional Management Group for Planning and Budget Regional Social Development Management Regional Economic Development Management Regional Infrastructure Management Regional directorates of the Regional Ucayali Governement Gobierno Regional de Ucayali (2014) and Gobierno Regional de Ucayali (2019) National Adaptation Plan National Commission for Climate Change Ad-hoc technical groups National Commission for Climate Change General Directorate of Climate Change, Desertification and Hydraulic Resources at MINAM MINAM National Commission for Climate Change MINAM (2015) National Adaptation Plan National Environmental Council–CONAM National Commission for Climate Change National Commission for Climate Change CONAM National Commission for Climate Change (CONCYTEC, Ministry of Foreign Affairs, Confiep, FONAM, IMARPE, INRENA, MEF, Ministry of Transport and Communication, Ministry of Energy and Mines, PCM, PRODUCE, SENAMHI) CONAM (2002) Open in new tab Apurímac (Gobierno Regional de Apurímac, 2012), Junín (Gobierno Regional Junín, 2015), Lima Metropolitan (Gobierno Regional de Lima, 2015) and Ucayali (Gobierno Regional de Ucayali, 2014), along with the 2015 ENCC (MINAM, 2015) included either the Ministry or Regional Health Directorate (DIRESA) in proposing as part of the Regional Technical Group for Climate Change (Table 1). Co-ordinating and approving the plans were left mainly to the regional governments, environmental, resource management departments and in some cases intergovernmental organizations. For Apurímac (Gobierno Regional de Apurímac, 2012), Loreto (Gobierno Regional de Loreto, 2011), Cajamarca (Gobierno Regional de Cajamarca, 2016) and Ayacucho (Gobierno Regional de Ayacucho, 2015), the leading actor in charge of carrying out adaptation strategies for the health sector is the Regional Health Directorate.4 The degree of involvement of the local Regional Health Directorate varies between regional departments. Despite including strategies (Table 4), plans and goals related to health, many regional departments lack the inclusion of the DIRESA in the execution aspect of the Regional Climate Change Strategies. Table 1 includes an overview of regional plans that have identified health actors and who have named them. Importantly, as health is not a priority in regional plans, health actors have barely been understood as a multisectoral approach to improve ecosystem health for human health protection and prevention of disease. In most cases, DIRESA is mentioned within the plans as the leading regional health authority, but there is no clear identification or designation of responsibility within the overall process (see also Table 3), which emphasizes the limited significance of health within the regional strategies. Table 4 Regional departments’ adaptation strategies to climate change impact on health Regional Department . Are adaptation strategies presented? . Plans/strategies . References . Ancash Yes Capacity building programmes and technical assistance to the Regional Health Directorate and local establishments Create a programmw to improve health infrastructure and health services Strengthening of epidemiological and sanitary surveillance system Strengthening of adaptive capacity of regional and municipal entities Implementation of nutritional practices in the face of climate change Gobierno Regional de Ancash (2016, p. 66) Apurimac Yes Strengthen capacity of public health Improve universal health care access Protect public and social infrastructure through health Increase the capacity of institutions related to public health in the region Allocate adequate resources in order to strengthen capacity in the public health sector Promote both economic development and preventative health in rural areas Recuperation and improved use of traditional medicine Gobierno Regional de Apurímac (2012, pp. 82, 90, 97–98) Arequipa No Gobierno Regional de Arequipa (2009) Ayacucho Yes Reduce health effects of the most vulnerable population Implement actions to improve and rehabilitate health infrastructure to ensure functioning services in the face of climate change Improve nutritional health in the face of adverse climate effects Conduct research on vulnerabilities in the health sector Creation and improvement of emergency services in children under five Actions to promote and prevent adverse health impacts Dissemination of knowledge, socialization on climate change impact on health Focalised study of diseases related to temperature increase in tropical areas Gobierno Regional de Ayacucho (2015, pp. 173, 175, 178–179, 233–234) Cajamarca Yes Strengthen epidemiological vigilance and health services to confront emerging diseases Gobierno Regional de Cajamarca (2016, p. 101) Cusco Yes Focus on the protection of people, which includes health, and increase capacity to assist the most vulnerable and rural populations Implement protection policies and prevention to promote adequacy, sufficient coverage and strengthening of institutional capacities of health services in order to face emerging diseases Develop research on the coverage of the health sector and health in the Andean and Amazonian rural areas, for timely and necessary care and prevention, and guarantee sufficient resources Dissemination of knowledge, socialization on climate change impact on health Improve socioemotional health care delivery to cope with climate change risk and disasters Implementation of a regional centre for hospital waste and its management Recuperate and systematic organisation of Andean/Amazonian plants and treatment knowledge for health prevention Gobierno Regional de Cusco (2012, pp.60, 64, 82–83, 94) Huancavelica Yes Adaptation to climate change impacts on health on health governance level Strengthening of capacities Generation of scientific evidence Articulation of epidemiological surveillance Strengthening of prevention programmes and infrastructure resilience Improvement of food security services in climate change risk environments Creation of information system to govern risks and disasters associated to CC. Gobierno Regional de Huancavelica (2017, pp. 102, 105–106) Huánuco Yes Development of dengue surveillance strategies Development of regional plan on food security Development of methodological plan for health promotion Diminish negative impacts on health infrastructure and on human health Strengthen regional governance and public health policies Generate scientific evidence and develop capacities for regional knowledge construction Capacity building and knowledge dissemination for health personal Generate risk assessment to develop surveillance actions Strengthening of community programmes and services Strengthening of regional problem-solving capacity Expansion of emergency services for respiratory infections for children under 5 years old Strengthening services for environmental governance to mitigate climate change, re-establish ecosystem health and protect biodiversity Gobierno Regional de Huánuco (2017, pp. 91, 94–95) Ica Yes Reduce the health effects of children under five, pregnant women, and elderly adults through expanding coverage and quality of health services Incorporate preventive measures for disaster risk management Reduce conditions of socioeconomic structural vulnerability of families Permanent improvement of the infrastructure, equipment and supplies of health centres Gobierno Regional de Ica (2014, p. 104) La Libertad No Gobierno Regional de la Libertad (2011) Yes Improvement public health management by including climate change in planification and investment Public health infrastructure improvement for better response Design an integrated surveillance system with a particular attention to climate change variability Implementation of good practice in health management Gobierno Regional de la Libertad (2016, p. 38) Lambayeque Yes Development of control of arthropods who are impacting human health Create a program to combat zoonotic disease Research into determinants of health under climate change Strengthen and develop capacity for surveillance and respondence to zoonotic and vector-borne diseases Development of specific adaptation plans for food security Gobierno Regional de Lambayeque (2010, pp. 48, 50, 59) Yes Capacity strengthening to respond to respiratory infections and diarrheal infections, vector-borne and zoonotic diseases Monitoring of environmental health Inclusion of climate change in health planification and investment Inclusion of climate change in health planning Good nutritional practices Fresh water surveillance under climate change Gobierno Regional de Lambayeque (2016a, pp. 47, 75, 87) Lima (Metropolitan) Yes Carry out and disseminate campaigns to prevent the regrowth and emergence of viral, fungal and dermatological diseases Strengthen and expand campaigns for the prevention of diseases linked to climate change, which includes vaccination and screening for infectious diseases Implement campaigns aimed at preventing and combating malnutrition and dehydration in children and the elderly Gerencia del Ambiente (2015, pp. 69, 73, 86, 88) Lima (Provincial) Yes Improve adaptive capacities of health services Research into climate change vulnerability and health Creation and strengthening of epidemiological surveillance system relevant to climate change Creation and strengthening of sanitary system surveillance Capacity building and strengthening of technical expertise for health professionals and authorities. Use of public finances for climate change and health adaptation policies Improvement of health care facilities Strengthening of good practices for food security Gobierno Regional de Lima (2015, p. 116) Loreto Yes Fumigation and vaccination campaigns Campaigns to combat respiratory diseases Research into climate change impact on health Gobierno Regional de Loreto (2011, p. 4, 6, 33) Junín Yes Prevention of diseases related to extreme colds Preventive actions related to climate change disease impacts Rehabilitation of health infrastructure affected by climate change Reduce risk of climate change health impacts on specific vulnerable social groups Technical capacity building for health professionals Gobierno Regional Junín (2015, pp. 105, 107, 110–111) Piura Yes Capacity building for DIRESA health personal Gobierno Regional de Piura (2013, p. 23) Puno Yes Prevent infections and diseases caused by extreme weather events through improved public health interventions. Generate scientific evidence Health risk definition for improved surveillance Strengthening, amplification and focalization of health prevention interventions Strengthening of resolutive capacity building for health services Recuperation of local ancestral knowledge Improvement of communication and sensitisation of preventive projects Improvement of access to pharmaceuticals for increased health risks Installation of preventive and protective services against UV radiation Installation of regional early warning system and epidemiological response to extreme weather events Amplification of nutrition surveillance on community level for high-risk groups (elderly, pregnant women, children under 5) Improved capacity building for project formulation, management and evaluation specific to climate change Installation of municipal service support to develop communal projects Gobierno Regional de Puno (2016, pp. 123, 128) Ucayali Yes Improve the capacity of the health sector resolutive capabilities Reduce vulnerability of public health infrastructure to extreme climatic events Improve the capacity and quality of care of the health sector Gobierno Regional de Ucayali (2013, pp. 113, 114, 122) National Adaptation Plan No MINAM(2015) National Adaptation Plan No CONAM (2002) Regional Department . Are adaptation strategies presented? . Plans/strategies . References . Ancash Yes Capacity building programmes and technical assistance to the Regional Health Directorate and local establishments Create a programmw to improve health infrastructure and health services Strengthening of epidemiological and sanitary surveillance system Strengthening of adaptive capacity of regional and municipal entities Implementation of nutritional practices in the face of climate change Gobierno Regional de Ancash (2016, p. 66) Apurimac Yes Strengthen capacity of public health Improve universal health care access Protect public and social infrastructure through health Increase the capacity of institutions related to public health in the region Allocate adequate resources in order to strengthen capacity in the public health sector Promote both economic development and preventative health in rural areas Recuperation and improved use of traditional medicine Gobierno Regional de Apurímac (2012, pp. 82, 90, 97–98) Arequipa No Gobierno Regional de Arequipa (2009) Ayacucho Yes Reduce health effects of the most vulnerable population Implement actions to improve and rehabilitate health infrastructure to ensure functioning services in the face of climate change Improve nutritional health in the face of adverse climate effects Conduct research on vulnerabilities in the health sector Creation and improvement of emergency services in children under five Actions to promote and prevent adverse health impacts Dissemination of knowledge, socialization on climate change impact on health Focalised study of diseases related to temperature increase in tropical areas Gobierno Regional de Ayacucho (2015, pp. 173, 175, 178–179, 233–234) Cajamarca Yes Strengthen epidemiological vigilance and health services to confront emerging diseases Gobierno Regional de Cajamarca (2016, p. 101) Cusco Yes Focus on the protection of people, which includes health, and increase capacity to assist the most vulnerable and rural populations Implement protection policies and prevention to promote adequacy, sufficient coverage and strengthening of institutional capacities of health services in order to face emerging diseases Develop research on the coverage of the health sector and health in the Andean and Amazonian rural areas, for timely and necessary care and prevention, and guarantee sufficient resources Dissemination of knowledge, socialization on climate change impact on health Improve socioemotional health care delivery to cope with climate change risk and disasters Implementation of a regional centre for hospital waste and its management Recuperate and systematic organisation of Andean/Amazonian plants and treatment knowledge for health prevention Gobierno Regional de Cusco (2012, pp.60, 64, 82–83, 94) Huancavelica Yes Adaptation to climate change impacts on health on health governance level Strengthening of capacities Generation of scientific evidence Articulation of epidemiological surveillance Strengthening of prevention programmes and infrastructure resilience Improvement of food security services in climate change risk environments Creation of information system to govern risks and disasters associated to CC. Gobierno Regional de Huancavelica (2017, pp. 102, 105–106) Huánuco Yes Development of dengue surveillance strategies Development of regional plan on food security Development of methodological plan for health promotion Diminish negative impacts on health infrastructure and on human health Strengthen regional governance and public health policies Generate scientific evidence and develop capacities for regional knowledge construction Capacity building and knowledge dissemination for health personal Generate risk assessment to develop surveillance actions Strengthening of community programmes and services Strengthening of regional problem-solving capacity Expansion of emergency services for respiratory infections for children under 5 years old Strengthening services for environmental governance to mitigate climate change, re-establish ecosystem health and protect biodiversity Gobierno Regional de Huánuco (2017, pp. 91, 94–95) Ica Yes Reduce the health effects of children under five, pregnant women, and elderly adults through expanding coverage and quality of health services Incorporate preventive measures for disaster risk management Reduce conditions of socioeconomic structural vulnerability of families Permanent improvement of the infrastructure, equipment and supplies of health centres Gobierno Regional de Ica (2014, p. 104) La Libertad No Gobierno Regional de la Libertad (2011) Yes Improvement public health management by including climate change in planification and investment Public health infrastructure improvement for better response Design an integrated surveillance system with a particular attention to climate change variability Implementation of good practice in health management Gobierno Regional de la Libertad (2016, p. 38) Lambayeque Yes Development of control of arthropods who are impacting human health Create a program to combat zoonotic disease Research into determinants of health under climate change Strengthen and develop capacity for surveillance and respondence to zoonotic and vector-borne diseases Development of specific adaptation plans for food security Gobierno Regional de Lambayeque (2010, pp. 48, 50, 59) Yes Capacity strengthening to respond to respiratory infections and diarrheal infections, vector-borne and zoonotic diseases Monitoring of environmental health Inclusion of climate change in health planification and investment Inclusion of climate change in health planning Good nutritional practices Fresh water surveillance under climate change Gobierno Regional de Lambayeque (2016a, pp. 47, 75, 87) Lima (Metropolitan) Yes Carry out and disseminate campaigns to prevent the regrowth and emergence of viral, fungal and dermatological diseases Strengthen and expand campaigns for the prevention of diseases linked to climate change, which includes vaccination and screening for infectious diseases Implement campaigns aimed at preventing and combating malnutrition and dehydration in children and the elderly Gerencia del Ambiente (2015, pp. 69, 73, 86, 88) Lima (Provincial) Yes Improve adaptive capacities of health services Research into climate change vulnerability and health Creation and strengthening of epidemiological surveillance system relevant to climate change Creation and strengthening of sanitary system surveillance Capacity building and strengthening of technical expertise for health professionals and authorities. Use of public finances for climate change and health adaptation policies Improvement of health care facilities Strengthening of good practices for food security Gobierno Regional de Lima (2015, p. 116) Loreto Yes Fumigation and vaccination campaigns Campaigns to combat respiratory diseases Research into climate change impact on health Gobierno Regional de Loreto (2011, p. 4, 6, 33) Junín Yes Prevention of diseases related to extreme colds Preventive actions related to climate change disease impacts Rehabilitation of health infrastructure affected by climate change Reduce risk of climate change health impacts on specific vulnerable social groups Technical capacity building for health professionals Gobierno Regional Junín (2015, pp. 105, 107, 110–111) Piura Yes Capacity building for DIRESA health personal Gobierno Regional de Piura (2013, p. 23) Puno Yes Prevent infections and diseases caused by extreme weather events through improved public health interventions. Generate scientific evidence Health risk definition for improved surveillance Strengthening, amplification and focalization of health prevention interventions Strengthening of resolutive capacity building for health services Recuperation of local ancestral knowledge Improvement of communication and sensitisation of preventive projects Improvement of access to pharmaceuticals for increased health risks Installation of preventive and protective services against UV radiation Installation of regional early warning system and epidemiological response to extreme weather events Amplification of nutrition surveillance on community level for high-risk groups (elderly, pregnant women, children under 5) Improved capacity building for project formulation, management and evaluation specific to climate change Installation of municipal service support to develop communal projects Gobierno Regional de Puno (2016, pp. 123, 128) Ucayali Yes Improve the capacity of the health sector resolutive capabilities Reduce vulnerability of public health infrastructure to extreme climatic events Improve the capacity and quality of care of the health sector Gobierno Regional de Ucayali (2013, pp. 113, 114, 122) National Adaptation Plan No MINAM(2015) National Adaptation Plan No CONAM (2002) Open in new tab Table 4 Regional departments’ adaptation strategies to climate change impact on health Regional Department . Are adaptation strategies presented? . Plans/strategies . References . Ancash Yes Capacity building programmes and technical assistance to the Regional Health Directorate and local establishments Create a programmw to improve health infrastructure and health services Strengthening of epidemiological and sanitary surveillance system Strengthening of adaptive capacity of regional and municipal entities Implementation of nutritional practices in the face of climate change Gobierno Regional de Ancash (2016, p. 66) Apurimac Yes Strengthen capacity of public health Improve universal health care access Protect public and social infrastructure through health Increase the capacity of institutions related to public health in the region Allocate adequate resources in order to strengthen capacity in the public health sector Promote both economic development and preventative health in rural areas Recuperation and improved use of traditional medicine Gobierno Regional de Apurímac (2012, pp. 82, 90, 97–98) Arequipa No Gobierno Regional de Arequipa (2009) Ayacucho Yes Reduce health effects of the most vulnerable population Implement actions to improve and rehabilitate health infrastructure to ensure functioning services in the face of climate change Improve nutritional health in the face of adverse climate effects Conduct research on vulnerabilities in the health sector Creation and improvement of emergency services in children under five Actions to promote and prevent adverse health impacts Dissemination of knowledge, socialization on climate