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Pappas A, Kovats S, Ranganathan M. Extreme weather events and maternal health in low-income and middle-income countries: a scoping review. BMJ Open 2024; 14:e079361. [PMID: 38830734 PMCID: PMC11149126 DOI: 10.1136/bmjopen-2023-079361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 05/09/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Despite global efforts to improve maternal health and healthcare, women throughout the world endure poor health during pregnancy. Extreme weather events (EWE) disrupt infrastructure and access to medical services, however little is known about their impact on the health of women during pregnancy in resource-poor settings. OBJECTIVES This review aims to examine the current literature on the impact of EWE on maternal health to identify the pathways between EWE and maternal health in low-income and middle-income countries to identify gaps. ELIGIBILITY CRITERIA Studies were eligible for inclusion if they were published before 15 December 2022 and the population of the studies included pregnant and postpartum women (defined at up to 6 weeks postpartum) who were living in low-income and middle-income countries. The exposure of the included study must be related to EWE and the result to maternal health outcomes. SOURCES OF EVIDENCE We searched the literature using five databases, Medline, Global Health, Embase, Web of Science and CINAHL in December 2022. We assessed the results using predetermined criteria that defined the scope of the population, exposures and outcomes. In total, 15 studies were included. CHARTING METHODS We identified studies that fit the criteria and extracted key themes. We extracted population demographics and sampling methodologies, assessed the quality of the studies and conducted a narrative synthesis to summarise the key findings. RESULTS Fifteen studies met the inclusion criteria. The quantitative studies (n=4) and qualitative (n=11) demonstrated an association between EWE and malnutrition, mental health, mortality and access to maternal health services. CONCLUSION EWE negatively impact maternal health through various mechanisms including access to services, stress and mortality. The results have demonstrated concerning effects, but there is also limited evidence surrounding these broad topics in low-resource settings. Research is necessary to determine the mechanisms by which EWE affect maternal health. PROSPERO REGISTRATION NUMBER CRD42022352915.
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Affiliation(s)
- Anna Pappas
- London School of Hygiene and Tropical Medicine, London, UK
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Meghna Ranganathan
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Burns PA, Mutunga C. Addressing the Impact of Climate Change on Sexual and Reproductive Health Among Adolescent Girls and Young Women in Low- and Middle-Income Countries. GLOBAL HEALTH, SCIENCE AND PRACTICE 2024; 12:GHSP-D-23-00374. [PMID: 38365281 PMCID: PMC10906547 DOI: 10.9745/ghsp-d-23-00374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 01/23/2024] [Indexed: 02/18/2024]
Abstract
There is an urgent need to better understand the role of climate change on sexual and reproductive health outcomes, particularly among adolescent girls and young women in low- and middle-income countries. Stakeholders at all levels should apply a rights-based, gendered approach to climate action and adaptation.
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Affiliation(s)
- Paul A Burns
- Department of Population Health Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.
