Previous research enabled the selection of two rural villages and associated municipalities to be the focus for exploring the interacting impacts of climate variability, water scarcity, and health issues. In order to identify and assess integrated and cross-sectoral adaptive management opportunities, an integrated analysis was undertaken of the exposure of livelihoods of vulnerable rural groups to water scarcity, climate variability, food insecurity and health risks and the impacts of these stresses at the individual, village, municipal and district levels.

The findings indicate that water scarcity and limited economic opportunities are two major constraints to development at both the village and district scale that undermines adaptive capacity. People to a large extent relate both climate stress and food insecurity back to these two dominant stressors. This highlights the need for integrated responses to support local adaptation that departs from hegemonic sectoral approaches. It also requires improved and increased communication between government and local communities to facilitate the integration of strategies being implemented at different scales and better align expectations. The municipal government needs to carefully assess the likely environmental, social and economic impacts of investing in different sectors, incorporating a view on climate change and prioritizing water saving and wealth distributing options with the aim of minimizing future vulnerability.