change impact on health Focalised study of diseases related to temperature increase in tropical areas Gobierno Regional de Ayacucho (2015, pp. 173, 175, 178–179, 233–234) Cajamarca Yes Strengthen epidemiological vigilance and health services to confront emerging diseases Gobierno Regional de Cajamarca (2016, p. 101) Cusco Yes Focus on the protection of people, which includes health, and increase capacity to assist the most vulnerable and rural populations Implement protection policies and prevention to promote adequacy, sufficient coverage and strengthening of institutional capacities of health services in order to face emerging diseases Develop research on the coverage of the health sector and health in the Andean and Amazonian rural areas, for timely and necessary care and prevention, and guarantee sufficient resources Dissemination of knowledge, socialization on climate change impact on health Improve socioemotional health care delivery to cope with climate change risk and disasters Implementation of a regional centre for hospital waste and its management Recuperate and systematic organisation of Andean/Amazonian plants and treatment knowledge for health prevention Gobierno Regional de Cusco (2012, pp.60, 64, 82–83, 94) Huancavelica Yes Adaptation to climate change impacts on health on health governance level Strengthening of capacities Generation of scientific evidence Articulation of epidemiological surveillance Strengthening of prevention programmes and infrastructure resilience Improvement of food security services in climate change risk environments Creation of information system to govern risks and disasters associated to CC. Gobierno Regional de Huancavelica (2017, pp. 102, 105–106) Huánuco Yes Development of dengue surveillance strategies Development of regional plan on food security Development of methodological plan for health promotion Diminish negative impacts on health infrastructure and on human health Strengthen regional governance and public health policies Generate scientific evidence and develop capacities for regional knowledge construction Capacity building and knowledge dissemination for health personal Generate risk assessment to develop surveillance actions Strengthening of community programmes and services Strengthening of regional problem-solving capacity Expansion of emergency services for respiratory infections for children under 5 years old Strengthening services for environmental governance to mitigate climate change, re-establish ecosystem health and protect biodiversity Gobierno Regional de Huánuco (2017, pp. 91, 94–95) Ica Yes Reduce the health effects of children under five, pregnant women, and elderly adults through expanding coverage and quality of health services Incorporate preventive measures for disaster risk management Reduce conditions of socioeconomic structural vulnerability of families Permanent improvement of the infrastructure, equipment and supplies of health centres Gobierno Regional de Ica (2014, p. 104) La Libertad No Gobierno Regional de la Libertad (2011) Yes Improvement public health management by including climate change in planification and investment Public health infrastructure improvement for better response Design an integrated surveillance system with a particular attention to climate change variability Implementation of good practice in health management Gobierno Regional de la Libertad (2016, p. 38) Lambayeque Yes Development of control of arthropods who are impacting human health Create a program to combat zoonotic disease Research into determinants of health under climate change Strengthen and develop capacity for surveillance and respondence to zoonotic and vector-borne diseases Development of specific adaptation plans for food security Gobierno Regional de Lambayeque (2010, pp. 48, 50, 59) Yes Capacity strengthening to respond to respiratory infections and diarrheal infections, vector-borne and zoonotic diseases Monitoring of environmental health Inclusion of climate change in health planification and investment Inclusion of climate change in health planning Good nutritional practices Fresh water surveillance under climate change Gobierno Regional de Lambayeque (2016a, pp. 47, 75, 87) Lima (Metropolitan) Yes Carry out and disseminate campaigns to prevent the regrowth and emergence of viral, fungal and dermatological diseases Strengthen and expand campaigns for the prevention of diseases linked to climate change, which includes vaccination and screening for infectious diseases Implement campaigns aimed at preventing and combating malnutrition and dehydration in children and the elderly Gerencia del Ambiente (2015, pp. 69, 73, 86, 88) Lima (Provincial) Yes Improve adaptive capacities of health services Research into climate change vulnerability and health Creation and strengthening of epidemiological surveillance system relevant to climate change Creation and strengthening of sanitary system surveillance Capacity building and strengthening of technical expertise for health professionals and authorities. Use of public finances for climate change and health adaptation policies Improvement of health care facilities Strengthening of good practices for food security Gobierno Regional de Lima (2015, p. 116) Loreto Yes Fumigation and vaccination campaigns Campaigns to combat respiratory diseases Research into climate change impact on health Gobierno Regional de Loreto (2011, p. 4, 6, 33) Junín Yes Prevention of diseases related to extreme colds Preventive actions related to climate change disease impacts Rehabilitation of health infrastructure affected by climate change Reduce risk of climate change health impacts on specific vulnerable social groups Technical capacity building for health professionals Gobierno Regional Junín (2015, pp. 105, 107, 110–111) Piura Yes Capacity building for DIRESA health personal Gobierno Regional de Piura (2013, p. 23) Puno Yes Prevent infections and diseases caused by extreme weather events through improved public health interventions. Generate scientific evidence Health risk definition for improved surveillance Strengthening, amplification and focalization of health prevention interventions Strengthening of resolutive capacity building for health services Recuperation of local ancestral knowledge Improvement of communication and sensitisation of preventive projects Improvement of access to pharmaceuticals for increased health risks Installation of preventive and protective services against UV radiation Installation of regional early warning system and epidemiological response to extreme weather events Amplification of nutrition surveillance on community level for high-risk groups (elderly, pregnant women, children under 5) Improved capacity building for project formulation, management and evaluation specific to climate change Installation of municipal service support to develop communal projects Gobierno Regional de Puno (2016, pp. 123, 128) Ucayali Yes Improve the capacity of the health sector resolutive capabilities Reduce vulnerability of public health infrastructure to extreme climatic events Improve the capacity and quality of care of the health sector Gobierno Regional de Ucayali (2013, pp. 113, 114, 122) National Adaptation Plan No MINAM(2015) National Adaptation Plan No CONAM (2002) Regional Department . Are adaptation strategies presented? . Plans/strategies . References . Ancash Yes Capacity building programmes and technical assistance to the Regional Health Directorate and local establishments Create a programmw to improve health infrastructure and health services Strengthening of epidemiological and sanitary surveillance system Strengthening of adaptive capacity of regional and municipal entities Implementation of nutritional practices in the face of climate change Gobierno Regional de Ancash (2016, p. 66) Apurimac Yes Strengthen capacity of public health Improve universal health care access Protect public and social infrastructure through health Increase the capacity of institutions related to public health in the region Allocate adequate resources in order to strengthen capacity in the public health sector Promote both economic development and preventative health in rural areas Recuperation and improved use of traditional medicine Gobierno Regional de Apurímac (2012, pp. 82, 90, 97–98) Arequipa No Gobierno Regional de Arequipa (2009) Ayacucho Yes Reduce health effects of the most vulnerable population Implement actions to improve and rehabilitate health infrastructure to ensure functioning services in the face of climate change Improve nutritional health in the face of adverse climate effects Conduct research on vulnerabilities in the health sector Creation and improvement of emergency services in children under five Actions to promote and prevent adverse health impacts Dissemination of knowledge, socialization on climate change impact on health Focalised study of diseases related to temperature increase in tropical areas Gobierno Regional de Ayacucho (2015, pp. 173, 175, 178–179, 233–234) Cajamarca Yes Strengthen epidemiological vigilance and health services to confront emerging diseases Gobierno Regional de Cajamarca (2016, p. 101) Cusco Yes Focus on the protection of people, which includes health, and increase capacity to assist the most vulnerable and rural populations Implement protection policies and prevention to promote adequacy, sufficient coverage and strengthening of institutional capacities of health services in order to face emerging diseases Develop research on the coverage of the health sector and health in the Andean and Amazonian rural areas, for timely and necessary care and prevention, and guarantee sufficient resources Dissemination of knowledge, socialization on climate change impact on health Improve socioemotional health care delivery to cope with climate change risk and disasters Implementation of a regional centre for hospital waste and its management Recuperate and systematic organisation of Andean/Amazonian plants and treatment knowledge for health prevention Gobierno Regional de Cusco (2012, pp.60, 64, 82–83, 94) Huancavelica Yes Adaptation to climate change impacts on health on health governance level Strengthening of capacities Generation of scientific evidence Articulation of epidemiological surveillance Strengthening of prevention programmes and infrastructure resilience Improvement of food security services in climate change risk environments Creation of information system to govern risks and disasters associated to CC. Gobierno Regional de Huancavelica (2017, pp. 102, 105–106) Huánuco Yes Development of dengue surveillance strategies Development of regional plan on food security Development of methodological plan for health promotion Diminish negative impacts on health infrastructure and on human health Strengthen regional governance and public health policies Generate scientific evidence and develop capacities for regional knowledge construction Capacity building and knowledge dissemination for health personal Generate risk assessment to develop surveillance actions Strengthening of community programmes and services Strengthening of regional problem-solving capacity Expansion of emergency services for respiratory infections for children under 5 years old Strengthening services for environmental governance to mitigate climate change, re-establish ecosystem health and protect biodiversity Gobierno Regional de Huánuco (2017, pp. 91, 94–95) Ica Yes Reduce the health effects of children under five, pregnant women, and elderly adults through expanding coverage and quality of health services Incorporate preventive measures for disaster risk management Reduce conditions of socioeconomic structural vulnerability of families Permanent improvement of the infrastructure, equipment and supplies of health centres Gobierno Regional de Ica (2014, p. 104) La Libertad No Gobierno Regional de la Libertad (2011) Yes Improvement public health management by including climate change in planification and investment Public health infrastructure improvement for better response Design an integrated surveillance system with a particular attention to climate change variability Implementation of good practice in health management Gobierno Regional de la Libertad (2016, p. 38) Lambayeque Yes Development of control of arthropods who are impacting human health Create a program to combat zoonotic disease Research into determinants of health under climate change Strengthen and develop capacity for surveillance and respondence to zoonotic and vector-borne diseases Development of specific adaptation plans for food security Gobierno Regional de Lambayeque (2010, pp. 48, 50, 59) Yes Capacity strengthening to respond to respiratory infections and diarrheal infections, vector-borne and zoonotic diseases Monitoring of environmental health Inclusion of climate change in health planification and investment Inclusion of climate change in health planning Good nutritional practices Fresh water surveillance under climate change Gobierno Regional de Lambayeque (2016a, pp. 47, 75, 87) Lima (Metropolitan) Yes Carry out and disseminate campaigns to prevent the regrowth and emergence of viral, fungal and dermatological diseases Strengthen and expand campaigns for the prevention of diseases linked to climate change, which includes vaccination and screening for infectious diseases Implement campaigns aimed at preventing and combating malnutrition and dehydration in children and the elderly Gerencia del Ambiente (2015, pp. 69, 73, 86, 88) Lima (Provincial) Yes Improve adaptive capacities of health services Research into climate change vulnerability and health Creation and strengthening of epidemiological surveillance system relevant to climate change Creation and strengthening of sanitary system surveillance Capacity building and strengthening of technical expertise for health professionals and authorities. Use of public finances for climate change and health adaptation policies Improvement of health care facilities Strengthening of good practices for food security Gobierno Regional de Lima (2015, p. 116) Loreto Yes Fumigation and vaccination campaigns Campaigns to combat respiratory diseases Research into climate change impact on health Gobierno Regional de Loreto (2011, p. 4, 6, 33) Junín Yes Prevention of diseases related to extreme colds Preventive actions related to climate change disease impacts Rehabilitation of health infrastructure affected by climate change Reduce risk of climate change health impacts on specific vulnerable social groups Technical capacity building for health professionals Gobierno Regional Junín (2015, pp. 105, 107, 110–111) Piura Yes Capacity building for DIRESA health personal Gobierno Regional de Piura (2013, p. 23) Puno Yes Prevent infections and diseases caused by extreme weather events through improved public health interventions. Generate scientific evidence Health risk definition for improved surveillance Strengthening, amplification and focalization of health prevention interventions Strengthening of resolutive capacity building for health services Recuperation of local ancestral knowledge Improvement of communication and sensitisation of preventive projects Improvement of access to pharmaceuticals for increased health risks Installation of preventive and protective services against UV radiation Installation of regional early warning system and epidemiological response to extreme weather events Amplification of nutrition surveillance on community level for high-risk groups (elderly, pregnant women, children under 5) Improved capacity building for project formulation, management and evaluation specific to climate change Installation of municipal service support to develop communal projects Gobierno Regional de Puno (2016, pp. 123, 128) Ucayali Yes Improve the capacity of the health sector resolutive capabilities Reduce vulnerability of public health infrastructure to extreme climatic events Improve the capacity and quality of care of the health sector Gobierno Regional de Ucayali (2013, pp. 113, 114, 122) National Adaptation Plan No MINAM(2015) National Adaptation Plan No CONAM (2002) Open in new tab Technical groups The first group of actors identified is the technical group for each ERCC, they encompass the public and private sectors. The ERCC include the participation of over 60 institutions, while regional departments vary widely in institutional participation, from 5 to almost 75 collaborators in the technical groups (MINAM, 2010b; Gobierno Regional de Ica, 2014; Gerencia del Ambiente, 2015; MINAM, 2016). While all of them include government institutions, they do not include the same institutions. None involved the Regional Health Directorate, the Ministry of Health,5 or IPRESS in the planning of the Regional Climate Change Strategies. A full list of the institutions taking part in proposing, co-ordinating, approving and executing the plan can be found in Table 3. For those that did not include such a table, the categories were filled using institutions mentioned in the technical groups as taking part in a task or objective. Figure 1 elaborates the variations found in the GTRCC compositions, where regional departments have chosen to involve institutions and organizations from across diverse backgrounds at different rates. Most of the regional departments have majority government institutions engaged, except for Junín (Gobierno Regional Junín., 2015), who has a strong presence of civic organizations and has included many of them in the GTRCC. Ica (Gobierno Regional de Ica., 2014) and Ucayali (Gobierno Regional de Ucayali, 2014) included petroleum and mining companies in the GTRCC, as shown in Figure 1, signalling their importance in the community, despite the potential dangers they pose both to the communities in terms of environmental, occupational and health hazards, but also their roles in the mitigation and adaptation to climate change. Figure 1 Open in new tabDownload slide Technical group composition for departments where information was available divided into public, civic, NGO, international, business and academic organizations where applicable. Missing departments did not provide adequate information for institutional mapping. Figure 1 Open in new tabDownload slide Technical group composition for departments where information was available divided into public, civic, NGO, international, business and academic organizations where applicable. Missing departments did not provide adequate information for institutional mapping. The context for the regional climate change strategies and the national climate change strategy: Peru and climate change Each regional department has considered their unique background. For example, Ucayali (Amazon) recognizes the need for further research and knowledge accumulation into how climate change will affect their region (Gobierno Regional de Ucayali, 2014). The Regional Technical Group for Climate Change recognizes the importance of local biodiversity and local biodiversity knowledge. Therefore, included in the plans for adaptation and mitigation is an incorporation of the use of traditional knowledge from indigenous populations (Gobierno Regional de Ucayali, 2014) (see also Table 4). As a country with a diverse geography (Coast, Andes, Amazon), most regional departments recognize a unique challenge in addressing their specific health needs as climate change alters the land where people live. Most regional departments are in biodiverse areas, which brings about fears of loss of genetic diversity in plants used for agriculture and medicine, along with a loss of diversity in animal species. Such depletion can destabilize ecosystems and create adverse effects for humans as well (Gobierno Regional de Ucayali, 2014). Huanuco’s focus on ecosystem health and biodiversity protection for human health prevention is a unique response to regional context and recognition of embeddedness of human within ecosystem health (Gobierno Regional de Huánuco, 2017). Content—climate change adaptation and health All regional strategies take into consideration the effects of climate change on their region, but not all of them examine in detail the impacts of climate change on health. The national strategies from 2002 and 2015 have very limited to non-analysis of health. This is much more elaborated on the regional level. Health becomes more prominent in regional plans published after 2011, with explicit allocation of whole sections or chapters in each plan. However, health is often related to infrastructure and health services and not in relation to ecosystem health (Table 1). There is no definition of health within the context of climate change, ecosystem and planetary health, which leads to a limited if not non-existential transdisciplinary approach. There is general data Regional and National climate data analysis, epidemiological information, surveillance of climate change variability, response to climatic events and a vulnerability assessment (Table 1). This information indicates the paths through which climate change will most likely impact their region and includes vulnerability/risk assessment of the most vulnerable areas that will be affected by climate change. The source of these data varies and may use past incidences as indicators for future climatic events, or through conducting original research. All regional departments except for La Libertad have been able to apply such data to the health sector. Health hazards vary according to the diverse geography of the country, and this is reflected in the variable emphasis placed on diseases throughout the ERCC. As shown in Table 1, two of the most discussed health hazards were food security/mal-nutrition and airborne/respiratory infections. These are linked to two of the most pressing concerns for the impacts of natural disasters. One of the main concerns is flooding and intense rains, which damages homes, flood agricultural lands, cause health facilities damage and additionally disrupt sewage and sanitary systems, causing waterborne diseases outbreaks (Du et al., 2010; Ahern and Kovats, 2013). The other hazard identified is drought, which causes the agricultural land to become less