The outsized effect of climate change on young children represents an “intergenerational injustice”, according to experts speaking at a side event on maternal and child health at COP28 in Dubai. 

“Nearly 90% of the global burden of disease associated with climate change is borne by children under the age of five,” according to UNICEF. 

“Climate change has already had an impact on heat-related child mortality in sub-Saharan Africa. The annual average heat-related child mortality for the period from 2005 to 2014 was approximately under 20% higher than would have been observed without climate change. This so-called ‘climate penalty’ will be worse over the coming years,” said Veronique Filippi, Professor at the London School of Hygiene and Tropical Medicine. 

There is also compelling evidence that heat can increase the risk of preterm births, stillbirths, hypertension as well as preeclampsia, she said.

“There are no physiological reasons why pregnant women or newborns are more vulnerable to the health impact of environmental disasters,” emphasized Filippi. “The main reason for vulnerability is the position of women in society, their limited agency and mobility.” 

Dr Anshu Banerjee, Director of Maternal, Newborn, Child and Adolescent Health and Ageing at the World Health Organization (WHO) said that while global carbon emissions have to be reduced, health facilities also have to be equipped with solar power and cooling facilities for patients. 

“For every climate-related project proposal, we should make sure that it has a maternal, child, adolescent health impact lens as well,” he said. 

Evidence gaps

While there is growing evidence of the different ways climate change affects pregnant women and young children, there continue to be gaps which affect the response.

“Most of the evidence is related to the effects of air pollution, followed by temperature and the effect of disasters, food insecurity, and water access,” Filippi said. 

Angela Baschieri, UNFPA’s Technical Lead on Climate Change, reiterated that it was important to generate “evidence that helps us to inform how we design program as well as the evidence that we need to ensure that we are targeting and we are reaching those who are left behind or may be more exposed”. 

Only 23 national climate action plans out of 119 reviewed by UNFPA have made some reference to maternal and newborn health. These responses have largely been community-led interventions, Baschieri said.
Improving basics like water and sanitation, as well as involving community healthcare workers emerged as some of the key responses that experts said are known to deliver results.

Improve basics like water access

Nobel Prize-winning economist Michael Kremer from the University of Chicago said ensuring communities have basics like clean drinking water can go a long way in responding to worsening climate impacts.

“First, cyclones, floods and heavy rains spread pathogens into drinking water sources causing disease spikes,” he said. “Second, droughts can force people to move to less safe water sources. Finally, increased temperatures can accelerate the growth of pathogens and water,” he explained, elaborating on the climate change and poor water quality link. 

Kremer said water treatment provides a proven safe and cost-effective solution and could prevent a quarter of children’s deaths.

“Water treatment can save more lives than virtually any other health intervention,” he said. Kremer pointed out gains countries like India, Rwanda and Malawi have policies and pilot projects to improve the delivery of safe drinking water to populations. 

“Water treatment has historically been neglected because it falls between the health sector and the water sector. And as many people emphasize, we need to move beyond the silos, particularly as climate change increases threats to water safety and health,” Kremer said.

Working with community-based health workers to improve healthcare delivery is a direct way to provide relief to pregnant women and children.

Community-based response

In 2022, when extreme rainfall worsened by climate change caused devastating floods in Pakistan,  over 100,000 pregnant women were affected, primarily because they could not access services.

“The breakdown that had happened in continuity of care led to so many adverse outcomes in maternal health,” said Neha Mankani, a midwife and project lead at the International Confederation of Midwives. 

“They did not have a safe place to give birth. There were abortion care services that they weren’t able to get, and there were newborn feeding issues that were happening,” she said, adding that community-based healthcare workers were a solution in times of crisis.

“We should look at climate change through a rights and human capital development lens and ensure that meaningful engagement of the most vulnerable. Women and children need to be engaged in setting policies because they are the ones who know how it affects them,” said Banerjee.

Image Credits: Guillaume de Germain/ Unsplash.