Heat and its effects on maternal and neonatal health care: Evidence from Burkina Faso

Climate change has a wide range of adverse consequences for human health. The effects of extreme weather on maternal and newborn health, as well as the availability and quality of health services, remain under-researched in the sub-Saharan region. The aim of this study is to examine the effects of heat on pregnant women's use of health services, the health facility working environment and the impact of heat on the quality of care in Burkina Faso, a limited resource country.

We adopted a qualitative approach to address the research objectives.

This study was conducted in the primary health care centers of Wemtenga in Ouagadougou and Delga in Kaya, Burkina Faso, from September 30th to October 30th^, 2020. The study included individual interviews and focus group discussions (FGD) with pregnant women, postpartum women, health providers and community leaders, women of reproductive age, as well as relatives and male spouses of women who recently had given birth. The interviews were transcribed into French and coded using NVivo11 software.

Forty pregnant and postpartum women, aged 20-40 years, were interviewed, and 31 women of childbearing age, aged 21-39 years, participated in the FGDs; 29 spouses also participated in the FDGs. Interviews indicated that extreme heat was reported to reduce the attendance and use of health services by pregnant and postpartum women. The women's choice of delivery center depended on the quality of the health centers, notably whether they were equipped with cooling systems, as lack of cooling could adversely affect the care of women and newborns, and the number of managed patients. The conveniences offered by health centers, notably the presence of fans or air conditioners, were important factors influencing women's decisions on where to give birth. All stakeholders agreed that extreme heat affected the relationship between caregivers and patients, especially facilities with inadequate infrastructures, such as the lack of a cooling system and cramped spaces.

Extreme ambient heat negatively impacts the use of maternal and child health services, the performance and quality of care provided by health professionals, and the relationship between carer and patient. This is particularly concerning as worsening heat could undermine the progress made in maternal and child health in Burkina Faso and other similar settings. It is crucial for healthcare systems to adapt to the effects of climate change, particularly to extreme heat and heatwaves, which are becoming increasingly intense, frequent and long-lasting.