fertile, thus shifting agriculture to new areas of production, in addition to creating heat-related illnesses, especially in vulnerable populations (Sena et al., 2017). Food security can be linked to agriculture and failed crops that will be caused by variable weather/climate (Myers et al., 2017), while respiratory infections are related to air pollution (Macintyre et al., 2014; Croft et al., 2019). While food security was not defined in any of the plans, regional departments such as Ayacucho (Gobierno Regional de Ayacucho, 2015) have formed specialised taskforces6 to deal with the issue, and have partnered with the Food and Agriculture Organization of the United Nations among others (see Table 1). Cusco and Cajamarca identify ecosystem deterioration and biodiversity loss as a result of climate change and impact on human health (Gobierno Regional de Cusco, 2012; Whitmee et al., 2015; Gobierno Regional de Cajamarca, 2016; Marselle et al., 2019). Health infrastructure includes the ability to provide services at health posts or hospitals once damage has occurred and having the capacity to rebuild afterwards. Departments that have experienced intense flooding, landslides or ‘El Niño’ events in the past described health infrastructure as being at risk for further damage as climate change progresses (Gobierno Regional de Lambayeque, 2010; Gobierno Regional de la Libertad, 2011; Gobierno Regional de Apurímac, 2012; Gobierno Regional de Ica, 2014; Gobierno Regional Junín, 2015). Content—health-related adaptation strategies The 2009 and 2011 MINAM published guidelines for creating regional strategies for climate change are mentioning health to be taken into account for adaptation interventions, but with no specific guidance on how to go about it (MINAM, 2009, 2011). While regional departments were able to identify health issues related to climate change, Arequipa (Gobierno Regional de Arequipa, 2009) and Gobierno Regional de Lambayeque (2010) who published their first plans before 2011 have not included health-related strategies (Table 4). Gobierno Regional de Lambayeque (2016a) has, however, done so in their updated plan, while Arequipa has not updated the content of their 2009 plan. Table 4 presents the adaptation strategies elaborated in the diverse ERCC. They can be summarized as focusing on capacity building on all levels, including institutional, knowledge, adaptive strategy development, research and infrastructure. Strengthening and improving surveillance in relation to climate change, yet it is not clear if that includes climate-sensitive data and collaboration between institutions. Cusco (Gobierno Regional de Cusco, 2012) and Apurímac (Gobierno Regional de Apurímac, 2012), mention the recuperation and use of traditional plant knowledge. Huánuco is the only región to have a strategy on biodiversity conservation and ecosystem health for human health protection (Gobierno Regional de Huánuco, 2017). They also include regional knowledge construction (Gobierno Regional de Huánuco, 2017). Cusco as the only regional department has a strategy to focus on socioemotional health of people due to climate change (Gobierno Regional de Cusco, 2012). Ayacucho also includes research on vulnerable groups and specific adaptations for vulnerable groups (Gobierno Regional de Ayacucho, 2015). As vulnerable groups are mentioned, people living in poverty, and in other plans, children under five, pregnant women and elderly people. Marginalized people, such as indigenous people and African-Peruvian, are not mentioned in the plans. Overall, regional departments focus on financial investment in infrastructure strengthening and for human resources. There are no health-related adaptations at the national level. Most of the regional departments have created methods to monitor the process of the adaptation plans and projects outlined in their strategies sections, and benchmarked goals to evaluate them in the future. Process The national adaption plans from 2002 and 2015 describe in detail national legal and conceptual processes influencing the adaption plan development as much as progress on adaptation initiatives (CONAM, 2002; Cancino, 2016). The national communication plans 1–3 (CONAM, 2001; MINAM, 2010a; Cancino, 2016), plus the workshop proceedings from 2016 (Cancino, 2016), monitor advances in the NAP process, legal developments, priority and strategy formulation and ways in which different actors can collaborate in its implementation. ERCCs have followed advise from the MINAM guidelines to develop regional GTRCC to design and implement regional strategies (MINAM, 2009, 2011). ERCC’s who have not followed the MINAM guidelines are less structured and with much less substance. Strategies that have followed the MINAM (2011) guidelines have gained in structure and systematization of information and strategies. Another improvement is to be seen in those ERCC’s published after 2015, which falls after the 2015 NAP publication (MINAM, 2015). Table 5 presents a summary of the regional and national processes, listing actors that have been involved in the establishing and formulation processes, the legal documents that were used, process supporting documents and regulations. Table 5 Process analysis of regional adaptation plans Regional Department . Establishing a process . Formulation process . Legal, normative and technical basis . Process supporting documents and regulations . References . Ancash Regional Technical Group for Climate Change (2013), Project IMACC for BID-MINAM: Vulnerability Diagnosis (2014), Technical Group Relaunch (2015) Financial support from the BID, the process has been led by the Natural Resources and Environmental Management group from Ancash, GTRCC, the Regional Environmental and Environmental Commission of the Regional Council Technical assistance from the General Directorate of Climate Change, Desertification and Water Resources, and the ‘Ensuring Water and Means of Mountain life’ project. Supreme Decree 011-2015-MINAM, which approves the National Strategy on Climate Change (ENCC); Regional Ordinance 006-2016-GRA/CR Methodological guidelines for the elaboration of ERCC Gobierno Regional de Ancash (2017, pp. 5, 55, 56) Apurímac Technical Group for Vulnerability and Adaptation to Climate Change (2009), Regional Operational Unit for Climate Change Programs and Projects; ERCC Drive Group Information was synthesized in workshops in each of the 10 provinces Inclusion of professionals, technicians and social leaders To collect information from the public regarding their perception of climate change To identify the issues at various ecological levels, To develop local proposals for climate change adaptation strategies and measures. Regional Ordinance 010-2012-GR-APURIMAC/CR Strategic Plan for Regional Concerted Development; The United Nations Framework Convention on Climate Change—UNFCCC Gobierno Regional de Apurímac (2012, pp. 3, 4, 7, 14, 23–25) Arequipa As per the 043-2008-GRA/CR-Arequipa Regional Agreement the elaboration of the Regional Strategy for Adaptation to Climate Change in the Arequipa Region was prioritized with a multidisciplinary and intersectoral vision. This included the planning of sustainable development in district and provincial local governments, emphasizing knowledge, prevention and mitigation of climate risks, In addition to seeking the allocation of public and private resources, and defining responsibilities at each level and organizational unit. Proposed actions for the continuity of adaptation measures and actors involved in the implementation: Development of the ERCC which includes input from the regional government, provincial municipalities, NGOs, universities Institutional regional development to begin studies, monitoring and prevention of the effects of climate change Strategic management for water systems, with a focus on rural and industrial areas Specific policy targeting the dissemination of climate information for preventive actions (national government, regional government, SENAMHI). Dissemination of adaptation measures for the management of water resources and agricultural production with irrigation organizations [MINAG, AUTODEMA, User Board, Subsectoral Irrigation Programme (PSI)]. Targeting the education sector to raise awareness about the issue and the formation of response capacities by the population (UGEL Education). Advance in the elaboration of regional contingency plans to face the projected critical scenarios (Regional Government. Civil Defense, Geophysical Institute, SENAMHI). Regional Agreement 043-2008-GRA/CR-AREQUIPA, which confirms the GTRCC to elaborate the ERCC Regional Agreement 143-2010-GRA/CR-AREQUIPA, to approve the ERCC The United Nations Framework Convention on Biological Diversity—CBD Kyoto Protocol The National Strategy for Climate Change, approved in 2002, State policies of the governance agreement (2002); Monitoring programme for monitoring climate change in the Piura region between 2003 and 2005; First pilot measure of climate change adaptation conducted between July 2007 and September 2008, Under the guidance of the Regional Government of Arequipa German Technical Co-operation (GTZ). Gobierno Regional de Arequipa (2009, pp. 1–2, 30, 31) Ayacucho The formulation process began in 2010 The ERCC was published in 2015 GTRCC as per the Executive Regional Resolution 222-2010-GRA/PRES) Action plan for the ERCC as per the Regional Ordinance 032-2011-GRA/CR from 26.12.2011 Ayacucho GTRCC as per the Executive Regional Resolution 865-2014-GRA/PRES (14.11.2014) Project entitled ‘Improving the Regional Environmental Management department of Ayacucho’ Co-ordination with the Regional Technical Group on Climate Change Collection of primary and secondary information Information analysis and processing Drafting of the adaptation diagnostic technical report 03 Decentralized workshops on ‘Socialization and Contributions of the Diagnoses of the Strategy and Regional Action Plan against Climate Change Ayacucho’ Workshop on ‘Socialization and Validation of the Diagnoses of the Strategy and Regional Plan of Action against Climate Change Ayacucho’ Articulation of the ERCC with planning instruments Grupo Técnico Regional de CC de Huancavelica, constituido el 2012 (Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR.) Artícle 53.c of the Law 27867 establishing the precedent that each regional government must have its own Regional Strategy against Climate Change Regional Ordinance No. 032-2011 GRA/CR, approve for social, economic and environmental benefits, The Regional Strategy for Climate Change in Ayacucho and the Action Plan of the Strategy for Climate Change in Ayacucho to 2017. Intergovernmental Panel on Climate Change (IPCC), Peru and Climate Change: Second National Communication on Climate Change United Nations Framework for Climate Change Convention (UNFCCC) Support and technical advise from MINAM. Gobierno Regional de Ayacucho (2015, pp. 10, 11, 13, 14, 15) Cajamarca Constitution of the Technical Group on Climate Change (2005), Creation and implementation of the Regional Technical Group of Climate Change and Risk Management for Cajamarca, Responsible for preparing a strategy proposal for Regional Climate Change and Risk Management, through a Regional Participatory Process (2011) The Regional Government of Cajamaca, through the Regional Environmental Commission and its GTRCC, prepared the ERCC, applying a participatory methodological proposal, Previously agreed upon and approved by MINAM, Adapting it to the region and to the proposals and suggestions of the actors involved in the process. Regional ordinance 021-2013-GR.CAJ-CR that approved the ERCC of Cajamarca; Organic law for regional governments (Ley 27867); National Environment Policy (2009); National Climate Change Strategy (2003); Adaptation and Mitigation Action Plan against Climate Change (2010); National Environmental Action Plan—PLANAA 2011–21 (9 July 2011); Peru Environment Agenda 2013–14. ·Guide for preparation of the ERCC (2011) Gobierno Regional de Cajamarca (2016, pp. 6–9, 10, 14) Cusco Creation of the Regional Operational Unit of the Adaptation Programme to Climate Change—UOR- PACC through the Regional Executive Resolution No. 1164-2009-GRCUSCO/PR, Which creates process of consensus and inter-institutional orientations Exhibited in OR 070-2010 CR/GRC on the steps to be taken and the instances to be commissioned; Thus, the GTRCC for the Cusco region was created The elaboration of the ERCC was carried through a participatory process, concerted and articulated, which gathered local and regional development actors: Authorities, institutions and citizens who were responsible for the formulation of ERCC. In this process, the GTRFCC was involved, thematic tables and territorial consultations were developed Regional Ordinance 020-2012-CR/ GRC.CUSCO approved the ERCC; Law 27867—Organic Law of Regional Governments; Regional Ordinance No. 081-2010-CR/GRCUSCO, which approved the Strategic Plan for the Development of Cusco; Regional Executive Resolution Nº 1164-2009-GR CUSCO/PR, make up the Regional Operational Unit of the Climate Change Adaptation Programme; Regional Ordinance Nº 070-2010 CR/GRC. CUSCO, created the GTRCC. Gobierno Regional de Cusco (2012, pp. 9, 10, 17, 18, 48, 49) Huancavelica GTRCC of Huancavelica, established in 2012 (through the Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR) The ERCC and implementation plan were formulated under the leadership of the Regional Government of Huancavelica, Represented by the Natural Resources and Environmental Management group, Participation by the GTRCC, an inter-institutional space composed of representatives of public and private institutions committed to the development of the Huancavelica region, With the participation of social leaders, political decision-makers, civil servants and civil society. Supreme Decree-011-2015-MINAM; Supreme Decree 058-2016-RE, ratifying the Paris Agreement; Ministerial Resolution 090-2016 MINAM, promoting integrated management of climate change. Organic Law of Regional Governments 27867; Organic Law of Municipalities ° 27972 (art. 73 inc. 3.1) Technical Document: Minimum content creation for the formulation of the ERCC Approved by the General Directorate of Climate Change, Desertification and Water Resources of the Ministry of Environment (DGCCDRH—MINAM). Gobierno Regional de Huancavelica (2017, pp. 10, 12, 13, 14) and Consejo Regional Huancavelica (2017) Huánuco Installation and preparation of the GTRCC work plan (2012) Based on the MINAM guidance on regional strategy development, they have divided this process into four stages. The initial stage involves the regional government of Huánuco sending representatives from RRNGA and the Ministry of the Environment, also included were the DGCCDRH (Desertification and Water Resources), and various public and private organizations. The formulation stage is ongoing and started in August 2012 with the first meeting of the GTRCC to carry out the planning of activities within the framework of its functions, With the latest meeting occurring in 2014 to gather feedback and create new methodological guidelines where the impact indicators were specified, and the approach incorporated of risk analysis from a sector perspective. A plan for implementation has been put in place with a focus on communities and districts, ecosystems, watersheds, and civil and private organization participation. National Climate Change Strategy (Supreme Decree No. 011-2015-MINAM); Organic Law of Regional Governments 27867; Organic Law of Municipalities N ° 27972 (art. 73 inc. 3.1); Regional Ordinance 080-2018-GRHCO, which approves the ERCC of the Huánuco region and its 2017–21 implementation plan and forms the Regional Climate Change Council. Guide for the preparation of the ERCC (2011); Intergovernmental Panel on Climate Change (IPCC), Regional Government of Huánuco (2012). Hydrography and hydrological balance studies: Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca provinces. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Climate study and living areas of the provinces of Pachitea, Huánuco, Puerto Inca, Leoncio Prado and Marañón of the Huánuco department. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Reports on soils and greater use capacity. Provinces of Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Forestry studies of the provinces of Huánuco, Leoncio Prado and Marañón. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Risk Study of the Provinces of Huánuco, Gobierno Regional de Huánuco(2017, pp. 10, 12, 14) and El Consejo Regional del Gobierno Regional Huánuco (2018) Ica · A unit was established in 2012 to establish the main guidelines and outline the general organization of the process (with IDB participation). The same year, the GTRCC was formed with 24 public and private institutions in the region. The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. Article 53.c of Organic Law 27867 Bicentennial Plan: Peru by 2021 (Strategic axis 6: Natural resources and environment) National Environment Policy (DS 012-2009-MINAM) National Strategy on Climate Change (DS 086-2003-PCM of 27 October 2003) Regional Ordinance 0012-2014-GORE-ICA (17 December 2014), which approves the Regional Climate Change Strategy of Ica (ERCC-ICA) Ica Regional Concerted Development Plan (PDRC-Ica) 2010–21 Regional Environmental Management System (created by Regional Ordinance 0015-2004-GORE-ICA) Regional Executive Resolution 0181-2014-GORE-ICA/PR (which approves the Integrated Regional Plan for Community Education in Disaster Risk Management and Climate Change Adaptation 2014–15) Guide for the preparation of the ERCC (2011); Gobierno Regional de Ica(2014, pp. 19–21, 22) La Libertad N/A N/A N/A N/A Gobierno Regional de la Libertad (2011) The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. The Regional Environmental Commission has worked on the 2015–16 Environmental Agenda. In the development process, we have: Collection of primary and secondary information; Analysis and information processing; Drafting of the adaptation diagnostic technical report, potential sources of GHG and institutionality; Socialization and Validation Workshops of the Components of Strategic Diagnosis of Vulnerability, Institutionality and GHG; Drafting of the ERCC strategic planning; Final systematization, including strategic planning. Regional Ordinance N 020-2016 GR-LL/CR, which updates the ERCC, 2016–21 National Climate Change Strategy (2015), Technical guidelines for the formulation of ERCC, Promoted by the Directorate General for Climate Change, Desertification and Water Resources of MINAM Gobierno Regional de la Libertad (2016, pp. 11–12, 116, 2017) Lambayeque The GTRCC was created through Executive Resolution No 338-2008-GR/LAMB/PR 23 of September 2008 Process begins with Establishment of GTRCC in 2008 Regional Government of Lambayeque and GTRCC of Lambayeque formulated the ERCC. N/A United Nations Framework for Climate Change Convention (UNFCCC) Intergovernmental Panel on Climate Change (IPCC) Kyoto Protocol Gobierno Regional de Lambayeque (2010) N/A La Gerencia Regional d Recursos Naturales y Gestión del Medio Ambiente ha liderado el proceso de actualización de la ERCC. (Dentro de la ERCC se menciona la necesidad de crear un Fondo de investigación sobre CC) Regional Ordinance 013-2016-GR.LAMB/CR approving the ERCC 2016–21 for Lambayeque (ERCC 2016–21) on 27.12.2016 Plan de Desarrollo Regional Conceertado—PDRC (2011–25) Proyecto Regional de creación de Fondo de investigación sobre CC Gobierno Regional de Lambayeque (2016a, pp. 73, 81, 2016b) Lima Metropolitana A regional workshop with representation from regional as well as international actors including PGRLM, IMP and the Environment Secretary from Ecuador. Also included were workshops with representatives from civil society. The process can be divided into two steps: the initial phase and the processing phase. The stages have been fluid, with some of them being carried out in parallel steps. As suggested in the Guide for the Development of Regional Climate Change Strategies of MINAM, while the MML promoted the formation of the GTCC within the Metropolitan Environmental Commission. The GTCC was formalized through the City Services Management Resolution No. 010 of 2012, which designates the members of the Metropolitan-GTM Technical Groups of the CAM. Ordinance 1836 (11 November 2014), approving the Adaptation Strategy and Mitigation Actions of the Province of Lima to Climate Change; Law 27867, Organic Law of the Regional Governments; Ordinance 1628 establishing the Metropolitan Environmental Policy; Ordinance 1640 which approved the Metropolitan Environmental Agenda 2012–14; Lima Metropolitan Municipal Environmental Plan 2011–14 Guide for the elaboration of Regional Strategies against Climate Change of MINAM The Methodological Guide for the Adaptation to the Impacts of Climate Change on Cities and Mitigation Options of Greenhouse Gas Emissions from the Cities for Life Forum, Scientific information provided by national and international entities and by civil society. Gerencia del Ambiente (2015, pp. 7, 8, 59, 136–138) and Municipalidad Metropolitana de Lima (2014) Lima Provincias Establishment of the Regional Environmental Commission (Regional Ordinance 07-2014-CR-GL); Regional Technical Group on Climate Change of the GORE Lima (Regional Decree 005-2015-GRL/PRES); EbA Mountain Project; Regional Resolution 538-2015 The plans for the ERCC began in August 2014. The GTRCC was then confirmed and formulated between January and June 2015. Centralized and decentralized workshops were held between 2013 and 2015 (a total of 15), Permanent technical assistance of the DGCCDRH of MINAM. In 2015, an ERCC strategic planning workshop was held, in addition to seven meetings with the key sectors prioritized in the ERCC, and the preliminary ERCC document was prepared. Finally, the regional consultation and consensus between the GTRCC and the Regional Environmental Commission were developed. Regional Ordinance 07-2016-CR/GRL, which approves the Regional Climate Change Strategy 2015–21 of the Lima Region; Organic Law of Regional Governments—Law 27867; Regional Ordinance 