In Jambi, unpredictable weather is no longer just a concern for farmers. Changing rainfall patterns and rising temperatures are affecting health, altering the spread of diseases, and challenging traditional health programmes.
The Climate-Resilient Village initiative, known locally as Desa/Kelurahan Sehat Iklim (DEKSI), is helping communities adapt to these changes. As a community-based initiative that helps villages adapt and stay healthy in a changing climate, DEKSI relies on community involvement to identify climate-related challenges and implement interventions accordingly. Beginning as Desa Desi, this national initiative originally focused on rural villages. In September 2025, it was renamed DEKSI and expanded to cover urban villages.
Jambi was the first province in Indonesia to implement Desa Desi and DEKSI, showing how local actions can address climate-related health risks.
The initiative began in 2018 when health officials from Jambi attended a climate adaptation training organised by the Ministry of Health and the World Health Organization (WHO). For Susilawati, a sanitarian at the Jambi Provincial Health Office (PHO), the training was an eye-opener.
“I realised how important it was to bring this to the villages. Climate change is affecting health, and communities need to learn how to adapt,” she said. By 2019, she was promoting climate-resilient villages across the province, using existing programmes and sometimes her own resources.
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Susilawati, a sanitarian at Jambi PHO, is one of the key advocates for climate-resilient and healthy villages in Jambi. Credit: WHO/Bunga Manggiasih
The PHO leadership supported the idea, prepared a provincial policy to sustain it and explained the rationale to the governor. In parallel, several villages began piloting the approach, using village funds to support community actions.
Governor Al Haris recognised the urgency and saw the initiative as a strategic response to Jambi's vulnerability to climate change. His decree, signed in 2024, provided legal backing and unlocked provincial funding for DEKSI villages. “We decided to start from the ground up, helping villages understand the importance of protecting the climate and their ecosystems,” he said.
To strengthen and expand DEKSI implementation, the Ministry of Health has issued a dedicated guideline. The ministry also supports climate adaptation through the development of technical guidelines and policy frameworks for health and environmental disaster response. The ministry has issued the National Action Plan for Climate Change Mitigation and Adaptation for the Health Sector (2025–2030). Meanwhile, provinces are encouraged to create their own Regional Action Plans.
Community action and visible change
In Sri Agung village, Tanjung Jabung Barat District, this initiative relies on multiple community networks. Family welfare cadres promote household waste management. Health cadres provide health education. Meanwhile, the youth contribute through campaigns on digital media and social platforms.
This participatory approach differs from traditional top-down health programmes. "We were quite surprised at first. We had to learn and discuss with colleagues from puskesmas (community health centre) and other government offices," said Ani Rizka Amelia, a member of the DEKSI working group in Sri Agung.
Working groups are the driving force behind this initiative in the villages. Comprising members representing women, youth, vulnerable groups, and other community organizations, the working groups are tasked with identifying climate-related health challenges in their villages, designing solutions to address these challenges, and implementing interventions to improve the situation.
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Residents of Sri Agung village discuss the dengue transmission cycle with resources provided by the Ministry of Health. Credit: WHO/Bunga Manggiasih
Thobrani, Head of Sri Agung Village, shared how the village embraced the programme. After a village meeting, people were enthusiastic. They planned and carried out various activities, including training health cadres, installing waste bins, and putting up posters about disease prevention. In 2024, the village allocated IDR 67 million (US$ 4000) to support climate-resilient village activities.
Maria, a sanitarian at Puskesmas Talang Bakung, saw the community’s social fabric as the main asset of DEKSI initiatives. “The community was already strong in cooperation, so we built on that. Based on discussion with the DEKSI working group, we started with education on waste management, dengue prevention, as well as nutrition and herbal plants.”
She noted how residents drove the initiative, including by planting various herbal plants as remedies for common ailments, which are useful when access to health care is disrupted by climate-related disasters. These include Javanese ginger for inflammation, celery to lower blood pressure, aloe vera for skin healing, and citronella to repel mosquitoes. Residents also grew vegetables in communal spaces. Harvested moringa leaves are used to cook puddings and distributed to toddlers attending posyandu (community health post) activities, while other vegetables are sold to neighbours.
In addition, the community has amped up regular inspection and elimination of mosquito breeding sites to prevent the spread of dengue and sought to acquire important tools such as compost bins and waste shredders.
The changes are visible. In Sri Agung, the incidence of climate-sensitive diseases declined between 2023 and 2024. Upper respiratory infections dropped from 7 cases to 3, and diarrhoea fell from 2 to zero. Habits have changed, too. “People used to throw rubbish wherever they liked. Now, waste is sorted, some for compost, some for sale,” Thobrani said.
“Before DEKSI, people didn’t understand how to manage rubbish. Now, they do,” Maria said. In Talang Bakung, DEKSI has helped residents maintain zero cases of diarrhoea, worm infections, malaria and dengue for three consecutive years.
Looking ahead
Dr Then Suyanti, Director of Environmental Health from the Ministry of Health, views Jambi’s leadership as a model for other provinces. "What I see in Jambi is the strength of local leadership commitment. This will become an example or model for other provinces to accelerate DEKSI implementation,” she said.
Governor Al Haris continues to encourage other local leaders to adopt DEKSI. "If we're late in addressing climate issues, we'll be late in saving our children and grandchildren in the future."
Susilawati echoed the Governor’s sentiment. “If we do not take care of the environment now, the impact will fall on our children and grandchildren. Take care of the environment, and it will take care of you,” she said.
In the villages, the sense of ownership is growing. “The environment is cleaner, people are more aware of healthy living, and our working groups are more active,” Ani said. “We’ve come a long way, and we’re ready to keep going.”
The DEKSI model in Jambi marks a shift from reactive health responses to proactive community-based climate adaptation. By recognising that environmental protection leads to human health, these communities are shaping a new approach to climate resilience in Indonesia.
Written by Bunga Manggiasih, National Professional Officer (Communication), WHO Indonesia