Impacts and Risks of Heatwaves and Floods on Maternal and Child Health Systems in Zambia; A multi evidence approach

Climate change is a pressing global challenge with adverse effects on human health and well-being. Like many sub-Saharan African countries, Zambia faces the dual burden of extreme weather events and health challenges, particularly in maternal and child health (MCH). We employed a multiple-evidence approach and conducted nine focus group discussions (FGDs), 75 key informant interviews (KIIs) and a structured document review of blended sources of evidence (scientific articles, governmental and non-governmental reports, national communications, and newspapers). We examined the impacts and risks of heatwaves and floods on MCH systems in Zambia. The FGDs and KIIs constituted community, health facility and district-level participants from Senanga and Sinazongwe Districts of Southern Zambia. Both districts have almost perennial occurrences of floods and heat waves. We explored the lived experiences of community members and health practitioners by examining the effects of floods and heatwaves on daily life and MCH service provision, access, quality, and related health outcomes. Further, we assessed the preparedness, risk reduction, mitigation, coping and adaptation strategies implemented by community, health facility and district-level stakeholders in response to the two climate hazards. Our study results show pathways through which heatwaves and floods impact MCH, including limiting access to healthcare and increasing the prevalence of infectious diseases. Additionally, the results highlight coping and adaptation measures instituted, such as external support from state and non-state actors, collaboration, and resource allocation to enhance or maintain MCH service delivery during these extreme weather events. Furthermore, the results showcase healthcare decision-making structures and how information is shared across stakeholders before and during disaster events. The results reveal innovative solutions at district, community, facility, and household levels adopted and desired by stakeholders within the MCH system to strengthen resilience to future extreme weather events. We recommend future research to better understand community challenges in accessing MCH services and for health facilities to provide such services during extreme weather events. This will streamline policy strategies to enhance community resilience and ensure the sustainability of MCH systems amidst the growing threats posed by climate change.