TY - JOUR
T1 - Reducing extreme heat impacts on health in pregnant women and infants
T2 - a community based intervention in Kilifi, Kenya
AU - Lusambili, Adelaide
AU - Scorgie, Fiona
AU - Oguna, Martha
AU - Chersich, Matthew
AU - Luchters, Stanley
AU - Gon, Giorgia
AU - Filippi, Veronique
AU - Kovats, Sari
AU - McCawley, Kevin
AU - Hess, Jeremy
AU - Nakstad, Britt
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.
PY - 2025/10/1
Y1 - 2025/10/1
N2 - High ambient temperatures affect maternal and newborn health outcomes and wellbeing. The Climate Heat and Maternal and Neonatal Health in Africa (CHAMNHA) consortium conducted formative qualitative research in rural Kilifi, Kenya, to examine perceptions of heat risks among women, household members, and community stakeholders. An intervention was co-designed together with community members. This paper presents the development, implementation, and evaluation of a behaviour-change intervention aimed at reducing the burden of heat on maternal and newborn health. The intervention used Digital Audio-Visual (DAV) storytelling (encompassing short videos and a set of photographs) and facilitated group discussions. Intervention groups included pregnant and postpartum women (n = 10), mothers-in-law (n = 10), male spouses (n = 10), and community influencers (n = 40). Researchers and local community health volunteers supported pregnant and postpartum women and their household networks weekly for 4 months. At month five, a structured interview, originally administered at baseline, was repeated to evaluate understandings of heat risks and changes in behaviour (reducing exposure to heat by changing daily schedules, reducing heavy workload, and increasing spousal support). Pregnant and postpartum women reported a better understanding of the effects of heat on their health and the newborn, including the importance of staying hydrated, breastfeeding frequently, and avoiding heavy clothing for newborns. They also reported an increase in mothers-in-law and male spouses assisting with household chores and disseminating heat-health messaging to families. However, women noted that male spouses who supported them with chores sometimes reported being stigmatized by their peers. Community approaches to support pregnant and postpartum women during heat periods are feasible, and key community influencers can be trained to include heat-health messaging in their daily routines. Additional research is needed to examine whether repeated training is required to ensure sustainability. Future heat interventions focusing on maternal and neonatal health should consider factors such as employment, age, and depth of support networks.
AB - High ambient temperatures affect maternal and newborn health outcomes and wellbeing. The Climate Heat and Maternal and Neonatal Health in Africa (CHAMNHA) consortium conducted formative qualitative research in rural Kilifi, Kenya, to examine perceptions of heat risks among women, household members, and community stakeholders. An intervention was co-designed together with community members. This paper presents the development, implementation, and evaluation of a behaviour-change intervention aimed at reducing the burden of heat on maternal and newborn health. The intervention used Digital Audio-Visual (DAV) storytelling (encompassing short videos and a set of photographs) and facilitated group discussions. Intervention groups included pregnant and postpartum women (n = 10), mothers-in-law (n = 10), male spouses (n = 10), and community influencers (n = 40). Researchers and local community health volunteers supported pregnant and postpartum women and their household networks weekly for 4 months. At month five, a structured interview, originally administered at baseline, was repeated to evaluate understandings of heat risks and changes in behaviour (reducing exposure to heat by changing daily schedules, reducing heavy workload, and increasing spousal support). Pregnant and postpartum women reported a better understanding of the effects of heat on their health and the newborn, including the importance of staying hydrated, breastfeeding frequently, and avoiding heavy clothing for newborns. They also reported an increase in mothers-in-law and male spouses assisting with household chores and disseminating heat-health messaging to families. However, women noted that male spouses who supported them with chores sometimes reported being stigmatized by their peers. Community approaches to support pregnant and postpartum women during heat periods are feasible, and key community influencers can be trained to include heat-health messaging in their daily routines. Additional research is needed to examine whether repeated training is required to ensure sustainability. Future heat interventions focusing on maternal and neonatal health should consider factors such as employment, age, and depth of support networks.
KW - Kenya
KW - behaviour change
KW - climate adaptation
KW - heat exposure
KW - implementation research
KW - maternal health
KW - newborn health
UR - https://www.scopus.com/pages/publications/105018489318
U2 - 10.1093/heapol/czaf028
DO - 10.1093/heapol/czaf028
M3 - Article
C2 - 40402548
AN - SCOPUS:105018489318
SN - 0268-1080
VL - 40
SP - 943
EP - 954
JO - Health Policy and Planning
JF - Health Policy and Planning
IS - 9
ER -
