Submission ID 118361
| Issue/Objective | The diversity of climate related exposures coupled with the complexities of collecting long-term data on climate change indicators pose limitations for understanding how and under what conditions climate change adversely impacts sexual and reproductive health (SRH) in LMICs. This scoping review focused on LMICs is the first synthesis of known and hypothesized mechanisms/pathways that underlie diverse and harmful associations between climate change and sexual and reproductive health. |
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| Methodology/Approach | We adopted an expansive conceptualization of climate change to capture primary (acute disasters and chronic changes in climate indicators), secondary (air and water quality), and tertiary (famine, deforestation, conflict) effects of climate change on SRH. We also considered varied domains of SRH (maternal health, abortion, menstrual hygiene, gender based violence, fertility, psychosexual health, education, contraception, HIV/STIs), based on the WHO framework. After structured database searches and systematic screening of over 40,000 quantitative, qualitative, and mixed methods sources, 289 articles conducted in LMICs were included and synthesized according to: mechanism, contextual factors, strength of evidence, funding source, and actionable intervention points. |
| Results | With the review ongoing, we expect to synthesize evidence on at least 10 mechanisms involving unique combinations of climate change exposures, SRH outcomes, mediators, and contextual moderators. Important mediators across contexts include: (1) infrastructure damage (transportation and health care), (2) displacement to camp settings, (3) feminization of poverty and woman-headed households, and (4) agricultural shocks and maladaptive household coping strategies. Further, context matters in the following ways: patriarchal norms that restrict women's/girls' decision-making and movement in disaster settings, (2) existing socio-economic gradients that perpetuate disparities, (3) exposure to armed conflict, (4) reliance on subsistence farming in rural areas. |
| Discussion/Conclusion | The synthesized mechanisms/pathways provide 4 pragmatic insights: (1) identification of strategic and multi-level intervention targets that could disrupt the harmful effects of mediators and contextual moderators, (2) prioritization of resources according to sub-populations at heightened risk for SRH harms, (3) distilling areas of understudied research by methodological approach, and (4) mapping declared funders of climate change and SRH research in LMICs to understand emerging shifts and opportunities. |
| Presenters and affiliations | Luissa Vahedi SickKids Centre for Global Child Health Michelle Gaffey SickKids Centre for Global Child Health Susan Pradhan SickKids Centre for Global Child Health Sakina Zaidi SickKids Centre for Global Child Health Zulfiqar Bhutta SickKids Center for Global Child Health |