015-2013-CR/GRL, which declares the development and implementation of the ERCC of priority interest, under the direction of the Regional Management of Natural Resources and Environmental Management; Strategic Plan for Regional Development Concerted Lima Region to 2021 (2008) Guide for the formulation of Regional Strategies for Climate Change (in update) of the MNAM; Directive 001-2014-CEPLAN, which guides the strategic planning process of the instruments of development. Gobierno Regional de Lima (2015, pp. 11, 13–15, 103, 104, 108, 2016) Loreto The Regional Environmental Commission of Loreto, through Regional Ordinance No. 020-2008-GRL-CR, dated 11 July 2008 created the GTRCC of Loreto. The GTRCC of Loreto, through various meetings and workshops validated the proposal of the Climate Change Diagnosis presented by the Regional Government of Loreto Subsequently initiated the ERCC. This document was reviewed and presented to the Regional Environmental Commission, validated in the LXXIII Regular Session dated 10 March 2011. Regional Ordinance N ° 009-2011-GRL-CR Regional Ordinance No. 014–2004—CR/GRL Organic Law of Regional Governments; Regulation of Organization and Functions of the Regional Government of Loreto (Regional Ordinance No. 031-2008-GRL-CR The United Nations Convention on Climate Change, ‘a guiding instrument for the regional plans, and frequently referenced in the plans’. The Kyoto Protocol, The United Nations Framework Convention on Biological Diversity (CBD), The United Nations Convention Fight against Desertification, The National Climate Change Strategy (ENCC), The National Environmental Agenda were referenced as well. Gobierno Regional de Loreto (2011, pp. iv, v, 17) Junín As per the Regional Executive Resolution No. 406-2014-GR-JUNÍN, the formation of the Regional Technical Group on Climate Change was approved, with the objective of having a technical body, composed of public institutions and private organizations, to accompany the formulation process of the ERCC. The ERCC was formulated over 2 years of work during various meetings with experts, authorities, political leaders and representatives of the public sector, civil society in addition to participatory and decentralized workshops within the department of Junín. For the formulation of the ERCC, the methodology, procedures, functional responsibilities and the work schedule were established, comprising all the entities that make up the GTRCC. The process was participatory and decentralized in the nine provinces of the department of Junín, with 22 workshops, 10 meetings of the Management Committee and 4 of the Regional Climate Change Technical Group, between January 2013 and October 2014, in which representatives participated of the DGCCDRH—MINAM, UNDP EbA Montaña, Junín Regional Government, local governments, private organizations, universities and civil society. Regional Ordinance 189—2014- GRJ/CR, which approves the Regional Climate Change Strategy of the Junín Region; Regional Ordinance 060-GRJ/CR Regional Decree 002-2007-GR-Junín/PR Regional Decree 003-2007-GR-Junín/PR Regional Ordinance 118-2011-GRJ/CR Regional Agreement 270-2011- GRJ/CR Regional Agreement 286—2011 –GRJ/CR Regional Agreement 361-2011-GRJ/CR Regional Executive Resolution 131-2012-GR –JUNIN/PR Regional Agreement 178-2013-GRJ/CR Regional Ordinance 175-2014-GRJ/CR Regional Ordinance 097—2009 GRJ/CR Supreme Decree 018—2011—MINAM Regional Ordinance 106—2011-GRJ/CR Regional Agreement 045- 2009- GR-Junín/PR Intergovernmental Panel on Climate Change (IPCC) The United Nations Framework Convention on Climate Change (UNFCCC); National Climate Change Strategy (ENCC) Gobierno Regional Junín (2015, pp. 12,13, 98–102) Madre de Dios Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 003-2019-RMDD/CR, which approves the environmental management document called: ‘Regional Climate Change Strategy of Madre de Dios 2017-2021’ Gobierno Regional de Madre de Dios (2019) Moquegua Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 10-2016-CR/GRM, which approves the 2016–21 Regional Climate Change Strategy of the Moquegua region and its Implementation Plan. Gobierno Regional de Moquegua (2016) Pasco Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 394-2016-G.R.P/CR, which approves the Pasco Regional Climate Change Strategy and Awareness, Communication and Capacity Building Plan for the Implementation of the Pascodel ERCC 5 May 2016 Gobierno Regional de Pasco (2016) Piura The strategy formulation process began in July 2010 The GTRCC was formalized by Regional Management Resolution 248-2010/GOB.REG.PIURA-RRMyGMAGR, of 29 December 2010. The document and study titled ‘REGIONAL STRATEGY OF CLIMATE CHANGE IN PIURA—Advances in the formulation’, was prepared by the IDEAS Center in February of 2011. The study was evaluated, observed, verified and subsequently approved in a session of the Multisectoral Climate Change Board, and subsequently approved unanimously, in Ordinary Session No. 10—2011 of the Council Regional Government Regional Piura, dated 19 October 2011. Organic Law of Regional Governments (Law 27867); Regional Ordinance No. 224-2011/GRP-CR, approve the ERCC of Piura. National Climate Change Strategy (ENCC); The Guide for the Development of Regional Strategies against Climate Change; The Adaptation and Mitigation Action Plan against Climate Ahange; Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Piura (2013, p. 6) Puno The GTRCC is created by RER N ° 147-2011-PR-GR PUNO of 13 April 2011, and as per Regional Decree 06-2013-PR-GR PUNO, the new conformation of the GTRCC is approved For the creation of the Puno ERCC, the following methodologies were used: Information collection: Information was collected from public institutions whose work is directly or indirectly related to environmental and/or related issues. Interviews: Interviews were conducted with representatives of public institutions that work on environmental and related issues. Participatory workshops: These workshops were held in 6 provinces of Puno: Melgar, Azángaro, Carabaya, El Collao, Sandia and Puno. Workshops allowed a participatory dialogue with representatives of public, private institutions and grassroots organizations Regional Ordinance 011-2013-GRP-CRP approves the Regional Environmental Management Instrument known as the Puno ERCC. Organic Law of Regional Governments, Law No. 27867. Regional Ordinance No. 020- 2005- CR-GRP approves the Regional System of Environmental Management of the Puno Region. Municipal Ordinance No. 04—2007—MDNC approves the Local Environmental Management System and the Formation of the Municipal Environmental Commission. Municipal Ordinance No. 07—2007—MDNC, approving the Local Environmental Policy, Local Environmental Diagnosis, Local Environmental Action Plan and the Local Environmental Agenda. Regional Ordinance No. 018-2010 approves the Regional Environment Policy-Puno. Intergovernmental Panel on Climate Change (IPCC) Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, pp. 529–532, 556, 584–590), Gobierno Regional de Puno (2016) and Gobierno Regional de Puno (2013, 2016) San Martín Note: only the Regional Ordinance approving the ERCC has been found Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. 591) Tacna Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 005-2015-CR/GOB.REG.TACNA approved the Regional Environmental Management instrument called: ‘Tacna Regional Climate Change Strategy (ERCC)’ and dictates other provisions Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. F23) Ucayali Note: The new ERCC of Ucayali has been approved by Ordinance 021-2019-GRU-CR, but its content could not be accessed. Regional Executive Resolution 1175-2012-GRU-P of 26 October 2012, created the Regional Technical Group on Climate Change of Ucayali, with the purpose of developing and monitoring the Ucayali Regional Climate Change Strategy. The formulation of the ERCC began in June 2012 with four workshops held in the city of Pucallpa, one in the Province of Atalaya and one in the Province of Padre Abad, In addition to a Specialization Course on Adaptation to Climate Change, ran in conjunction with the Pontifical Catholic University From Peru. Regional Ordinance 011-2014-GRU/CR approved the Management Instrument known as the Ucayali ERCC; Regional Ordinance No. 011-2012-CR/GRU Regional Executive Resolution No. 0924—2011-GRU-P approved the—Concerted Regional Development Plan 2011–21 Law No. 27867—Organic Law of Regional Governments. Article 53—Functions in environmental matters and territorial planning Regional Ordinance No. 017-2011-GRU/CR recognizes the Regional Environmental Commission of Ucayali—CARU and its Regulations. Regional Ordinance No. 004-2012-GRU/CR, approved the Regional Environmental Policy, the Regional Environmental Action Plan 2012–21 and the Regional Environmental Agenda 2012–13. Intergovernmental Panel on Climate Change (IPCC) First National Communication to the United Nations Secretariat of the Framework Convention on Climate Change Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Ucayali (2013, pp. 12, 19, 25, 104) and Gobierno Regional de Ucayali (2019) National Adaptation Plan The purpose of the ENCC is to ensure that public entities and government sectors are able to carry out a management process that allows the delivery of products/goods and services to citizens through processes that are effective, economical and of quality. The ENCC is structured in accordance with the National Policy of Modernization of Public Management in 2021, as the instrument that guides and promotes national actions related to climate change, providing the necessary guidelines for sectors, regions and public institutions in general to implement according to action plans. Supreme Decree 011-2015-MINAM; Fifth Report of the Intergovernmental Panel on Climate Change1 (IPCC); COP 20 (Lima, 2014), which approved the ‘Lima Call for Climate Action’; National Policy for Modernization of Public Management (PNMGE) –D.S. No. 004-2013-PCM; General Directive of the Strategic Planning Process of the National Strategic Planning System—Presidency Resolution of the Board of Directors No. 26-2014-CEPLAN and Directive No. 001-201-CEPLAN Thematic Working Groups (GTT) of the National Commission on Climate Change; The Multisectoral Commission Report created by Resolution 189-2012-PCM, through which it is planned to update the National Climate Change Strategy and establish a Climate Change Plan (CC Plan); Expected and Determined Contribution at National Level (iNDC). MINAM(2015, pp. 9, 19, 33, 41) National Adaptation Plan Reduce adverse impacts of climate change through integrated vulnerability and adaptation studies, which will identify vulnerable areas and/or sectors in the country where adaptation projects will be implemented. The process of preparing the National Climate Change Strategy is based on the document created by the National Commission in Cusipata (2001). It outlines 11 strategic lines with their respective strategic objectives and strategic goals (developed by thematic working groups). Additionally, a workshop on prioritization of strategic lines was held. United Nations Framework Convention on Climate Change (UNFCCC); Kyoto Protocol; Supreme Decree 086-2003-PCM (published by the ENCC) National Communication of Peru to the United Nations Framework Convention on Climate Change CONAM (2002, pp. 9–13, 15) Regional Department . Establishing a process . Formulation process . Legal, normative and technical basis . Process supporting documents and regulations . References . Ancash Regional Technical Group for Climate Change (2013), Project IMACC for BID-MINAM: Vulnerability Diagnosis (2014), Technical Group Relaunch (2015) Financial support from the BID, the process has been led by the Natural Resources and Environmental Management group from Ancash, GTRCC, the Regional Environmental and Environmental Commission of the Regional Council Technical assistance from the General Directorate of Climate Change, Desertification and Water Resources, and the ‘Ensuring Water and Means of Mountain life’ project. Supreme Decree 011-2015-MINAM, which approves the National Strategy on Climate Change (ENCC); Regional Ordinance 006-2016-GRA/CR Methodological guidelines for the elaboration of ERCC Gobierno Regional de Ancash (2017, pp. 5, 55, 56) Apurímac Technical Group for Vulnerability and Adaptation to Climate Change (2009), Regional Operational Unit for Climate Change Programs and Projects; ERCC Drive Group Information was synthesized in workshops in each of the 10 provinces Inclusion of professionals, technicians and social leaders To collect information from the public regarding their perception of climate change To identify the issues at various ecological levels, To develop local proposals for climate change adaptation strategies and measures. Regional Ordinance 010-2012-GR-APURIMAC/CR Strategic Plan for Regional Concerted Development; The United Nations Framework Convention on Climate Change—UNFCCC Gobierno Regional de Apurímac (2012, pp. 3, 4, 7, 14, 23–25) Arequipa As per the 043-2008-GRA/CR-Arequipa Regional Agreement the elaboration of the Regional Strategy for Adaptation to Climate Change in the Arequipa Region was prioritized with a multidisciplinary and intersectoral vision. This included the planning of sustainable development in district and provincial local governments, emphasizing knowledge, prevention and mitigation of climate risks, In addition to seeking the allocation of public and private resources, and defining responsibilities at each level and organizational unit. Proposed actions for the continuity of adaptation measures and actors involved in the implementation: Development of the ERCC which includes input from the regional government, provincial municipalities, NGOs, universities Institutional regional development to begin studies, monitoring and prevention of the effects of climate change Strategic management for water systems, with a focus on rural and industrial areas Specific policy targeting the dissemination of climate information for preventive actions (national government, regional government, SENAMHI). Dissemination of adaptation measures for the management of water resources and agricultural production with irrigation organizations [MINAG, AUTODEMA, User Board, Subsectoral Irrigation Programme (PSI)]. Targeting the education sector to raise awareness about the issue and the formation of response capacities by the population (UGEL Education). Advance in the elaboration of regional contingency plans to face the projected critical scenarios (Regional Government. Civil Defense, Geophysical Institute, SENAMHI). Regional Agreement 043-2008-GRA/CR-AREQUIPA, which confirms the GTRCC to elaborate the ERCC Regional Agreement 143-2010-GRA/CR-AREQUIPA, to approve the ERCC The United Nations Framework Convention on Biological Diversity—CBD Kyoto Protocol The National Strategy for Climate Change, approved in 2002, State policies of the governance agreement (2002); Monitoring programme for monitoring climate change in the Piura region between 2003 and 2005; First pilot measure of climate change adaptation conducted between July 2007 and September 2008, Under the guidance of the Regional Government of Arequipa German Technical Co-operation (GTZ). Gobierno Regional de Arequipa (2009, pp. 1–2, 30, 31) Ayacucho The formulation process began in 2010 The ERCC was published in 2015 GTRCC as per the Executive Regional Resolution 222-2010-GRA/PRES) Action plan for the ERCC as per the Regional Ordinance 032-2011-GRA/CR from 26.12.2011 Ayacucho GTRCC as per the Executive Regional Resolution 865-2014-GRA/PRES (14.11.2014) Project entitled ‘Improving the Regional Environmental Management department of Ayacucho’ Co-ordination with the Regional Technical Group on Climate Change Collection of primary and secondary information Information analysis and processing Drafting of the adaptation diagnostic technical report 03 Decentralized workshops on ‘Socialization and Contributions of the Diagnoses of the Strategy and Regional Action Plan against Climate Change Ayacucho’ Workshop on ‘Socialization and Validation of the Diagnoses of the Strategy and Regional Plan of Action against Climate Change Ayacucho’ Articulation of the ERCC with planning instruments Grupo Técnico Regional de CC de Huancavelica, constituido el 2012 (Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR.) Artícle 53.c of the Law 27867 establishing the precedent that each regional government must have its own Regional Strategy against Climate Change Regional Ordinance No. 032-2011 GRA/CR, approve for social, economic and environmental benefits, The Regional Strategy for Climate Change in Ayacucho and the Action Plan of the Strategy for Climate Change in Ayacucho to 2017. Intergovernmental Panel on Climate Change (IPCC), Peru and Climate Change: Second National Communication on Climate Change United Nations Framework for Climate Change Convention (UNFCCC) Support and technical advise from MINAM. Gobierno Regional de Ayacucho (2015, pp. 10, 11, 13, 14, 15) Cajamarca Constitution of the Technical Group on Climate Change (2005), Creation and implementation of the Regional Technical Group of Climate Change and Risk Management for Cajamarca, Responsible for preparing a strategy proposal for Regional Climate Change and Risk Management, through a Regional Participatory Process (2011) The Regional Government of Cajamaca, through the Regional Environmental Commission and its GTRCC, prepared the ERCC, applying a participatory methodological proposal, Previously agreed upon and approved by MINAM, Adapting it to the region and to the proposals and suggestions of the actors involved in the process. Regional ordinance 021-2013-GR.CAJ-CR that approved the ERCC of Cajamarca; Organic law for regional governments (Ley 27867); National Environment Policy (2009); National Climate Change Strategy (2003); Adaptation and Mitigation Action Plan against Climate Change (2010); National Environmental Action Plan—PLANAA 2011–21 (9 July 2011); Peru Environment Agenda 2013–14. ·Guide for preparation of the ERCC (2011) Gobierno Regional de Cajamarca (2016, pp. 6–9, 10, 14) Cusco Creation of the Regional Operational Unit of the Adaptation Programme to Climate Change—UOR- PACC through the Regional Executive Resolution No. 1164-2009-GRCUSCO/PR, Which creates process of consensus and inter-institutional orientations Exhibited in OR 070-2010 CR/GRC on the steps to be taken and the instances to be commissioned; Thus, the GTRCC for the Cusco region was created The elaboration of the ERCC was carried through a participatory process, concerted and articulated, which gathered local and regional development actors: Authorities, institutions and citizens who were responsible for the formulation of ERCC. In this process, the GTRFCC was involved, thematic tables and territorial consultations were developed Regional Ordinance 020-2012-CR/ GRC.CUSCO approved the ERCC; Law 27867—Organic Law of Regional Governments; Regional Ordinance No. 081-2010-CR/GRCUSCO, which approved the Strategic Plan for the Development of Cusco; Regional Executive Resolution Nº 1164-2009-GR CUSCO/PR, make up the Regional Operational Unit of the Climate Change Adaptation Programme; Regional Ordinance Nº 070-2010 CR/GRC. CUSCO, created the GTRCC. Gobierno Regional de Cusco (2012, pp. 9, 10, 17, 18, 48, 49) Huancavelica GTRCC of Huancavelica, established in 2012 (through the Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR) The ERCC and implementation plan were formulated under the leadership of the Regional Government of Huancavelica, Represented by the Natural Resources and Environmental Management group, Participation by the GTRCC, an inter-institutional space composed of representatives of public and private institutions committed to the development of the Huancavelica region, With the participation of social leaders, political decision-makers, civil servants and civil society. Supreme Decree-011-2015-MINAM; Supreme Decree 058-2016-RE, ratifying the Paris Agreement; Ministerial Resolution 090-2016 MINAM, promoting integrated management of climate change. Organic Law of Regional Governments 27867; Organic Law of Municipalities ° 27972 (art. 73 inc. 3.1) Technical Document: Minimum content creation for the formulation of the ERCC Approved by the General Directorate of Climate Change, Desertification and Water Resources of the Ministry of Environment (DGCCDRH—MINAM). Gobierno Regional de Huancavelica (2017, pp. 10, 12, 13, 14) and Consejo Regional Huancavelica (2017) Huánuco Installation and preparation of the GTRCC work plan (2012) Based on the MINAM guidance on regional strategy development, they have divided this process into four stages. The initial stage involves the regional government of Huánuco sending representatives from RRNGA and the Ministry of the Environment, also included were the DGCCDRH (Desertification and Water Resources), and various public and private organizations. The formulation stage is ongoing and started in August 2012 with the first meeting of the GTRCC to carry out the planning of activities within the framework of its functions, With the latest meeting occurring in 2014 to gather feedback and create new methodological guidelines where the impact indicators were specified, and the approach incorporated of risk analysis from a sector perspective. A plan for implementation has been put in place with a focus on communities and districts, ecosystems, watersheds, and civil and private organization participation. National Climate Change Strategy (Supreme Decree No. 011-2015-MINAM); Organic Law of Regional Governments 27867; Organic Law of Municipalities N ° 27972 (art. 73 inc. 3.1); Regional Ordinance 080-2018-GRHCO, which approves the ERCC of the Huánuco region and its 2017–21 implementation plan and forms the Regional Climate Change Council. Guide for the preparation of the ERCC (2011); Intergovernmental Panel on Climate Change (IPCC), Regional Government of Huánuco (2012). Hydrography and hydrological balance studies: Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca provinces. