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Environmental change and health risks in coastal Semarang, Indonesia: importance of local indigenous knowledge for strengthening adaptation policies

ABSTRACT Climate and environmental change are currently in the forefront as global development issues due to their economic, societal and health impacts, and the complex ways these interact. Experience and perception play an important role regarding the overall nature and severity of the environmental change, as these shape coping behaviour. Therefore, more insight is needed into local health-related risk perception, knowledge and coping mechanisms. In Semarang, a low-lying coastal city in Indonesia, a concurrent mixed-methods study design was applied using a cross-sectional survey supplemented by six focus group discussions and eight semi-structured key informant interviews with village officers and health-care workers. Respondents exhibited high awareness of environmental change and impact on health, housing and livelihood, and acknowledged the role of human activity, yet insight in underlying disease mechanisms was low. Most coping mechanisms were mainly short-term due to financial limitations and the frequency and intensity of environmental events. Existing health educational programs should be expanded and incorporate local perception and knowledge, to optimise coping behaviour and strengthen population resilience to environmental change. Further research needs to focus on differences regarding perception and desired coping strategies between household members and individual vulnerability to environmental change.