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==== 7.4.3.1 Governance, Collaboration and Coordination ==== <div id="h3-53-siblings" class="h3-siblings"></div> ''Effective governance institutions, arrangements, funding and mandates are key for adaptation to climate-related health risks'' ( ''high confidence'' ) ''.'' Without integration and collaboration across sectors, health adaptation can become siloed, leading to less effective adaptation or even maladaptation ( [[#Magnan--2016|Magnan et al., 2016]] ; [[#Fox--2019|Fox et al., 2019]] ). Integration and collaboration include working laterally across national government departments and agencies, as well as vertically from national agencies to local governments and with the private sector, academia, NGOs and civil society. In this context, top-down policy design and implementation are complemented by bottom-up approaches that engage community actors in programme design and draw upon their local practices, perspectives, opinions and experiences. Opportunities exist to better integrate public health into climate change discourse and policymaking processes, and to strengthen public health partnerships and collaborations ( [[#Awuor--2020|Awuor et al., 2020]] ). Creating networks, integration across organisations and jointly developed policies can facilitate cross-sectoral collaboration ( [[#Bowen--2017|Bowen and Ebi, 2017]] ). <div id="7.4.3.2" class="h3-container"></div> <span id="multi-sectoral-collaborations"></span>
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