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Climate study and living areas of the provinces of Pachitea, Huánuco, Puerto Inca, Leoncio Prado and Marañón of the Huánuco department. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Reports on soils and greater use capacity. Provinces of Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Forestry studies of the provinces of Huánuco, Leoncio Prado and Marañón. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Risk Study of the Provinces of Huánuco, Gobierno Regional de Huánuco(2017, pp. 10, 12, 14) and El Consejo Regional del Gobierno Regional Huánuco (2018) Ica · A unit was established in 2012 to establish the main guidelines and outline the general organization of the process (with IDB participation). The same year, the GTRCC was formed with 24 public and private institutions in the region. The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. Article 53.c of Organic Law 27867 Bicentennial Plan: Peru by 2021 (Strategic axis 6: Natural resources and environment) National Environment Policy (DS 012-2009-MINAM) National Strategy on Climate Change (DS 086-2003-PCM of 27 October 2003) Regional Ordinance 0012-2014-GORE-ICA (17 December 2014), which approves the Regional Climate Change Strategy of Ica (ERCC-ICA) Ica Regional Concerted Development Plan (PDRC-Ica) 2010–21 Regional Environmental Management System (created by Regional Ordinance 0015-2004-GORE-ICA) Regional Executive Resolution 0181-2014-GORE-ICA/PR (which approves the Integrated Regional Plan for Community Education in Disaster Risk Management and Climate Change Adaptation 2014–15) Guide for the preparation of the ERCC (2011); Gobierno Regional de Ica(2014, pp. 19–21, 22) La Libertad N/A N/A N/A N/A Gobierno Regional de la Libertad (2011) The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. The Regional Environmental Commission has worked on the 2015–16 Environmental Agenda. In the development process, we have: Collection of primary and secondary information; Analysis and information processing; Drafting of the adaptation diagnostic technical report, potential sources of GHG and institutionality; Socialization and Validation Workshops of the Components of Strategic Diagnosis of Vulnerability, Institutionality and GHG; Drafting of the ERCC strategic planning; Final systematization, including strategic planning. Regional Ordinance N 020-2016 GR-LL/CR, which updates the ERCC, 2016–21 National Climate Change Strategy (2015), Technical guidelines for the formulation of ERCC, Promoted by the Directorate General for Climate Change, Desertification and Water Resources of MINAM Gobierno Regional de la Libertad (2016, pp. 11–12, 116, 2017) Lambayeque The GTRCC was created through Executive Resolution No 338-2008-GR/LAMB/PR 23 of September 2008 Process begins with Establishment of GTRCC in 2008 Regional Government of Lambayeque and GTRCC of Lambayeque formulated the ERCC. N/A United Nations Framework for Climate Change Convention (UNFCCC) Intergovernmental Panel on Climate Change (IPCC) Kyoto Protocol Gobierno Regional de Lambayeque (2010) N/A La Gerencia Regional d Recursos Naturales y Gestión del Medio Ambiente ha liderado el proceso de actualización de la ERCC. (Dentro de la ERCC se menciona la necesidad de crear un Fondo de investigación sobre CC) Regional Ordinance 013-2016-GR.LAMB/CR approving the ERCC 2016–21 for Lambayeque (ERCC 2016–21) on 27.12.2016 Plan de Desarrollo Regional Conceertado—PDRC (2011–25) Proyecto Regional de creación de Fondo de investigación sobre CC Gobierno Regional de Lambayeque (2016a, pp. 73, 81, 2016b) Lima Metropolitana A regional workshop with representation from regional as well as international actors including PGRLM, IMP and the Environment Secretary from Ecuador. Also included were workshops with representatives from civil society. The process can be divided into two steps: the initial phase and the processing phase. The stages have been fluid, with some of them being carried out in parallel steps. As suggested in the Guide for the Development of Regional Climate Change Strategies of MINAM, while the MML promoted the formation of the GTCC within the Metropolitan Environmental Commission. The GTCC was formalized through the City Services Management Resolution No. 010 of 2012, which designates the members of the Metropolitan-GTM Technical Groups of the CAM. Ordinance 1836 (11 November 2014), approving the Adaptation Strategy and Mitigation Actions of the Province of Lima to Climate Change; Law 27867, Organic Law of the Regional Governments; Ordinance 1628 establishing the Metropolitan Environmental Policy; Ordinance 1640 which approved the Metropolitan Environmental Agenda 2012–14; Lima Metropolitan Municipal Environmental Plan 2011–14 Guide for the elaboration of Regional Strategies against Climate Change of MINAM The Methodological Guide for the Adaptation to the Impacts of Climate Change on Cities and Mitigation Options of Greenhouse Gas Emissions from the Cities for Life Forum, Scientific information provided by national and international entities and by civil society. Gerencia del Ambiente (2015, pp. 7, 8, 59, 136–138) and Municipalidad Metropolitana de Lima (2014) Lima Provincias Establishment of the Regional Environmental Commission (Regional Ordinance 07-2014-CR-GL); Regional Technical Group on Climate Change of the GORE Lima (Regional Decree 005-2015-GRL/PRES); EbA Mountain Project; Regional Resolution 538-2015 The plans for the ERCC began in August 2014. The GTRCC was then confirmed and formulated between January and June 2015. Centralized and decentralized workshops were held between 2013 and 2015 (a total of 15), Permanent technical assistance of the DGCCDRH of MINAM. In 2015, an ERCC strategic planning workshop was held, in addition to seven meetings with the key sectors prioritized in the ERCC, and the preliminary ERCC document was prepared. Finally, the regional consultation and consensus between the GTRCC and the Regional Environmental Commission were developed. Regional Ordinance 07-2016-CR/GRL, which approves the Regional Climate Change Strategy 2015–21 of the Lima Region; Organic Law of Regional Governments—Law 27867; Regional Ordinance 015-2013-CR/GRL, which declares the development and implementation of the ERCC of priority interest, under the direction of the Regional Management of Natural Resources and Environmental Management; Strategic Plan for Regional Development Concerted Lima Region to 2021 (2008) Guide for the formulation of Regional Strategies for Climate Change (in update) of the MNAM; Directive 001-2014-CEPLAN, which guides the strategic planning process of the instruments of development. Gobierno Regional de Lima (2015, pp. 11, 13–15, 103, 104, 108, 2016) Loreto The Regional Environmental Commission of Loreto, through Regional Ordinance No. 020-2008-GRL-CR, dated 11 July 2008 created the GTRCC of Loreto. The GTRCC of Loreto, through various meetings and workshops validated the proposal of the Climate Change Diagnosis presented by the Regional Government of Loreto Subsequently initiated the ERCC. This document was reviewed and presented to the Regional Environmental Commission, validated in the LXXIII Regular Session dated 10 March 2011. Regional Ordinance N ° 009-2011-GRL-CR Regional Ordinance No. 014–2004—CR/GRL Organic Law of Regional Governments; Regulation of Organization and Functions of the Regional Government of Loreto (Regional Ordinance No. 031-2008-GRL-CR The United Nations Convention on Climate Change, ‘a guiding instrument for the regional plans, and frequently referenced in the plans’. The Kyoto Protocol, The United Nations Framework Convention on Biological Diversity (CBD), The United Nations Convention Fight against Desertification, The National Climate Change Strategy (ENCC), The National Environmental Agenda were referenced as well. Gobierno Regional de Loreto (2011, pp. iv, v, 17) Junín As per the Regional Executive Resolution No. 406-2014-GR-JUNÍN, the formation of the Regional Technical Group on Climate Change was approved, with the objective of having a technical body, composed of public institutions and private organizations, to accompany the formulation process of the ERCC. The ERCC was formulated over 2 years of work during various meetings with experts, authorities, political leaders and representatives of the public sector, civil society in addition to participatory and decentralized workshops within the department of Junín. For the formulation of the ERCC, the methodology, procedures, functional responsibilities and the work schedule were established, comprising all the entities that make up the GTRCC. The process was participatory and decentralized in the nine provinces of the department of Junín, with 22 workshops, 10 meetings of the Management Committee and 4 of the Regional Climate Change Technical Group, between January 2013 and October 2014, in which representatives participated of the DGCCDRH—MINAM, UNDP EbA Montaña, Junín Regional Government, local governments, private organizations, universities and civil society. Regional Ordinance 189—2014- GRJ/CR, which approves the Regional Climate Change Strategy of the Junín Region; Regional Ordinance 060-GRJ/CR Regional Decree 002-2007-GR-Junín/PR Regional Decree 003-2007-GR-Junín/PR Regional Ordinance 118-2011-GRJ/CR Regional Agreement 270-2011- GRJ/CR Regional Agreement 286—2011 –GRJ/CR Regional Agreement 361-2011-GRJ/CR Regional Executive Resolution 131-2012-GR –JUNIN/PR Regional Agreement 178-2013-GRJ/CR Regional Ordinance 175-2014-GRJ/CR Regional Ordinance 097—2009 GRJ/CR Supreme Decree 018—2011—MINAM Regional Ordinance 106—2011-GRJ/CR Regional Agreement 045- 2009- GR-Junín/PR Intergovernmental Panel on Climate Change (IPCC) The United Nations Framework Convention on Climate Change (UNFCCC); National Climate Change Strategy (ENCC) Gobierno Regional Junín (2015, pp. 12,13, 98–102) Madre de Dios Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 003-2019-RMDD/CR, which approves the environmental management document called: ‘Regional Climate Change Strategy of Madre de Dios 2017-2021’ Gobierno Regional de Madre de Dios (2019) Moquegua Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 10-2016-CR/GRM, which approves the 2016–21 Regional Climate Change Strategy of the Moquegua region and its Implementation Plan. Gobierno Regional de Moquegua (2016) Pasco Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 394-2016-G.R.P/CR, which approves the Pasco Regional Climate Change Strategy and Awareness, Communication and Capacity Building Plan for the Implementation of the Pascodel ERCC 5 May 2016 Gobierno Regional de Pasco (2016) Piura The strategy formulation process began in July 2010 The GTRCC was formalized by Regional Management Resolution 248-2010/GOB.REG.PIURA-RRMyGMAGR, of 29 December 2010. The document and study titled ‘REGIONAL STRATEGY OF CLIMATE CHANGE IN PIURA—Advances in the formulation’, was prepared by the IDEAS Center in February of 2011. The study was evaluated, observed, verified and subsequently approved in a session of the Multisectoral Climate Change Board, and subsequently approved unanimously, in Ordinary Session No. 10—2011 of the Council Regional Government Regional Piura, dated 19 October 2011. Organic Law of Regional Governments (Law 27867); Regional Ordinance No. 224-2011/GRP-CR, approve the ERCC of Piura. National Climate Change Strategy (ENCC); The Guide for the Development of Regional Strategies against Climate Change; The Adaptation and Mitigation Action Plan against Climate Ahange; Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Piura (2013, p. 6) Puno The GTRCC is created by RER N ° 147-2011-PR-GR PUNO of 13 April 2011, and as per Regional Decree 06-2013-PR-GR PUNO, the new conformation of the GTRCC is approved For the creation of the Puno ERCC, the following methodologies were used: Information collection: Information was collected from public institutions whose work is directly or indirectly related to environmental and/or related issues. Interviews: Interviews were conducted with representatives of public institutions that work on environmental and related issues. Participatory workshops: These workshops were held in 6 provinces of Puno: Melgar, Azángaro, Carabaya, El Collao, Sandia and Puno. Workshops allowed a participatory dialogue with representatives of public, private institutions and grassroots organizations Regional Ordinance 011-2013-GRP-CRP approves the Regional Environmental Management Instrument known as the Puno ERCC. Organic Law of Regional Governments, Law No. 27867. Regional Ordinance No. 020- 2005- CR-GRP approves the Regional System of Environmental Management of the Puno Region. Municipal Ordinance No. 04—2007—MDNC approves the Local Environmental Management System and the Formation of the Municipal Environmental Commission. Municipal Ordinance No. 07—2007—MDNC, approving the Local Environmental Policy, Local Environmental Diagnosis, Local Environmental Action Plan and the Local Environmental Agenda. Regional Ordinance No. 018-2010 approves the Regional Environment Policy-Puno. Intergovernmental Panel on Climate Change (IPCC) Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, pp. 529–532, 556, 584–590), Gobierno Regional de Puno (2016) and Gobierno Regional de Puno (2013, 2016) San Martín Note: only the Regional Ordinance approving the ERCC has been found Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. 591) Tacna Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 005-2015-CR/GOB.REG.TACNA approved the Regional Environmental Management instrument called: ‘Tacna Regional Climate Change Strategy (ERCC)’ and dictates other provisions Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. F23) Ucayali Note: The new ERCC of Ucayali has been approved by Ordinance 021-2019-GRU-CR, but its content could not be accessed. Regional Executive Resolution 1175-2012-GRU-P of 26 October 2012, created the Regional Technical Group on Climate Change of Ucayali, with the purpose of developing and monitoring the Ucayali Regional Climate Change Strategy. The formulation of the ERCC began in June 2012 with four workshops held in the city of Pucallpa, one in the Province of Atalaya and one in the Province of Padre Abad, In addition to a Specialization Course on Adaptation to Climate Change, ran in conjunction with the Pontifical Catholic University From Peru. Regional Ordinance 011-2014-GRU/CR approved the Management Instrument known as the Ucayali ERCC; Regional Ordinance No. 011-2012-CR/GRU Regional Executive Resolution No. 0924—2011-GRU-P approved the—Concerted Regional Development Plan 2011–21 Law No. 27867—Organic Law of Regional Governments. Article 53—Functions in environmental matters and territorial planning Regional Ordinance No. 017-2011-GRU/CR recognizes the Regional Environmental Commission of Ucayali—CARU and its Regulations. Regional Ordinance No. 004-2012-GRU/CR, approved the Regional Environmental Policy, the Regional Environmental Action Plan 2012–21 and the Regional Environmental Agenda 2012–13. Intergovernmental Panel on Climate Change (IPCC) First National Communication to the United Nations Secretariat of the Framework Convention on Climate Change Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Ucayali (2013, pp. 12, 19, 25, 104) and Gobierno Regional de Ucayali (2019) National Adaptation Plan The purpose of the ENCC is to ensure that public entities and government sectors are able to carry out a management process that allows the delivery of products/goods and services to citizens through processes that are effective, economical and of quality. The ENCC is structured in accordance with the National Policy of Modernization of Public Management in 2021, as the instrument that guides and promotes national actions related to climate change, providing the necessary guidelines for sectors, regions and public institutions in general to implement according to action plans. Supreme Decree 011-2015-MINAM; Fifth Report of the Intergovernmental Panel on Climate Change1 (IPCC); COP 20 (Lima, 2014), which approved the ‘Lima Call for Climate Action’; National Policy for Modernization of Public Management (PNMGE) –D.S. No. 004-2013-PCM; General Directive of the Strategic Planning Process of the National Strategic Planning System—Presidency Resolution of the Board of Directors No. 26-2014-CEPLAN and Directive No. 001-201-CEPLAN Thematic Working Groups (GTT) of the National Commission on Climate Change; The Multisectoral Commission Report created by Resolution 189-2012-PCM, through which it is planned to update the National Climate Change Strategy and establish a Climate Change Plan (CC Plan); Expected and Determined Contribution at National Level (iNDC). MINAM(2015, pp. 9, 19, 33, 41) National Adaptation Plan Reduce adverse impacts of climate change through integrated vulnerability and adaptation studies, which will identify vulnerable areas and/or sectors in the country where adaptation projects will be implemented. The process of preparing the National Climate Change Strategy is based on the document created by the National Commission in Cusipata (2001). It outlines 11 strategic lines with their respective strategic objectives and strategic goals (developed by thematic working groups). Additionally, a workshop on prioritization of strategic lines was held. United Nations Framework Convention on Climate Change (UNFCCC); Kyoto Protocol; Supreme Decree 086-2003-PCM (published by the ENCC) National Communication of Peru to the United Nations Framework Convention on Climate Change CONAM (2002, pp. 9–13, 15) Open in new tab Table 5 Process analysis of regional adaptation plans Regional Department . Establishing a process . Formulation process . Legal, normative and technical basis . Process supporting documents and regulations . References . Ancash Regional Technical Group for Climate Change (2013), Project IMACC for BID-MINAM: Vulnerability Diagnosis (2014), Technical Group Relaunch (2015) Financial support from the BID, the process has been led by the Natural Resources and Environmental Management group from Ancash, GTRCC, the Regional Environmental and Environmental Commission of the Regional Council Technical assistance from the General Directorate of Climate Change, Desertification and Water Resources, and the ‘Ensuring Water and Means of Mountain life’ project. Supreme Decree 011-2015-MINAM, which approves the National Strategy on Climate Change (ENCC); Regional Ordinance 006-2016-GRA/CR Methodological guidelines for the elaboration of ERCC Gobierno Regional de Ancash (2017, pp. 5, 55, 56) Apurímac Technical Group for Vulnerability and Adaptation to Climate Change (2009), Regional Operational Unit for Climate Change Programs and Projects; ERCC Drive Group Information was synthesized in workshops in each of the 10 provinces Inclusion of professionals, technicians and social leaders To collect information from the public regarding their perception of climate change To identify the issues at various ecological levels, To develop local proposals for climate change adaptation strategies and measures. Regional Ordinance 010-2012-GR-APURIMAC/CR Strategic Plan for Regional Concerted Development; The United Nations Framework Convention on Climate Change—UNFCCC Gobierno Regional de Apurímac (2012, pp. 3, 4, 7, 14, 23–25) Arequipa As per the 043-2008-GRA/CR-Arequipa Regional Agreement the elaboration of the Regional Strategy for Adaptation to Climate Change in the Arequipa Region was prioritized with a multidisciplinary and intersectoral vision. This included the planning of sustainable development in district and provincial local governments, emphasizing knowledge, prevention and mitigation of climate risks, In addition to seeking the allocation of public and private resources, and defining responsibilities at each level and organizational unit. Proposed actions for the continuity of adaptation measures and actors involved in the implementation: Development of the ERCC which includes input from the regional government, provincial municipalities, NGOs, universities Institutional regional development to begin studies, monitoring and prevention of the effects of climate change Strategic management for water systems, with a focus on rural and industrial areas Specific policy targeting the dissemination of climate information for preventive actions (national government, regional government, SENAMHI). Dissemination of adaptation measures for the management of water resources and agricultural production with irrigation organizations [MINAG, AUTODEMA, User Board, Subsectoral Irrigation Programme (PSI)]. Targeting the education sector to raise awareness about the issue and the formation of response capacities by the population (UGEL Education). Advance in the elaboration of regional contingency plans to face the projected critical scenarios (Regional Government. Civil Defense, Geophysical Institute, SENAMHI). Regional Agreement 043-2008-GRA/CR-AREQUIPA, which confirms the GTRCC to elaborate the ERCC Regional Agreement 143-2010-GRA/CR-AREQUIPA, to approve the ERCC The United Nations Framework Convention on Biological Diversity—CBD Kyoto Protocol The National Strategy for Climate Change, approved in 2002, State policies of the governance agreement (2002); Monitoring programme for monitoring climate change in the Piura region between 2003 and 2005; First pilot measure of climate change adaptation conducted between July 2007 and September 2008, Under the guidance of the Regional Government of Arequipa German Technical Co-operation (GTZ). Gobierno Regional de Arequipa (2009, pp. 1–2, 30, 31) Ayacucho The formulation process began in 2010 The ERCC was published in 2015 GTRCC as per the Executive Regional Resolution 222-2010-GRA/PRES) Action plan for the ERCC as per the Regional Ordinance 032-2011-GRA/CR from 26.12.2011 Ayacucho GTRCC as per the Executive Regional Resolution 865-2014-GRA/PRES (14.11.2014) Project entitled ‘Improving the Regional Environmental Management department of Ayacucho’ Co-ordination with the Regional Technical Group on Climate Change Collection of primary and secondary information Information analysis and processing Drafting of the adaptation diagnostic technical report 03 Decentralized workshops on ‘Socialization and Contributions of the Diagnoses of the