- U.S. Agency for International Development, Bureau for Global Health, Office of Population and Reproductive Health, Division of Research, Technology and Utilization, Washington, DC
- American Association for the Advancement of Science, Washington, DC
| | - Clive Mutunga
- BUILD (Building Capacity for Integrated Family Planning & Reproductive Health and Population, Environment and Development Action), The African Institute for Development for Policy, Lilongwe, Malawi
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Begum A, Hamid SA. Maternal healthcare utilization in rural Bangladesh: A comparative analysis between high and low disaster-prone areas. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001409. [PMID: 37523343 PMCID: PMC10389743 DOI: 10.1371/journal.pgph.0001409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/30/2023] [Indexed: 08/02/2023]
Abstract
This study examined the disparity in antenatal care (ANC) visits and institutional delivery between high-disaster-prone (HDP) and low-disaster-prone (LDP) areas, defined based on multi-hazards, in Bangladesh and assessed the influencing factors using Andersen's behavioral model. In this study, cross-sectional data of 345 mothers, who had live birth the year preceding the survey, were used from the second-round multipurpose survey of a longitudinal research project conducted in May-June 2011. Hierarchical multinomial logistic and binary logistic models were respectively used to assess the determinants of ANC contacts and choice of childbirth place. We found very low utilization of 4+ ANC visits in both HDP (20%) and LDP (15%) areas. The difference is also not significant. The strong influencing factors of receiving 4+ ANC were mother's education, household size, income, and proximity to health facility. The level of institutional delivery was also low (21%), and no significant difference between HDP (15.2%) and LDP (25.7%) was found. However, in the case of institutional delivery, significant (p-value ≤ .01) difference was found in C-section between HDP (42%) and LDP (79%). A significant (p-value ≤ .05) difference was also found in the attendance of graduate doctors/gynecologists between HDP (58%) and LDP (88%). Mothers of HDP areas were 52 percent less likely to choose institutional delivery compared to those of LDP areas. Moreover, there was 30 percent less likelihood of choosing institutional delivery with an increase in distance to the nearest health facility. Specific demand-side (e.g., awareness raising, expanding maternal voucher scheme, covering more mothers under maternal allowance, and facilitating more income-generating activities especially off-farm ones) and supply-side interventions (e.g., providing training to local traditional birth attendants, and deployment of boat-based medical teams in coastal and char areas) need to be undertaken to increase institutional delivery, especially in HDP areas. However, the ultimate solution depends on adopting long-term measures to prepare facilities ready by filling the vacant posts and reducing absenteeism. Public-private partnerships modality can also be introduced especially in the HDP areas. Policy attention is needed to introduce such interventions.
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Affiliation(s)
- Afroza Begum
- Department of Statistics, University of Chittagong, Chittagong, Bangladesh
| | - Syed Abdul Hamid
- Institute of Health Economics, University of Dhaka, Dhaka, Bangladesh
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Dewi SP, Kasim R, Sutarsa IN, Hunter A, Dykgraaf SH. Effects of climate-related risks and extreme events on health outcomes and health utilization of primary care in rural and remote areas: a scoping review. Fam Pract 2023; 40:486-497. [PMID: 36718099 DOI: 10.1093/fampra/cmac151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Rural populations are at risk of climate-related impacts due to ecological and geographical determinants, potentially leading to greater morbidity and health utilization. They are often highly dependent on primary care services. However, no rural- or primary care specific synthesis of these issues has ever been conducted. This review aimed to identify, characterize, and summarize existing research on the effects of climate-related events on utilization and health outcomes of primary care in rural and remote areas and identify related adaptation strategies used in primary care to climate-related events. METHODS A scoping review following PRISMA-ScR guidelines was conducted, examining peer-reviewed English-language articles published up to 31 October 2022. Eligible papers were empirical studies conducted in primary care settings that involved climate-related events as exposures, and health outcomes or utilization as study outcomes. Two reviewers independently screened and extracted relevant information from selected papers. Data were analysed using content analysis and presented using a narrative approach. RESULTS We screened 693 non-duplicate papers, of those, 60 papers were analysed. Climate-related events were categorized by type, with outcomes described in terms of primary, secondary, and tertiary effects. Disruption of primary care often resulted from shortages in health resources. Primary care may be ill-prepared for climate-related events but has an important role in supporting the development of community. CONCLUSIONS Findings suggest various effects of climate-related events on primary care utilization and health outcomes in rural and remote areas. There is a need to prepare rural and remote primary care service before and after climate-related events.
