What happens to essential maternal and child healthcare when floods or extreme heat make it harder for families to reach clinics and for health workers to deliver services? IIASA Health, Aging, and Health Systems Research Group Leader, Josephine Borghi, shares perspectives from the REACH project, which is exploring emerging risks and promising strategies to build more climate-resilient health systems.
Floods and heatwaves are among the most frequent and damaging climate hazards, affecting billions worldwide and posing particular risks for mothers and children. Beyond the direct health impacts, these events can disrupt essential services such as antenatal care, skilled birth attendance, and child immunization, especially in low- and middle-income countries (LMICs) where health systems are already under pressure.
The Building Resilience to Floods and Heat in the Maternal and Child Health System in Brazil and Zambia (REACH) project prepared a background document for COP30 providing evidence of how floods and heatwaves affect maternal and child healthcare, and adaptation strategies to reduce climate impacts on the delivery of and access to routine maternal and child healthcare.
The project combined systematic reviews of global evidence with participatory workshops involving health workers, community members, and local authorities in each country to identify both vulnerabilities and strategies for adaptation finding that floods and heatwaves disrupt transport and reduce household income, limiting access to care, while reduced staff productivity and supply chain constraints hinder service delivery.
The analysis identified 17 categories of interventions that can reduce these risks, from strengthening health worker capacity to broader cross-sectoral policies supporting continuity of care. When mapped against the World Health Organization (WHO) climate-resilient health systems framework, a notable gap emerged: there is limited evidence on risk assessment and monitoring interventions relative to interventions for other health system building blocks. This suggests a need for greater integration of risk-informed thinking within health systems policy and planning. Additionally, many interventions focus on increasing quantities of health system inputs with less evidence of efforts to transform how decisions are made or who controls resources.
A key takeaway for policymakers, however, is that many interventions have potential to reduce risks from both floods and heatwaves, and that health system strengthening and climate adaptation can be mutually reinforcing. By recognizing these synergies and prioritizing interventions that address vulnerabilities from multiple hazards, while improving service quality, countries can build resilient health systems capable of delivering more effective care.
Note: This article gives the views of the author, and not the position of the Nexus blog, nor of the International Institute for Applied Systems Analysis.