Strategy and Regional Action Plan against Climate Change Ayacucho’ Workshop on ‘Socialization and Validation of the Diagnoses of the Strategy and Regional Plan of Action against Climate Change Ayacucho’ Articulation of the ERCC with planning instruments Grupo Técnico Regional de CC de Huancavelica, constituido el 2012 (Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR.) Artícle 53.c of the Law 27867 establishing the precedent that each regional government must have its own Regional Strategy against Climate Change Regional Ordinance No. 032-2011 GRA/CR, approve for social, economic and environmental benefits, The Regional Strategy for Climate Change in Ayacucho and the Action Plan of the Strategy for Climate Change in Ayacucho to 2017. Intergovernmental Panel on Climate Change (IPCC), Peru and Climate Change: Second National Communication on Climate Change United Nations Framework for Climate Change Convention (UNFCCC) Support and technical advise from MINAM. Gobierno Regional de Ayacucho (2015, pp. 10, 11, 13, 14, 15) Cajamarca Constitution of the Technical Group on Climate Change (2005), Creation and implementation of the Regional Technical Group of Climate Change and Risk Management for Cajamarca, Responsible for preparing a strategy proposal for Regional Climate Change and Risk Management, through a Regional Participatory Process (2011) The Regional Government of Cajamaca, through the Regional Environmental Commission and its GTRCC, prepared the ERCC, applying a participatory methodological proposal, Previously agreed upon and approved by MINAM, Adapting it to the region and to the proposals and suggestions of the actors involved in the process. Regional ordinance 021-2013-GR.CAJ-CR that approved the ERCC of Cajamarca; Organic law for regional governments (Ley 27867); National Environment Policy (2009); National Climate Change Strategy (2003); Adaptation and Mitigation Action Plan against Climate Change (2010); National Environmental Action Plan—PLANAA 2011–21 (9 July 2011); Peru Environment Agenda 2013–14. ·Guide for preparation of the ERCC (2011) Gobierno Regional de Cajamarca (2016, pp. 6–9, 10, 14) Cusco Creation of the Regional Operational Unit of the Adaptation Programme to Climate Change—UOR- PACC through the Regional Executive Resolution No. 1164-2009-GRCUSCO/PR, Which creates process of consensus and inter-institutional orientations Exhibited in OR 070-2010 CR/GRC on the steps to be taken and the instances to be commissioned; Thus, the GTRCC for the Cusco region was created The elaboration of the ERCC was carried through a participatory process, concerted and articulated, which gathered local and regional development actors: Authorities, institutions and citizens who were responsible for the formulation of ERCC. In this process, the GTRFCC was involved, thematic tables and territorial consultations were developed Regional Ordinance 020-2012-CR/ GRC.CUSCO approved the ERCC; Law 27867—Organic Law of Regional Governments; Regional Ordinance No. 081-2010-CR/GRCUSCO, which approved the Strategic Plan for the Development of Cusco; Regional Executive Resolution Nº 1164-2009-GR CUSCO/PR, make up the Regional Operational Unit of the Climate Change Adaptation Programme; Regional Ordinance Nº 070-2010 CR/GRC. CUSCO, created the GTRCC. Gobierno Regional de Cusco (2012, pp. 9, 10, 17, 18, 48, 49) Huancavelica GTRCC of Huancavelica, established in 2012 (through the Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR) The ERCC and implementation plan were formulated under the leadership of the Regional Government of Huancavelica, Represented by the Natural Resources and Environmental Management group, Participation by the GTRCC, an inter-institutional space composed of representatives of public and private institutions committed to the development of the Huancavelica region, With the participation of social leaders, political decision-makers, civil servants and civil society. Supreme Decree-011-2015-MINAM; Supreme Decree 058-2016-RE, ratifying the Paris Agreement; Ministerial Resolution 090-2016 MINAM, promoting integrated management of climate change. Organic Law of Regional Governments 27867; Organic Law of Municipalities ° 27972 (art. 73 inc. 3.1) Technical Document: Minimum content creation for the formulation of the ERCC Approved by the General Directorate of Climate Change, Desertification and Water Resources of the Ministry of Environment (DGCCDRH—MINAM). Gobierno Regional de Huancavelica (2017, pp. 10, 12, 13, 14) and Consejo Regional Huancavelica (2017) Huánuco Installation and preparation of the GTRCC work plan (2012) Based on the MINAM guidance on regional strategy development, they have divided this process into four stages. The initial stage involves the regional government of Huánuco sending representatives from RRNGA and the Ministry of the Environment, also included were the DGCCDRH (Desertification and Water Resources), and various public and private organizations. The formulation stage is ongoing and started in August 2012 with the first meeting of the GTRCC to carry out the planning of activities within the framework of its functions, With the latest meeting occurring in 2014 to gather feedback and create new methodological guidelines where the impact indicators were specified, and the approach incorporated of risk analysis from a sector perspective. A plan for implementation has been put in place with a focus on communities and districts, ecosystems, watersheds, and civil and private organization participation. National Climate Change Strategy (Supreme Decree No. 011-2015-MINAM); Organic Law of Regional Governments 27867; Organic Law of Municipalities N ° 27972 (art. 73 inc. 3.1); Regional Ordinance 080-2018-GRHCO, which approves the ERCC of the Huánuco region and its 2017–21 implementation plan and forms the Regional Climate Change Council. Guide for the preparation of the ERCC (2011); Intergovernmental Panel on Climate Change (IPCC), Regional Government of Huánuco (2012). Hydrography and hydrological balance studies: Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca provinces. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Climate study and living areas of the provinces of Pachitea, Huánuco, Puerto Inca, Leoncio Prado and Marañón of the Huánuco department. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Reports on soils and greater use capacity. Provinces of Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Forestry studies of the provinces of Huánuco, Leoncio Prado and Marañón. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Risk Study of the Provinces of Huánuco, Gobierno Regional de Huánuco(2017, pp. 10, 12, 14) and El Consejo Regional del Gobierno Regional Huánuco (2018) Ica · A unit was established in 2012 to establish the main guidelines and outline the general organization of the process (with IDB participation). The same year, the GTRCC was formed with 24 public and private institutions in the region. The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. Article 53.c of Organic Law 27867 Bicentennial Plan: Peru by 2021 (Strategic axis 6: Natural resources and environment) National Environment Policy (DS 012-2009-MINAM) National Strategy on Climate Change (DS 086-2003-PCM of 27 October 2003) Regional Ordinance 0012-2014-GORE-ICA (17 December 2014), which approves the Regional Climate Change Strategy of Ica (ERCC-ICA) Ica Regional Concerted Development Plan (PDRC-Ica) 2010–21 Regional Environmental Management System (created by Regional Ordinance 0015-2004-GORE-ICA) Regional Executive Resolution 0181-2014-GORE-ICA/PR (which approves the Integrated Regional Plan for Community Education in Disaster Risk Management and Climate Change Adaptation 2014–15) Guide for the preparation of the ERCC (2011); Gobierno Regional de Ica(2014, pp. 19–21, 22) La Libertad N/A N/A N/A N/A Gobierno Regional de la Libertad (2011) The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. The Regional Environmental Commission has worked on the 2015–16 Environmental Agenda. In the development process, we have: Collection of primary and secondary information; Analysis and information processing; Drafting of the adaptation diagnostic technical report, potential sources of GHG and institutionality; Socialization and Validation Workshops of the Components of Strategic Diagnosis of Vulnerability, Institutionality and GHG; Drafting of the ERCC strategic planning; Final systematization, including strategic planning. Regional Ordinance N 020-2016 GR-LL/CR, which updates the ERCC, 2016–21 National Climate Change Strategy (2015), Technical guidelines for the formulation of ERCC, Promoted by the Directorate General for Climate Change, Desertification and Water Resources of MINAM Gobierno Regional de la Libertad (2016, pp. 11–12, 116, 2017) Lambayeque The GTRCC was created through Executive Resolution No 338-2008-GR/LAMB/PR 23 of September 2008 Process begins with Establishment of GTRCC in 2008 Regional Government of Lambayeque and GTRCC of Lambayeque formulated the ERCC. N/A United Nations Framework for Climate Change Convention (UNFCCC) Intergovernmental Panel on Climate Change (IPCC) Kyoto Protocol Gobierno Regional de Lambayeque (2010) N/A La Gerencia Regional d Recursos Naturales y Gestión del Medio Ambiente ha liderado el proceso de actualización de la ERCC. (Dentro de la ERCC se menciona la necesidad de crear un Fondo de investigación sobre CC) Regional Ordinance 013-2016-GR.LAMB/CR approving the ERCC 2016–21 for Lambayeque (ERCC 2016–21) on 27.12.2016 Plan de Desarrollo Regional Conceertado—PDRC (2011–25) Proyecto Regional de creación de Fondo de investigación sobre CC Gobierno Regional de Lambayeque (2016a, pp. 73, 81, 2016b) Lima Metropolitana A regional workshop with representation from regional as well as international actors including PGRLM, IMP and the Environment Secretary from Ecuador. Also included were workshops with representatives from civil society. The process can be divided into two steps: the initial phase and the processing phase. The stages have been fluid, with some of them being carried out in parallel steps. As suggested in the Guide for the Development of Regional Climate Change Strategies of MINAM, while the MML promoted the formation of the GTCC within the Metropolitan Environmental Commission. The GTCC was formalized through the City Services Management Resolution No. 010 of 2012, which designates the members of the Metropolitan-GTM Technical Groups of the CAM. Ordinance 1836 (11 November 2014), approving the Adaptation Strategy and Mitigation Actions of the Province of Lima to Climate Change; Law 27867, Organic Law of the Regional Governments; Ordinance 1628 establishing the Metropolitan Environmental Policy; Ordinance 1640 which approved the Metropolitan Environmental Agenda 2012–14; Lima Metropolitan Municipal Environmental Plan 2011–14 Guide for the elaboration of Regional Strategies against Climate Change of MINAM The Methodological Guide for the Adaptation to the Impacts of Climate Change on Cities and Mitigation Options of Greenhouse Gas Emissions from the Cities for Life Forum, Scientific information provided by national and international entities and by civil society. Gerencia del Ambiente (2015, pp. 7, 8, 59, 136–138) and Municipalidad Metropolitana de Lima (2014) Lima Provincias Establishment of the Regional Environmental Commission (Regional Ordinance 07-2014-CR-GL); Regional Technical Group on Climate Change of the GORE Lima (Regional Decree 005-2015-GRL/PRES); EbA Mountain Project; Regional Resolution 538-2015 The plans for the ERCC began in August 2014. The GTRCC was then confirmed and formulated between January and June 2015. Centralized and decentralized workshops were held between 2013 and 2015 (a total of 15), Permanent technical assistance of the DGCCDRH of MINAM. In 2015, an ERCC strategic planning workshop was held, in addition to seven meetings with the key sectors prioritized in the ERCC, and the preliminary ERCC document was prepared. Finally, the regional consultation and consensus between the GTRCC and the Regional Environmental Commission were developed. Regional Ordinance 07-2016-CR/GRL, which approves the Regional Climate Change Strategy 2015–21 of the Lima Region; Organic Law of Regional Governments—Law 27867; Regional Ordinance 015-2013-CR/GRL, which declares the development and implementation of the ERCC of priority interest, under the direction of the Regional Management of Natural Resources and Environmental Management; Strategic Plan for Regional Development Concerted Lima Region to 2021 (2008) Guide for the formulation of Regional Strategies for Climate Change (in update) of the MNAM; Directive 001-2014-CEPLAN, which guides the strategic planning process of the instruments of development. Gobierno Regional de Lima (2015, pp. 11, 13–15, 103, 104, 108, 2016) Loreto The Regional Environmental Commission of Loreto, through Regional Ordinance No. 020-2008-GRL-CR, dated 11 July 2008 created the GTRCC of Loreto. The GTRCC of Loreto, through various meetings and workshops validated the proposal of the Climate Change Diagnosis presented by the Regional Government of Loreto Subsequently initiated the ERCC. This document was reviewed and presented to the Regional Environmental Commission, validated in the LXXIII Regular Session dated 10 March 2011. Regional Ordinance N ° 009-2011-GRL-CR Regional Ordinance No. 014–2004—CR/GRL Organic Law of Regional Governments; Regulation of Organization and Functions of the Regional Government of Loreto (Regional Ordinance No. 031-2008-GRL-CR The United Nations Convention on Climate Change, ‘a guiding instrument for the regional plans, and frequently referenced in the plans’. The Kyoto Protocol, The United Nations Framework Convention on Biological Diversity (CBD), The United Nations Convention Fight against Desertification, The National Climate Change Strategy (ENCC), The National Environmental Agenda were referenced as well. Gobierno Regional de Loreto (2011, pp. iv, v, 17) Junín As per the Regional Executive Resolution No. 406-2014-GR-JUNÍN, the formation of the Regional Technical Group on Climate Change was approved, with the objective of having a technical body, composed of public institutions and private organizations, to accompany the formulation process of the ERCC. The ERCC was formulated over 2 years of work during various meetings with experts, authorities, political leaders and representatives of the public sector, civil society in addition to participatory and decentralized workshops within the department of Junín. For the formulation of the ERCC, the methodology, procedures, functional responsibilities and the work schedule were established, comprising all the entities that make up the GTRCC. The process was participatory and decentralized in the nine provinces of the department of Junín, with 22 workshops, 10 meetings of the Management Committee and 4 of the Regional Climate Change Technical Group, between January 2013 and October 2014, in which representatives participated of the DGCCDRH—MINAM, UNDP EbA Montaña, Junín Regional Government, local governments, private organizations, universities and civil society. Regional Ordinance 189—2014- GRJ/CR, which approves the Regional Climate Change Strategy of the Junín Region; Regional Ordinance 060-GRJ/CR Regional Decree 002-2007-GR-Junín/PR Regional Decree 003-2007-GR-Junín/PR Regional Ordinance 118-2011-GRJ/CR Regional Agreement 270-2011- GRJ/CR Regional Agreement 286—2011 –GRJ/CR Regional Agreement 361-2011-GRJ/CR Regional Executive Resolution 131-2012-GR –JUNIN/PR Regional Agreement 178-2013-GRJ/CR Regional Ordinance 175-2014-GRJ/CR Regional Ordinance 097—2009 GRJ/CR Supreme Decree 018—2011—MINAM Regional Ordinance 106—2011-GRJ/CR Regional Agreement 045- 2009- GR-Junín/PR Intergovernmental Panel on Climate Change (IPCC) The United Nations Framework Convention on Climate Change (UNFCCC); National Climate Change Strategy (ENCC) Gobierno Regional Junín (2015, pp. 12,13, 98–102) Madre de Dios Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 003-2019-RMDD/CR, which approves the environmental management document called: ‘Regional Climate Change Strategy of Madre de Dios 2017-2021’ Gobierno Regional de Madre de Dios (2019) Moquegua Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 10-2016-CR/GRM, which approves the 2016–21 Regional Climate Change Strategy of the Moquegua region and its Implementation Plan. Gobierno Regional de Moquegua (2016) Pasco Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 394-2016-G.R.P/CR, which approves the Pasco Regional Climate Change Strategy and Awareness, Communication and Capacity Building Plan for the Implementation of the Pascodel ERCC 5 May 2016 Gobierno Regional de Pasco (2016) Piura The strategy formulation process began in July 2010 The GTRCC was formalized by Regional Management Resolution 248-2010/GOB.REG.PIURA-RRMyGMAGR, of 29 December 2010. The document and study titled ‘REGIONAL STRATEGY OF CLIMATE CHANGE IN PIURA—Advances in the formulation’, was prepared by the IDEAS Center in February of 2011. The study was evaluated, observed, verified and subsequently approved in a session of the Multisectoral Climate Change Board, and subsequently approved unanimously, in Ordinary Session No. 10—2011 of the Council Regional Government Regional Piura, dated 19 October 2011. Organic Law of Regional Governments (Law 27867); Regional Ordinance No. 224-2011/GRP-CR, approve the ERCC of Piura. National Climate Change Strategy (ENCC); The Guide for the Development of Regional Strategies against Climate Change; The Adaptation and Mitigation Action Plan against Climate Ahange; Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Piura (2013, p. 6) Puno The GTRCC is created by RER N ° 147-2011-PR-GR PUNO of 13 April 2011, and as per Regional Decree 06-2013-PR-GR PUNO, the new conformation of the GTRCC is approved For the creation of the Puno ERCC, the following methodologies were used: Information collection: Information was collected from public institutions whose work is directly or indirectly related to environmental and/or related issues. Interviews: Interviews were conducted with representatives of public institutions that work on environmental and related issues. Participatory workshops: These workshops were held in 6 provinces of Puno: Melgar, Azángaro, Carabaya, El Collao, Sandia and Puno. Workshops allowed a participatory dialogue with representatives of public, private institutions and grassroots organizations Regional Ordinance 011-2013-GRP-CRP approves the Regional Environmental Management Instrument known as the Puno ERCC. Organic Law of Regional Governments, Law No. 27867. Regional Ordinance No. 020- 2005- CR-GRP approves the Regional System of Environmental Management of the Puno Region. Municipal Ordinance No. 04—2007—MDNC approves the Local Environmental Management System and the Formation of the Municipal Environmental Commission. Municipal Ordinance No. 07—2007—MDNC, approving the Local Environmental Policy, Local Environmental Diagnosis, Local Environmental Action Plan and the Local Environmental Agenda. Regional Ordinance No. 018-2010 approves the Regional Environment Policy-Puno. Intergovernmental Panel on Climate Change (IPCC) Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, pp. 529–532, 556, 584–590), Gobierno Regional de Puno (2016) and Gobierno Regional de Puno (2013, 2016) San Martín Note: only the Regional Ordinance approving the ERCC has been found Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. 