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Affiliation(s)
- Sari Puspa Dewi
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.,Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Rosny Kasim
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
| | - I Nyoman Sutarsa
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia.,Department of Public Health and Preventive Medicine, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - Arnagretta Hunter
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sally Hall Dykgraaf
- Rural Clinical School, School of Medicine and Psychology, College of Health and Medicine, Australian National University, Canberra, Australia
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Afroz S, Sutopa TS, Haque MR. Young mothers’ attitudes towards domestic violence and their maternal healthcare services utilization in Bangladesh: A multilevel cluster analysis. PLoS One 2022; 17:e0268062. [PMID: 35913966 PMCID: PMC9342752 DOI: 10.1371/journal.pone.0268062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
This paper examined the association between young mothers’ attitudes towards domestic violence and four or more antenatal care (ANC) and health-center-based delivery service utilization using two cross-sectional waves of the Bangladesh Demographic and Health Surveys (2014 and 2018) data. We carried out a multilevel logistic regression analysis. Findings show that a strong cluster variation exists in four or more ANC and health-center-based delivery service utilization. Although the utilization of four or more ANC and health-center-based delivery services has increased over the years, it is far behind the targets of SDGs, particularly for young mothers with justified attitudes towards domestic violence. Extension of maternity allowance coverage and motivational programs are important policy recommendations.
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Affiliation(s)
- Sawkia Afroz
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
| | | | - Md Rabiul Haque
- Department of Population Sciences, University of Dhaka, Dhaka, Bangladesh
- * E-mail:
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van Daalen KR, Dada S, Issa R, Chowdhury M, Jung L, Singh L, Stokes D, Orcutt M, Singh NS. A Scoping Review to Assess Sexual and Reproductive Health Outcomes, Challenges and Recommendations in the Context of Climate Migration. Front Glob Womens Health 2021; 2:757153. [PMID: 34816251 PMCID: PMC8594026 DOI: 10.3389/fgwh.2021.757153] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 09/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background: As growing numbers of people may be forced to migrate due to climate change and variability, it is important to consider the disparate impacts on health for vulnerable populations, including sexual and reproductive health (SRH). This scoping review aims to explore the relationship between climate migration and SRH. Methods: We searched PubMed/MEDLINE, CINAHL Plus, EMBASE, Web of Science, Scopus, Global Health and Google for peer-reviewed and gray literature published before 2nd July 2021 in English that reported on SRH in the context of climate migration. Data were extracted using a piloted extraction tool and findings are reported in a narrative synthesis. Results: We screened 1,607 documents. Ten full-text publications were included for analysis: five peer-reviewed articles and five gray literature documents. Reported SRH outcomes focused on maternal health, access to family planning and antiretroviral therapy, sexual and gender-based violence, transactional sex, and early/forced marriage. Recommendations to improve SRH in the context of climate migration called for gender-transformative health systems, education and behavior change programmes, and the involvement of local women in policy planning and programme implementation. Discussion: While the disparate impacts of climate change and migration are well-established, primary data on the scope of impact due to climate migration is limited. The SRH outcomes reported in the literature focus on a relatively narrow range of SRH domains, emphasizing women and girls, over men. Achieving holistic and equitable SRH in the context of climate migration requires engaging all genders across the range of SRH outcomes and migration contexts. This review highlights the need for further empirical evidence on the effect of climate migration on SRH, with research that is context-specific and engages communities in order to reflect the heterogeneity of outcomes and impact in the climate-migration-SRH nexus.
