CHAMNHA (Climate, Heat, and Maternal and Neonatal Health in Africa)

Impact of environmental heat exposure around the time of childbirth on women’s and children’s health: a community and facility-based qualitative inquiry in Burkina Faso and Kenya.

Rationale

The frequency and intensity of heat waves have increased in sub-Saharan Africa (SSA) and are set to escalate in the coming decades. Heatwaves and high seasonal temperatures present major health threats, especially for vulnerable population groups, such as those with limited socio-economic resources or compromised physiological ability to respond to heat stress. Pregnant women form one such vulnerable group but recognition of this vulnerability has been slow.

Growing evidence (mostly from high-income countries) shows that heat stress affects a wide range of MNH outcomes, resulting in a major disease burden. Heat and aridity are strongly associated with preterm birth and low birth weight. There is further evidence that heat exposure increases the risk of pre-eclampsia and postpartum haemorrhage. Few studies on the impact of heat on MNH have been conducted in sus-Saharan Africa.

Women may interpret symptoms of heat stress – such as dehydration in the neonate – and act to relieve these symptoms using culturally specific models of health and illness. There is little evidence on pregnant women’s lived experience of and responses to extreme ambient heat, including how new mothers (and other family members) act to protect newborn babies from heat stress. To design feasible and acceptable heat mitigating health interventions for pregnant and postpartum women and their newborns, we need a better understanding of local explanatory models that are used to explain risk, illness and harm in relation to pregnancy and childbirth.


Primary Objectives

To examine how exposure to extreme heat during pregnancy and in the postpartum is viewed by a range of stakeholders, and the extent to which they view it as a priority for intervention

To explore women’s cooling behaviours and general resilience to heat stress

To document how women identify discomfort from heat in their neonates, understand their neonate’s fluid and nutritional needs, and formulate strategies to cool them down

To investigate how heat stress affects women’s utilisation of antenatal care (ANC) and postnatal care (PNC), and how the health system copes with demand during periods of extreme heat

To identify community- and facility-based heat-health interventions considered feasible and acceptable by potential beneficiaries and local stakeholders


Study Design

The study is qualitative in approach. Data will be collected in two sites in Burkina Faso and two sites in Kenya, through the following activities:

• In-depth interviews (IDI)

• Focus group discussions (FGD)

• Key informant interviews (KII)

• Observations and temperature monitoring in maternity units of healthcare facilities

• Co-design workshops with local beneficiaries and stakeholders in MNH and climate services to design an intervention


Study Population

Pregnant and postpartum women, Women ever pregnant, Elderly female relatives, Male partners, Community Health Volunteers, Community Workers, and Health Care workers.


Investigators

Fiona Scorgie, Wits RHI

Kadidiatou Kadio, Institute de Recherche en Siences de la Santé (IRSS), Burkina Faso

Adelaide Lusambili, Aga Khan University, Kenya


Sponsors/Donors

The study is funded by The Belmont Forum and channelled via sub-contract to WRHI through LSHTM, UK and Karolinska Institutet, Sweden.

Latest Update: 23 August 2021

For more about CHAMNHA (Climate, Heat, and Maternal and Neonatal Health in Africa) please email lto:rhicomms@wrhi.ac.za” title=”“>rhicomms@wrhi.ac.za