Effects of extreme temperatures on maternal and child health in Senegal and Bangladesh
Using a realistic approach, understand how vulnerable women and children adapt to extreme temperatures and evaluate community interventions aimed at reducing their health impacts in Senegal and Bangladesh.
Humanitarian or social context and issues
In a global context of climate change, extreme temperatures (ET) pose a growing threat to human health, particularly in low- and middle-income countries. Pregnant women, nursing mothers and young children are among the most vulnerable, exposed to increased risks of obstetric complications, psychological distress and neonatal mortality. These impacts are exacerbated by fragile health systems and persistent social inequalities, which limit access to care. Despite the scale of the problem, research on the combined effects of ETs on the physical and mental health of mothers and children in the Global South remains scarce. Yet the stakes are high: understanding these vulnerabilities and strengthening local adaptive capacities related to breastfeeding practices is essential to preserving gains in maternal and child health and devising equitable responses to climate crises.
This research aims to understand how pregnant or breastfeeding women and their young children adapt to ETs (particularly in terms of breastfeeding practices and mental health) and to evaluate community interventions designed to mitigate their effects. Using realistic evaluation, it will analyse the psychosocial, social and structural mechanisms that influence these adaptations, as well as the contextual conditions that facilitate or hinder them. The objective is twofold: to shed light on the diversity of adaptation trajectories and to identify the most relevant interventions for reducing inequalities in exposure and vulnerability, in order to provide socially just solutions that can be transferred to other contexts.
What psychosocial, social and structural mechanisms explain the adaptive behaviours of pregnant or breastfeeding women in response to extreme temperatures? Under what conditions do interventions reinforce or transform these mechanisms?
Field of research and methodology
The project is being carried out in two regions that are particularly vulnerable to ET: the Satkhira district in Bangladesh and the Matam region in Senegal. These areas, which have worrying maternal and child health indicators and limited health resources, are home to populations that are vulnerable to the effects of climate change. The research focuses on pregnant women, nursing mothers, their close families and local health professionals. It uses realistic evaluation, an approach adapted to complex interventions, which seeks to understand how and why these interventions produce different effects depending on the context. The investigation is based mainly on qualitative interviews, conducted before and during the implementation of co-constructed community interventions, and on the analysis of context-mechanism-effect configurations.
The scientific significance of the research and its implications for humanitarian and social actors
The results will provide social, humanitarian and health actors with tools to design and adjust interventions tailored to local realities. By identifying the drivers and barriers to effective adaptation behaviours, this research will help anticipate the differentiated effects on different social groups and target the most vulnerable more effectively. The lessons learned will strengthen the relevance, equity and effectiveness of interventions in response to climate change.
This research fills a dual scientific gap. On the one hand, it documents the effects of ETs on maternal and child health in Southern countries, whereas most existing data comes from high-income countries. On the other hand, it uses realistic evaluation, which is still rarely used in climate health, to shed light on the mechanisms that determine the effectiveness of interventions. Through this approach, it offers an explanatory and contextualised interpretation of adaptation trajectories, enhancing the transferability of knowledge. It will thus make an original contribution to research on the links between climate, health and equity.
Biography
Sarah Louart recently completed her PhD in Economics at the University of Lille. Her research focuses primarily on health innovation in low- and middle-income countries, particularly diagnostic innovations, with a focus on conditions for adoption, acceptability and implementation. She is also interested in access to healthcare for vulnerable populations, through work on healthcare navigation and analysis of the barriers encountered throughout the care pathway. She mainly uses qualitative and mixed methods, as well as approaches such as realistic evaluation to analyse the social, institutional and organisational dynamics of healthcare systems.
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