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Affiliation(s)
- Kim Robin van Daalen
- Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom
| | - Sara Dada
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland
| | - Rita Issa
- Institute for Global Health, University College London, London, United Kingdom
| | | | - Laura Jung
- Faculty of Medicine, Leipzig University, Leipzig, Germany
| | - Lucy Singh
- EGA Institute for Women's Health, University College London, London, United Kingdom
| | | | - Miriam Orcutt
- Institute for Global Health, University College London, London, United Kingdom
| | - Neha S. Singh
- Health in Humanitarian Crises Centre, London School of Tropical Hygiene and Medicine, London, United Kingdom
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Harville EW, Beitsch L, Uejio CK, Sherchan S, Lichtveld MY. Assessing the effects of disasters and their aftermath on pregnancy and infant outcomes: A conceptual model. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2021; 62:102415. [PMID: 34336567 PMCID: PMC8318346 DOI: 10.1016/j.ijdrr.2021.102415] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although many studies have examined broad patterns of effects on pregnancy and infant outcomes after disasters, the causes of adverse outcomes are not always clear. Disasters cause interrelated exposure to environmental pollutants, psychological stressors, and lack of health care, and interacts with other social determinants of health. This topical review examines the short- and long-term effects of disasters on pregnancy and how they are mediated by social, behavioral, and environmental effects. In the short term, disasters are associated with physical trauma, adverse environmental exposures, and unstable housing. In the longer term, disasters may lead to relocation, changes in family functioning, and negative economic effects. These aspects of disaster exposure, in turn, lead to lack of access to health care, increased stress and negative mental health outcomes, and negative behavioral changes, including smoking and substance use, poor nutrition, physical overexertion and limited activity, and reduction in breastfeeding. All of these factors interact with social determinants of health to worsen effects on the most vulnerable women, infants, and communities. Few interventions after disasters have been tested. With the increase in disasters due to climate change and the ongoing coronavirus pandemic, the models of effects of disasters and their human health consequences need increasing refinement, and, more importantly, should be applied to interventions that improve disaster prevention, mitigation, and response.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
| | - Leslie Beitsch
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL
| | - Christopher K Uejio
- Department of Geography, College of Social Sciences and Public Policy, Florida State University, Tallahassee, FL
| | - Samendra Sherchan
- Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
| | - Maureen Y Lichtveld
- Professor and Chair, Department of Environmental Health Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA; Currently Dean and professor, Department of Environmental and Occupational Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA
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Nayna Schwerdtle P, Stockemer J, Bowen KJ, Sauerborn R, McMichael C, Danquah I. A Meta-Synthesis of Policy Recommendations Regarding Human Mobility in the Context of Climate Change. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9342. [PMID: 33327439 PMCID: PMC7764877 DOI: 10.3390/ijerph17249342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023]
Abstract
Changing mobility patterns combined with changes in the climate present challenges and opportunities for global health, requiring effective, relevant, and humane policy responses. This study used data from a systematic literature review that examined the intersection between climate change, migration, and health. The study aimed to synthesize policy recommendations in the peer-reviewed literature, regarding this type of environmental migration with respect to health, to strengthen the evidence-base. Systematic searches were conducted in four academic databases (PubMed, Ovid Medline, Global Health and Scopus) and Google Scholar for empirical studies published between 1990-2020 that used any study design to investigate migration and health in the context of climate change. Studies underwent a two-stage protocol-based screening process and eligible studies were appraised for quality using a standardized mixed-methods tool. From the initial 2425 hits, 68 articles were appraised for quality and included in the synthesis. Among the policy recommendations, six themes were discernible: (1) avoid the universal promotion of migration as an adaptive response to climate risk; (2) preserve cultural and social ties of mobile populations; (3) enable the participation of migrants in decision-making in sites of relocation and resettlement; (4) strengthen health systems and reduce barriers for migrant access to health care; (5) support and promote optimization of social determinants of migrant health; (6) integrate health into loss and damage assessments related to climate change, and consider immobile and trapped populations. The results call for transformative policies that support the health and wellbeing of people engaging in or affected by mobility responses, including those whose migration decisions and experiences are influenced by climate change, and to establish and develop inclusive migrant healthcare.
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Affiliation(s)
- Patricia Nayna Schwerdtle
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
- Nursing & Midwifery, Faculty of Medicine, Nursing & Health Science, Monash University, Clayton, VIC 3800, Australia
| | - Julia Stockemer
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
| | - Kathryn J. Bowen
- Fenner School of Environment and Society, and Research School of Population Health, Australian National University, Canberra, ACT 2601, Australia;
- Institute for Advanced Sustainability Studies, 14467 Potsdam, Germany
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC 3010, Australia
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
| | - Celia McMichael
- School of Geography, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Ina Danquah
- Heidelberg Institute of Global Health, Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany; (J.S.); (R.S.); (I.D.)
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