591) Tacna Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 005-2015-CR/GOB.REG.TACNA approved the Regional Environmental Management instrument called: ‘Tacna Regional Climate Change Strategy (ERCC)’ and dictates other provisions Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. F23) Ucayali Note: The new ERCC of Ucayali has been approved by Ordinance 021-2019-GRU-CR, but its content could not be accessed. Regional Executive Resolution 1175-2012-GRU-P of 26 October 2012, created the Regional Technical Group on Climate Change of Ucayali, with the purpose of developing and monitoring the Ucayali Regional Climate Change Strategy. The formulation of the ERCC began in June 2012 with four workshops held in the city of Pucallpa, one in the Province of Atalaya and one in the Province of Padre Abad, In addition to a Specialization Course on Adaptation to Climate Change, ran in conjunction with the Pontifical Catholic University From Peru. Regional Ordinance 011-2014-GRU/CR approved the Management Instrument known as the Ucayali ERCC; Regional Ordinance No. 011-2012-CR/GRU Regional Executive Resolution No. 0924—2011-GRU-P approved the—Concerted Regional Development Plan 2011–21 Law No. 27867—Organic Law of Regional Governments. Article 53—Functions in environmental matters and territorial planning Regional Ordinance No. 017-2011-GRU/CR recognizes the Regional Environmental Commission of Ucayali—CARU and its Regulations. Regional Ordinance No. 004-2012-GRU/CR, approved the Regional Environmental Policy, the Regional Environmental Action Plan 2012–21 and the Regional Environmental Agenda 2012–13. Intergovernmental Panel on Climate Change (IPCC) First National Communication to the United Nations Secretariat of the Framework Convention on Climate Change Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Ucayali (2013, pp. 12, 19, 25, 104) and Gobierno Regional de Ucayali (2019) National Adaptation Plan The purpose of the ENCC is to ensure that public entities and government sectors are able to carry out a management process that allows the delivery of products/goods and services to citizens through processes that are effective, economical and of quality. The ENCC is structured in accordance with the National Policy of Modernization of Public Management in 2021, as the instrument that guides and promotes national actions related to climate change, providing the necessary guidelines for sectors, regions and public institutions in general to implement according to action plans. Supreme Decree 011-2015-MINAM; Fifth Report of the Intergovernmental Panel on Climate Change1 (IPCC); COP 20 (Lima, 2014), which approved the ‘Lima Call for Climate Action’; National Policy for Modernization of Public Management (PNMGE) –D.S. No. 004-2013-PCM; General Directive of the Strategic Planning Process of the National Strategic Planning System—Presidency Resolution of the Board of Directors No. 26-2014-CEPLAN and Directive No. 001-201-CEPLAN Thematic Working Groups (GTT) of the National Commission on Climate Change; The Multisectoral Commission Report created by Resolution 189-2012-PCM, through which it is planned to update the National Climate Change Strategy and establish a Climate Change Plan (CC Plan); Expected and Determined Contribution at National Level (iNDC). MINAM(2015, pp. 9, 19, 33, 41) National Adaptation Plan Reduce adverse impacts of climate change through integrated vulnerability and adaptation studies, which will identify vulnerable areas and/or sectors in the country where adaptation projects will be implemented. The process of preparing the National Climate Change Strategy is based on the document created by the National Commission in Cusipata (2001). It outlines 11 strategic lines with their respective strategic objectives and strategic goals (developed by thematic working groups). Additionally, a workshop on prioritization of strategic lines was held. United Nations Framework Convention on Climate Change (UNFCCC); Kyoto Protocol; Supreme Decree 086-2003-PCM (published by the ENCC) National Communication of Peru to the United Nations Framework Convention on Climate Change CONAM (2002, pp. 9–13, 15) Regional Department . Establishing a process . Formulation process . Legal, normative and technical basis . Process supporting documents and regulations . References . Ancash Regional Technical Group for Climate Change (2013), Project IMACC for BID-MINAM: Vulnerability Diagnosis (2014), Technical Group Relaunch (2015) Financial support from the BID, the process has been led by the Natural Resources and Environmental Management group from Ancash, GTRCC, the Regional Environmental and Environmental Commission of the Regional Council Technical assistance from the General Directorate of Climate Change, Desertification and Water Resources, and the ‘Ensuring Water and Means of Mountain life’ project. Supreme Decree 011-2015-MINAM, which approves the National Strategy on Climate Change (ENCC); Regional Ordinance 006-2016-GRA/CR Methodological guidelines for the elaboration of ERCC Gobierno Regional de Ancash (2017, pp. 5, 55, 56) Apurímac Technical Group for Vulnerability and Adaptation to Climate Change (2009), Regional Operational Unit for Climate Change Programs and Projects; ERCC Drive Group Information was synthesized in workshops in each of the 10 provinces Inclusion of professionals, technicians and social leaders To collect information from the public regarding their perception of climate change To identify the issues at various ecological levels, To develop local proposals for climate change adaptation strategies and measures. Regional Ordinance 010-2012-GR-APURIMAC/CR Strategic Plan for Regional Concerted Development; The United Nations Framework Convention on Climate Change—UNFCCC Gobierno Regional de Apurímac (2012, pp. 3, 4, 7, 14, 23–25) Arequipa As per the 043-2008-GRA/CR-Arequipa Regional Agreement the elaboration of the Regional Strategy for Adaptation to Climate Change in the Arequipa Region was prioritized with a multidisciplinary and intersectoral vision. This included the planning of sustainable development in district and provincial local governments, emphasizing knowledge, prevention and mitigation of climate risks, In addition to seeking the allocation of public and private resources, and defining responsibilities at each level and organizational unit. Proposed actions for the continuity of adaptation measures and actors involved in the implementation: Development of the ERCC which includes input from the regional government, provincial municipalities, NGOs, universities Institutional regional development to begin studies, monitoring and prevention of the effects of climate change Strategic management for water systems, with a focus on rural and industrial areas Specific policy targeting the dissemination of climate information for preventive actions (national government, regional government, SENAMHI). Dissemination of adaptation measures for the management of water resources and agricultural production with irrigation organizations [MINAG, AUTODEMA, User Board, Subsectoral Irrigation Programme (PSI)]. Targeting the education sector to raise awareness about the issue and the formation of response capacities by the population (UGEL Education). Advance in the elaboration of regional contingency plans to face the projected critical scenarios (Regional Government. Civil Defense, Geophysical Institute, SENAMHI). Regional Agreement 043-2008-GRA/CR-AREQUIPA, which confirms the GTRCC to elaborate the ERCC Regional Agreement 143-2010-GRA/CR-AREQUIPA, to approve the ERCC The United Nations Framework Convention on Biological Diversity—CBD Kyoto Protocol The National Strategy for Climate Change, approved in 2002, State policies of the governance agreement (2002); Monitoring programme for monitoring climate change in the Piura region between 2003 and 2005; First pilot measure of climate change adaptation conducted between July 2007 and September 2008, Under the guidance of the Regional Government of Arequipa German Technical Co-operation (GTZ). Gobierno Regional de Arequipa (2009, pp. 1–2, 30, 31) Ayacucho The formulation process began in 2010 The ERCC was published in 2015 GTRCC as per the Executive Regional Resolution 222-2010-GRA/PRES) Action plan for the ERCC as per the Regional Ordinance 032-2011-GRA/CR from 26.12.2011 Ayacucho GTRCC as per the Executive Regional Resolution 865-2014-GRA/PRES (14.11.2014) Project entitled ‘Improving the Regional Environmental Management department of Ayacucho’ Co-ordination with the Regional Technical Group on Climate Change Collection of primary and secondary information Information analysis and processing Drafting of the adaptation diagnostic technical report 03 Decentralized workshops on ‘Socialization and Contributions of the Diagnoses of the Strategy and Regional Action Plan against Climate Change Ayacucho’ Workshop on ‘Socialization and Validation of the Diagnoses of the Strategy and Regional Plan of Action against Climate Change Ayacucho’ Articulation of the ERCC with planning instruments Grupo Técnico Regional de CC de Huancavelica, constituido el 2012 (Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR.) Artícle 53.c of the Law 27867 establishing the precedent that each regional government must have its own Regional Strategy against Climate Change Regional Ordinance No. 032-2011 GRA/CR, approve for social, economic and environmental benefits, The Regional Strategy for Climate Change in Ayacucho and the Action Plan of the Strategy for Climate Change in Ayacucho to 2017. Intergovernmental Panel on Climate Change (IPCC), Peru and Climate Change: Second National Communication on Climate Change United Nations Framework for Climate Change Convention (UNFCCC) Support and technical advise from MINAM. Gobierno Regional de Ayacucho (2015, pp. 10, 11, 13, 14, 15) Cajamarca Constitution of the Technical Group on Climate Change (2005), Creation and implementation of the Regional Technical Group of Climate Change and Risk Management for Cajamarca, Responsible for preparing a strategy proposal for Regional Climate Change and Risk Management, through a Regional Participatory Process (2011) The Regional Government of Cajamaca, through the Regional Environmental Commission and its GTRCC, prepared the ERCC, applying a participatory methodological proposal, Previously agreed upon and approved by MINAM, Adapting it to the region and to the proposals and suggestions of the actors involved in the process. Regional ordinance 021-2013-GR.CAJ-CR that approved the ERCC of Cajamarca; Organic law for regional governments (Ley 27867); National Environment Policy (2009); National Climate Change Strategy (2003); Adaptation and Mitigation Action Plan against Climate Change (2010); National Environmental Action Plan—PLANAA 2011–21 (9 July 2011); Peru Environment Agenda 2013–14. ·Guide for preparation of the ERCC (2011) Gobierno Regional de Cajamarca (2016, pp. 6–9, 10, 14) Cusco Creation of the Regional Operational Unit of the Adaptation Programme to Climate Change—UOR- PACC through the Regional Executive Resolution No. 1164-2009-GRCUSCO/PR, Which creates process of consensus and inter-institutional orientations Exhibited in OR 070-2010 CR/GRC on the steps to be taken and the instances to be commissioned; Thus, the GTRCC for the Cusco region was created The elaboration of the ERCC was carried through a participatory process, concerted and articulated, which gathered local and regional development actors: Authorities, institutions and citizens who were responsible for the formulation of ERCC. In this process, the GTRFCC was involved, thematic tables and territorial consultations were developed Regional Ordinance 020-2012-CR/ GRC.CUSCO approved the ERCC; Law 27867—Organic Law of Regional Governments; Regional Ordinance No. 081-2010-CR/GRCUSCO, which approved the Strategic Plan for the Development of Cusco; Regional Executive Resolution Nº 1164-2009-GR CUSCO/PR, make up the Regional Operational Unit of the Climate Change Adaptation Programme; Regional Ordinance Nº 070-2010 CR/GRC. CUSCO, created the GTRCC. Gobierno Regional de Cusco (2012, pp. 9, 10, 17, 18, 48, 49) Huancavelica GTRCC of Huancavelica, established in 2012 (through the Regional Executive Resolution Nº 398-2012/GOB.REG-HVCA/PR) The ERCC and implementation plan were formulated under the leadership of the Regional Government of Huancavelica, Represented by the Natural Resources and Environmental Management group, Participation by the GTRCC, an inter-institutional space composed of representatives of public and private institutions committed to the development of the Huancavelica region, With the participation of social leaders, political decision-makers, civil servants and civil society. Supreme Decree-011-2015-MINAM; Supreme Decree 058-2016-RE, ratifying the Paris Agreement; Ministerial Resolution 090-2016 MINAM, promoting integrated management of climate change. Organic Law of Regional Governments 27867; Organic Law of Municipalities ° 27972 (art. 73 inc. 3.1) Technical Document: Minimum content creation for the formulation of the ERCC Approved by the General Directorate of Climate Change, Desertification and Water Resources of the Ministry of Environment (DGCCDRH—MINAM). Gobierno Regional de Huancavelica (2017, pp. 10, 12, 13, 14) and Consejo Regional Huancavelica (2017) Huánuco Installation and preparation of the GTRCC work plan (2012) Based on the MINAM guidance on regional strategy development, they have divided this process into four stages. The initial stage involves the regional government of Huánuco sending representatives from RRNGA and the Ministry of the Environment, also included were the DGCCDRH (Desertification and Water Resources), and various public and private organizations. The formulation stage is ongoing and started in August 2012 with the first meeting of the GTRCC to carry out the planning of activities within the framework of its functions, With the latest meeting occurring in 2014 to gather feedback and create new methodological guidelines where the impact indicators were specified, and the approach incorporated of risk analysis from a sector perspective. A plan for implementation has been put in place with a focus on communities and districts, ecosystems, watersheds, and civil and private organization participation. National Climate Change Strategy (Supreme Decree No. 011-2015-MINAM); Organic Law of Regional Governments 27867; Organic Law of Municipalities N ° 27972 (art. 73 inc. 3.1); Regional Ordinance 080-2018-GRHCO, which approves the ERCC of the Huánuco region and its 2017–21 implementation plan and forms the Regional Climate Change Council. Guide for the preparation of the ERCC (2011); Intergovernmental Panel on Climate Change (IPCC), Regional Government of Huánuco (2012). Hydrography and hydrological balance studies: Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca provinces. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Climate study and living areas of the provinces of Pachitea, Huánuco, Puerto Inca, Leoncio Prado and Marañón of the Huánuco department. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Reports on soils and greater use capacity. Provinces of Huánuco, Leoncio Prado, Marañón, Pachitea and Puerto Inca. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Forestry studies of the provinces of Huánuco, Leoncio Prado and Marañón. Ecological and Economic Zoning. Regional Government of Huánuco (2012). Risk Study of the Provinces of Huánuco, Gobierno Regional de Huánuco(2017, pp. 10, 12, 14) and El Consejo Regional del Gobierno Regional Huánuco (2018) Ica · A unit was established in 2012 to establish the main guidelines and outline the general organization of the process (with IDB participation). The same year, the GTRCC was formed with 24 public and private institutions in the region. The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. Article 53.c of Organic Law 27867 Bicentennial Plan: Peru by 2021 (Strategic axis 6: Natural resources and environment) National Environment Policy (DS 012-2009-MINAM) National Strategy on Climate Change (DS 086-2003-PCM of 27 October 2003) Regional Ordinance 0012-2014-GORE-ICA (17 December 2014), which approves the Regional Climate Change Strategy of Ica (ERCC-ICA) Ica Regional Concerted Development Plan (PDRC-Ica) 2010–21 Regional Environmental Management System (created by Regional Ordinance 0015-2004-GORE-ICA) Regional Executive Resolution 0181-2014-GORE-ICA/PR (which approves the Integrated Regional Plan for Community Education in Disaster Risk Management and Climate Change Adaptation 2014–15) Guide for the preparation of the ERCC (2011); Gobierno Regional de Ica(2014, pp. 19–21, 22) La Libertad N/A N/A N/A N/A Gobierno Regional de la Libertad (2011) The GTRCC was created through the Regional Ordinance 020-2008-GR-LL/CR, has updated the strategy under the guidelines of the DGRHCC-MINAM. The Regional Environmental Commission has worked on the 2015–16 Environmental Agenda. In the development process, we have: Collection of primary and secondary information; Analysis and information processing; Drafting of the adaptation diagnostic technical report, potential sources of GHG and institutionality; Socialization and Validation Workshops of the Components of Strategic Diagnosis of Vulnerability, Institutionality and GHG; Drafting of the ERCC strategic planning; Final systematization, including strategic planning. Regional Ordinance N 020-2016 GR-LL/CR, which updates the ERCC, 2016–21 National Climate Change Strategy (2015), Technical guidelines for the formulation of ERCC, Promoted by the Directorate General for Climate Change, Desertification and Water Resources of MINAM Gobierno Regional de la Libertad (2016, pp. 11–12, 116, 2017) Lambayeque The GTRCC was created through Executive Resolution No 338-2008-GR/LAMB/PR 23 of September 2008 Process begins with Establishment of GTRCC in 2008 Regional Government of Lambayeque and GTRCC of Lambayeque formulated the ERCC. N/A United Nations Framework for Climate Change Convention (UNFCCC) Intergovernmental Panel on Climate Change (IPCC) Kyoto Protocol Gobierno Regional de Lambayeque (2010) N/A La Gerencia Regional d Recursos Naturales y Gestión del Medio Ambiente ha liderado el proceso de actualización de la ERCC. (Dentro de la ERCC se menciona la necesidad de crear un Fondo de investigación sobre CC) Regional Ordinance 013-2016-GR.LAMB/CR approving the ERCC 2016–21 for Lambayeque (ERCC 2016–21) on 27.12.2016 Plan de Desarrollo Regional Conceertado—PDRC (2011–25) Proyecto Regional de creación de Fondo de investigación sobre CC Gobierno Regional de Lambayeque (2016a, pp. 73, 81, 2016b) Lima Metropolitana A regional workshop with representation from regional as well as international actors including PGRLM, IMP and the Environment Secretary from Ecuador. Also included were workshops with representatives from civil society. The process can be divided into two steps: the initial phase and the processing phase. The stages have been fluid, with some of them being carried out in parallel steps. As suggested in the Guide for the Development of Regional Climate Change Strategies of MINAM, while the MML promoted the formation of the GTCC within the Metropolitan Environmental Commission. The GTCC was formalized through the City Services Management Resolution No. 010 of 2012, which designates the members of the Metropolitan-GTM Technical Groups of the CAM. Ordinance 1836 (11 November 2014), approving the Adaptation Strategy and Mitigation Actions of the Province of Lima to Climate Change; Law 27867, Organic Law of the Regional Governments; Ordinance 1628 establishing the Metropolitan Environmental Policy; Ordinance 1640 which approved the Metropolitan Environmental Agenda 2012–14; Lima Metropolitan Municipal Environmental Plan 2011–14 Guide for the elaboration of Regional Strategies against Climate Change of MINAM The Methodological Guide for the Adaptation to the Impacts of Climate Change on Cities and Mitigation Options of Greenhouse Gas Emissions from the Cities for Life Forum, Scientific information provided by national and international entities and by civil society. Gerencia del Ambiente (2015, pp. 7, 8, 59, 136–138) and Municipalidad Metropolitana de Lima (2014) Lima Provincias Establishment of the Regional Environmental Commission (Regional Ordinance 07-2014-CR-GL); Regional Technical Group on Climate Change of the GORE Lima (Regional Decree 005-2015-GRL/PRES); EbA Mountain Project; Regional Resolution 538-2015 The plans for the ERCC began in August 2014. The GTRCC was then confirmed and formulated between January and June 2015. Centralized and decentralized workshops were held between 2013 and 2015 (a total of 15), Permanent technical assistance of the DGCCDRH of MINAM. In 2015, an ERCC strategic planning workshop was held, in addition to seven meetings with the key sectors prioritized in the ERCC, and the preliminary ERCC document was prepared. Finally, the regional consultation and consensus between the GTRCC and the Regional Environmental Commission were developed. Regional Ordinance 07-2016-CR/GRL, which approves the Regional Climate Change Strategy 2015–21 of the Lima Region; Organic Law of Regional Governments—Law 27867; Regional Ordinance 015-2013-CR/GRL, which declares the development and implementation of the ERCC of priority interest, under the direction of the Regional Management of Natural Resources and Environmental Management; Strategic Plan for Regional Development Concerted Lima Region to 2021 (2008) Guide for the formulation of Regional Strategies for Climate Change (in update) of the MNAM; Directive 001-2014-CEPLAN, which guides the strategic planning process of the instruments of development. Gobierno Regional de Lima (2015, pp. 11, 13–15, 103, 104, 108, 2016) Loreto The Regional Environmental Commission of Loreto, through Regional Ordinance No. 020-2008-GRL-CR, dated 11 July 2008 created the GTRCC of Loreto. The GTRCC of Loreto, through various meetings and workshops validated the proposal of the Climate Change Diagnosis presented by the Regional Government of Loreto Subsequently initiated the ERCC. This document was reviewed and presented to the Regional Environmental Commission, validated in the LXXIII Regular Session dated 10 March 2011. Regional Ordinance N ° 009-2011-GRL-CR Regional Ordinance No. 014–2004—CR/GRL Organic Law of Regional Governments; Regulation of Organization and Functions of the Regional Government of Loreto (Regional Ordinance No. 031-2008-GRL-CR The United Nations Convention on Climate Change, ‘a guiding instrument for the regional plans, and frequently referenced in the plans’. The Kyoto Protocol, The United Nations Framework Convention on Biological Diversity (CBD), The United Nations Convention Fight against Desertification, The National Climate Change Strategy (ENCC), The National Environmental Agenda were referenced as well. Gobierno Regional de Loreto (2011, pp. iv, v, 17) Junín As per the Regional Executive Resolution No. 406-2014-GR-JUNÍN, the formation of the Regional Technical Group on Climate Change was approved, with the objective of having a technical body, composed of public institutions and private organizations, to accompany the formulation process of the ERCC. The ERCC was formulated over 2 years of work during various meetings with experts, authorities, political leaders and representatives of the public sector, civil society in addition to participatory and decentralized workshops within the department of Junín. For the formulation of the ERCC, the methodology, procedures, functional responsibilities and the work schedule were established, comprising all the entities that make up the GTRCC. The process was participatory and decentralized in the nine provinces of the department of Junín, with 22 workshops, 10 meetings of the Management Committee and 4 of the Regional Climate Change Technical Group, between January 2013 and October 2014, in which representatives participated of the DGCCDRH—MINAM, UNDP EbA Montaña, Junín Regional Government, local governments, private organizations, universities and civil society. Regional Ordinance 189—2014- GRJ/CR, which approves the Regional Climate Change Strategy of the Junín Region; Regional Ordinance 060-GRJ/CR Regional Decree 002-2007-GR-Junín/PR Regional Decree 003-2007-GR-Junín/PR Regional Ordinance 118-2011-GRJ/CR Regional Agreement 270-2011- GRJ/CR Regional Agreement 286—2011 –GRJ/CR Regional Agreement 361-2011-GRJ/CR Regional Executive Resolution 131-2012-GR –JUNIN/PR Regional Agreement 178-2013-GRJ/CR Regional Ordinance 175-2014-GRJ/CR Regional Ordinance 097—2009 GRJ/CR Supreme Decree 018—2011—MINAM Regional Ordinance 106—2011-GRJ/CR Regional Agreement 045- 2009- GR-Junín/PR Intergovernmental Panel on Climate Change (IPCC) The United Nations Framework Convention on Climate Change (UNFCCC); National Climate Change Strategy (ENCC) Gobierno Regional Junín (2015, pp. 12,13, 98–102) Madre de Dios Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 003-2019-RMDD/CR, which approves the environmental management document called: ‘Regional Climate Change Strategy of Madre de Dios 2017-2021’ Gobierno Regional de Madre de Dios (2019) Moquegua Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 10-2016-CR/GRM, which approves the 2016–21 Regional Climate Change Strategy of the Moquegua region and its Implementation Plan. Gobierno Regional de Moquegua (2016) Pasco Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 394-2016-G.R.P/CR, which approves the Pasco Regional Climate Change Strategy and Awareness, Communication and Capacity Building Plan for the Implementation of the Pascodel ERCC 5 May 2016 Gobierno Regional de Pasco (2016) Piura The strategy formulation process began in July 2010 The GTRCC was formalized by Regional Management Resolution 248-2010/GOB.REG.PIURA-RRMyGMAGR, of 29 December 2010. The document and study titled ‘REGIONAL STRATEGY OF CLIMATE CHANGE IN PIURA—Advances in the formulation’, was prepared by the IDEAS Center in February of 2011. The study was evaluated, observed, verified and subsequently approved in a session of the Multisectoral Climate Change Board, and subsequently approved unanimously, in Ordinary Session No. 10—2011 of the Council Regional Government Regional Piura, dated 19 October 2011. Organic Law of Regional Governments (Law 27867); Regional Ordinance No. 224-2011/GRP-CR, approve the ERCC of Piura. National Climate Change Strategy (ENCC); The Guide for the Development of Regional Strategies against Climate Change; The Adaptation and Mitigation Action Plan against Climate Ahange; Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Piura (2013, p. 6) Puno The GTRCC is created by RER N ° 147-2011-PR-GR PUNO of 13 April 2011, and as per Regional Decree 06-2013-PR-GR PUNO, the new conformation of the GTRCC is approved For the creation of the Puno ERCC, the following methodologies were used: Information collection: Information was collected from public institutions whose work is directly or indirectly related to environmental and/or related issues. Interviews: Interviews were conducted with representatives of public institutions that work on environmental and related issues. Participatory workshops: These workshops were held in 6 provinces of Puno: Melgar, Azángaro, Carabaya, El Collao, Sandia and Puno. Workshops allowed a participatory dialogue with representatives of public, private institutions and grassroots organizations Regional Ordinance 011-2013-GRP-CRP approves the Regional Environmental Management Instrument known as the Puno ERCC. Organic Law of Regional Governments, Law No. 27867. Regional Ordinance No. 020- 2005- CR-GRP approves the Regional System of Environmental Management of the Puno Region. Municipal Ordinance No. 04—2007—MDNC approves the Local Environmental Management System and the Formation of the Municipal Environmental Commission. Municipal Ordinance No. 07—2007—MDNC, approving the Local Environmental Policy, Local Environmental Diagnosis, Local Environmental Action Plan and the Local Environmental Agenda. Regional Ordinance No. 018-2010 approves the Regional Environment Policy-Puno. Intergovernmental Panel on Climate Change (IPCC) Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, pp. 529–532, 556, 584–590), Gobierno Regional de Puno (2016) and Gobierno Regional de Puno (2013, 2016) San Martín Note: only the Regional Ordinance approving the ERCC has been found Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. 591) Tacna Note: only the Regional Ordinance approving the ERCC has been found Regional Ordinance 005-2015-CR/GOB.REG.TACNA approved the Regional Environmental Management instrument called: ‘Tacna Regional Climate Change Strategy (ERCC)’ and dictates other provisions Congreso de la República del Perú y Sociedad Peruana de Derecho Ambiental (2014, p. F23) Ucayali Note: The new ERCC of Ucayali has been approved by Ordinance 021-2019-GRU-CR, but its content could not be accessed. Regional Executive Resolution 1175-2012-GRU-P of 26 October 2012, created the Regional Technical Group on Climate Change of Ucayali, with the purpose of developing and monitoring the Ucayali Regional Climate Change Strategy. The formulation of the ERCC began in June 2012 with four workshops held in the city of Pucallpa, one in the Province of Atalaya and one in the Province of Padre Abad, In addition to a Specialization Course on Adaptation to Climate Change, ran in conjunction with the Pontifical Catholic University From Peru. Regional Ordinance 011-2014-GRU/CR approved the Management Instrument known as the Ucayali ERCC; Regional Ordinance No. 011-2012-CR/GRU Regional Executive Resolution No. 0924—2011-GRU-P approved the—Concerted Regional Development Plan 2011–21 Law No. 27867—Organic Law of Regional Governments. Article 53—Functions in environmental matters and territorial planning Regional Ordinance No. 017-2011-GRU/CR recognizes the Regional Environmental Commission of Ucayali—CARU and its Regulations. Regional Ordinance No. 004-2012-GRU/CR, approved the Regional Environmental Policy, the Regional Environmental Action Plan 2012–21 and the Regional Environmental Agenda 2012–13. Intergovernmental Panel on Climate Change (IPCC) First National Communication to the United Nations Secretariat of the Framework Convention on Climate Change Peru and Climate Change: Second National Communication on Climate Change Gobierno Regional de Ucayali (2013, pp. 12, 19, 25, 104) and Gobierno Regional de Ucayali (2019) National Adaptation Plan The purpose of the ENCC is to ensure that public entities and government sectors are able to carry out a management process that allows the delivery of products/goods and services to citizens through processes that are effective, economical and of quality. The ENCC is structured in accordance with the National Policy of Modernization of Public Management in 2021, as the instrument that guides and promotes national actions related to climate change, providing the necessary guidelines for sectors, regions and public institutions in general to implement according to action plans. Supreme Decree 011-2015-MINAM; Fifth Report of the Intergovernmental Panel on Climate Change1 (IPCC); COP 20 (Lima, 2014), which approved the ‘Lima Call for Climate Action’; National Policy for Modernization of Public Management (PNMGE) –D.S. No. 004-2013-PCM; General Directive of the Strategic Planning Process of the National Strategic Planning System—Presidency Resolution of the Board of Directors No. 26-2014-CEPLAN and Directive No. 001-201-CEPLAN Thematic Working Groups (GTT) of the National Commission on Climate Change; The Multisectoral Commission Report created by Resolution 189-2012-PCM, through which it is planned to update the National Climate Change Strategy and establish a Climate Change Plan (CC Plan); Expected and Determined Contribution at National Level (iNDC). MINAM(2015, pp. 9, 19, 33, 41) National Adaptation Plan Reduce adverse impacts of climate change through integrated vulnerability and adaptation studies, which will identify vulnerable areas and/or sectors in the country where adaptation projects will be implemented. The process of preparing the National Climate Change Strategy is based on the document created by the National Commission in Cusipata (2001). It outlines 11 strategic lines with their respective strategic objectives and strategic goals (developed by thematic working groups). Additionally, a workshop on prioritization of strategic lines was held. United Nations Framework Convention on Climate Change (UNFCCC); Kyoto Protocol; Supreme Decree 086-2003-PCM (published by the ENCC) National Communication of Peru to the United Nations Framework Convention on Climate Change CONAM (2002, pp. 9–13, 15) Open in new tab Discussion The regional departments have developed unique strategies, emphasizing distinct actors, local environment and citizen needs. The two NAPs (CONAM, 2002; MINAM, 2015) and the three national communications on climate change adaptation and mitigation process (CONAM, 2001; MINAM, 2010a; MINAM, 2016) have primarily focused on environmental conservation and mitigation. The National and Regional Climate Change Strategies help widen the scope of adaptation to new fields, including health, sanitation and housing (MINAM, 2015; MINAM, 2016). The regional strategies reflect what Burstein Roda (2016), Sánchez Zavaleta (2016) describe for the overall policy context that health has not been a priority so far regarding mitigation or adaptation of climate change. Importantly, the first regional strategies were developed without any guidance on the health component, taking into account that health was not even mentioned in the first NAP from 2002 (CONAM, 2002). With improvement on the MINAM guidance in 2009 and 2011, the consideration of health within the plans has been improved; however, there has not been a clear strategy of analysis, of inclusion of scientific knowledge or frameworks for risk and vulnerability assessment. There has been no clear differentiation between primary, secondary and tertiary impacts and its relationship to ecosystem health and therefore the need for interdisciplinary research and interventions (Butler and Harley, 2010; Bowen et al., 2011; Butler, 2014; McMichael, 2014; Whitmee et al., 2015; Marselle et al., 2019). The impact of climate change on chronic diseases has not been addressed at all (Avilez et al., 2016) and mental health is only as socioemotional support in the regional plan by Cusco (Table 4). Loreto mentions the need for research (Table 4), which in fact has been undertaken in the recent years and could inform future updated strategies (Zavaleta et al., 2018). It is expected that the current HNAP development, will change the national scenario and have an impact on future regional strategies. According to ‘Peru Adapts’7 (Cancino, 2016), health is one of the priority areas for implementation of the NAP, along with water, agriculture, fishing, aquaculture and forests. In this document, specific health sector priorities include concentrating on universal health coverage, decreasing rates of communicable and non-communicable diseases, monitoring emerging diseases and implementation of electronic patient files and integrated systems in department capitals (Cancino, 2016). While general potential health impacts are discussed, regional details are not specified. A specific guidance on how regional strategies should prioritize health and why and how health is intrinsically linked to and embedded within ecosystem health will be fundamental to developing lasting adaptation policies that go beyond simple enumerating of past epidemiology and perceived vulnerabilities. As per (Cancino, 2016) success of the health sector will be dependent upon good governance and ultimately suggest the reinstitution of the ‘Sectorial Climate Change Commission8’ to oversee the changes that need to be brought about in the health sector in the face of climate change (p. 11). However, a strengthening of the health care system is central to adaptation frameworks, and universal coverage is an important step in health care system strengthening to protect population from negative health outcomes (Bowen et al., 2011; Bowen and Friel, 2012; Vermeersch et al., 2014; Burstein Roda, 2016; Velásquez et al., 2016). Recent developments in Peru include declaring access to medicines as a human right and introducing universal health coverage, which will be an essential step forward to protect the Peruvian population from negative health outcomes (Poder Ejecutivo Perú, 2019a,b). Marginalized populations and vulnerabilities Vulnerabilities are mentioned in the plans in relation to age, gender, geographies and economic status. Gender, geography and economic status are part of social determination that puts people at a higher risk than others to suffering and ill health (Curtis and Rees Jones, 1998; Breilh Paz y Miño, 2003; Stewart et al., 2009; Brown and Moon, 2012; Shannon et al., 2017). There has been no critical engagement with social determination and particularly not in relation to the most marginalized, ethnic and minority groups in Peru who have been forced to live in environmentally harsh and degraded areas with limited or no access to health care. There is not much literature on climate change in the Afro-Peruvian populations, and while there is some on the indigenous communities in Peru, the research is still lacking (Hofmeijer et al., 2013). Ford et al. (2018), Hofmeijer et al. (2013), Sherman et al. (2015) and Zavaleta et al. (2018) lay the groundwork for vulnerability analysis of climate change on health in different Amerindian communities in the regional Department of Loreto and Ucayali. The authors also use a community adaptation framework as emphasized by Ebi and Semenza (2008) and Ebi (2009). AIDESEP (2016), the Interethnic Association of the Development of the Peruvian Amazon, presents an adaptation plan with a specific focus on gender for their Kechwa people in the Cumbaza basin, within regional department of San Martin. This shows the importance of vulnerability analysis, participation, academic and local knowledge inclusion that is central to health-centred governance in the Anthropocene and happens to be missing from most regional plans (Bowen et al., 2011; AIDESEP, 2016). Numerous plans mention using indigenous knowledge and incorporating it into their adaptation and mitigation plan, such as Apurimac and Ucayali (Table 4), but do not specify who from the community they will obtain this knowledge from, or how this person/people/organization can be integrated into the existing governance system. Indigenous people, however, being at a higher risk than others are not topic within the plans. There seems no clear and strategic inclusion of representatives of marginalized groups within the creation of the plans. There is minimal discussion on gender as a determinant of health. Ayacucho, Lima and Ucayali are the only regional departments to mention gender (Gobierno Regional de Ucayali, 2014 Gerencia del Ambiente, 2015; Gobierno Regional de Ayacucho, 2015). Ucayali places emphasis on bringing about gender equality, especially since inequalities may be exacerbated by climate change (Gobierno Regional de Ucayali , 2014). They intend on using their focus on gender as an integral part of the design, implementation, monitor and evaluation of the policies and programmes found in the Regional Climate Change Strategies (Gobierno Regional de Ucayali, 2014; Gerencia del Ambiente, 2015; Gobierno Regional de Ayacucho, 2015). Marginalization because of gender is a crucial day to day reality in Peru, therefore, a gender approach needs to become essential for climate change adaptation in urban and rural contexts in Peru (Gumucio and Rueda, 2015; AIDESEP, 2016; Arana, 2016). Characterization of deficits in strategies It is also essential to remember that health adaptation is an iterative process and that plans should be produced iteratively, taking into consideration that climate change will occur over an extended period with health effects to be expected over many years and impacts on health will always be in a flux (Tompkins and Adger, 2005; Tschakert and Dietrich, 2010; Hess et al., 2012; LCD Expert Group, 2012; Gramberger et al., 2015). It is unclear how this iterative process is structured throughout the plans, taking into account aspects of institutional instability in Peru, as much as the need for continues research informing the policy process (Figueroa and Barrón, 2005; Helmke, 2010; Zegarra, 2015). Adaptation in the health system should prepare communities for changes that will increase the incidence, seasonality or geographic range of climate-relevant health outcomes (see Table 1) (Hofmeijer et al., 2013; Aguilar-León and Solano-Zapata, 2016; Hernández-Vásquez et al., 2016; Miranda et al., 2016; Mark et al., 2017; Ramírez and Briones, 2017; Tito et al., 2018; Watts et al., 2018). It is unclear if the WHO guidelines already had an impact on regional plans and if they had and how they will have an impact in the future on regional plans. Will there be a regional health adaptation plan for each regional department? Theoretically, this would be the way, if health would not become a specific case of more nationalized policies. While, capacity is an important aspect of adaptation plans in relation to the health sector, community adaptations as it is suggested by Ebi et al. (2006), Ebi and Semenza (2008), Ebi and Otmani del Barrio (2017) is not a topic at all. Analysing the adaptations and the descriptions of potential impacts on health, it is clear that specific guidelines on a systemic analysis and approach to impact assessment and responses including experts and actors in all phases would improve the quality and ensure lasting impacts of the plans (Charron, 2012). The Peruvian case study within a global context Ebi and Otmani del Barrio (2017) analyse global lessons learned in climate change adaptation, Araos et al. (2016) present the necessity of a global baseline for urban adaptation policies and Berry et al. (2010) analyse global progress on national and local adaptations and its challenges. There is an increasing number of Peruvian academics working on the topic and rethinking their research area, such as chronic and infectious diseases within an Anthropocene context (Avilez et al., 2016; Quispe et al., 2016; Ford et al., 2018). Austin et al. (2018) article on the challenges of federalist states, in their case Germany and Canada, to develop adaptation strategies has shown challenges based on diverse local and regional networks and processes of agreement with national level. It is not much known about the processes in-depth and further research will be necessary. However, what is clear that changes in government and political discrepancies might well have an impact, which might be laid out in institutional instability and deserves in-depth research, which would also allow on how to develop a response that is in regional and national interest independent of governmental changes on local, federal and national level. While Austin et al. (2016) analyse the commonalities and challenges of health adaptations across Organisation for Economic Co-operation and Development countries, there is no such analysis in relation to either middle- or low-income countries or more interestingly in relation to regional integration processes for the European Union, the Asian Regional Network or the Andean Community or Mercosur, for example. Conclusion The adaptation plans are incredibly uneven, with regional departments that have made outstanding efforts to create comprehensive plans, conducting the necessary research, devising strategies for the various sectors that will be impacted by climate change and formulating ideas for practical implementation that include evaluation and monitoring to create an iterative process. On the other hand, there are ideas and plans being thrown out into the policy world, but there is not always the data, knowledge, attention to detail or capacity to back them up and carry them out to ensure proper implementation. The common theme of the Regional Climate Change Strategies is the objectives they want to achieve and how to measure them, but limited information on implementing strategies to ensure the objectives are met. Future research should map the NHA and apply the Instrument for the Performance evaluation of the NHA steering role as specified by the steering document (PAHO et al., 2007), in which the NHA identifies and evaluates weaknesses, and identifies bottlenecks within the health sector impeding progress. When we consider health under anthropogenic climate change, health systems need to be strengthened to support the well-being and health of populations. Additionally, mental health needs to be included in the conversation. In the end, it seems that the Regional Climate Change Strategies and the National Climate Change Strategy have not accomplished much, they have failed to adequately plan and set in motion preparations to safeguard the future health of the Peruvian population. This could be improved by a national process of accountability to ensure quality of ERCC’s, NAP and HNAP and their implementation. In order to bring health to the forefront of the adaptation conversation, it may be necessary for the DIRESA to create a guide separate from the existing strategies for regional health adaptation strategies to climate change. From there, health policies may be folded into the larger conversation on climate change adaptation and included in departmental and national strategies. This will include the collaboration of the health department with other departments such as the environmental department, which have already set their goals and strategies in some cases. Meteorological data are widely known to be lacking, and improvement in tracking of such data have been declared a goal in many of the plans. We recommend a policy that lays out the ways in which the national government and the regional departments will partner in order to combat health effects of climate change. The national government needs to provide more substantial support for the departments in terms of human resources, capacity building, structural change and financing. Finally, this case study resembles global challenges putting health in the centre of national adaptation plans. In-depth case studies and cross-country analysis are still missing but urgently needed to learn from other experiences. We need to understand better what countries are doing, how they are doing it and what works, why and how, so that we can learn and improve urgently needed health-centred national adaptations to climate change. 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TI - Health system adaptation to climate change: a Peruvian case study
JF - Health Policy and Planning
DO - 10.1093/heapol/czaa072
DA - 2021-03-03
UR - https://www.deepdyve.com/lp/oxford-university-press/health-system-adaptation-to-climate-change-a-peruvian-case-study-8yTOSrK6Mn
SP - 45
EP - 83
VL - 36
IS - 1
DP - DeepDyve
ER -