This article was originally published in Economist Impact
Healthcare providers have a critical role to play in climate change preparedness for women’s health, but they also need to develop soft skills and support the development of allied community workers, argues Alison Malmqvist, a Vice President and Climate Health lead at Population Services International, an organisation working to improve the quality and affordability of healthcare around the world.
The disproportionate impact of climate change on women’s health outcomes is emerging as a major issue within the broader nexus between climate change and health. Critically, its adverse effect on women’s health is compounded in low- and middle-income countries (LMICs), where socioeconomic factors and underprepared and underfunded healthcare systems leave women more vulnerable than their counterparts in high-income nations.
The extent of climate change’s impact on women’s health is vast. Rising temperatures, droughts, floods and fires can have far-reaching effects, from disrupting supply chains to decreasing access to essential medicines. They can also cause food insecurity, heighten the risk of complications during pregnancy, impact breastfeeding practices and menstrual hygiene, aggravate symptoms of menopause, and disrupt access to women’s health services.1,2,3,4,5,6,7,8 Increases in gender-based violence are likely to rise during climate crises, as well as physical displacement.9
Women in underserved ‘last-mile’ communities face further challenges in receiving adequate care and treatment during climate events. These communities can exist in any urban, suburban, or rural area not well served by existing public health infrastructure. Networks of both formal and informal healthcare providers play a pivotal role in reaching these vulnerable communities and providing essential care to women, especially during climate crises.
“Women in underserved ‘last-mile’ communities face further challenges in receiving adequate care and treatment during climate events.”
Alison Malmqvist is a Vice President with PSI and leads PSI’s climate and health portfolio.
Opportunities for providers to create impact and develop soft skills
We can explore several opportunities to develop a climate-smart health workforce. Upskilling health workers and equipping them with the necessary tools to address health issues and risks specific to women during climate events is key. Also, we must acknowledge what health providers need to ensure their patients are adequately informed of climate risks.
Community health workers are integral to localised care delivery in many LMICs. Their provision of first-contact care to women is well-documented.10For example, midwives are a valuable resource in providing local antenatal, postnatal and paediatric care during climate events,11 while providing essential care to the wider community. A midwife or a frontline health worker is a trusted member of the community and engages with locals in ways that formal providers may not. In light of the vast and damaging effects of climate change on women’s health and wellbeing, there needs to be more recognition of the vital role of community health workers and other providers outside the formal health system in strengthening the response to climate change. Climate and health leaders need to consider and define their roles in preparing for and adapting to the climate crisis and ensure they have access to the skills, training, and knowledge to better care for women in their communities in response to climate change.
International governing organisations can play an essential role by outlining common knowledge gaps among healthcare providers specific to climate change that must be addressed in the education of healthcare providers, which will be a cornerstone in the development of national climate adaptation plans. The World Health Organization and other institutions are already looking to understand how we can upskill health workers through improved medical and health curricula, but adoption and implementation of these efforts must be expanded. Although healthcare workers need to be aware of the clinical elements of the impact of climate change on women’s health, integrating education plans with training on the soft skills necessary for care delivery in crisis settings is equally important. Empathetic care is essential for delivering maternal services to displaced and vulnerable women, as it increases trust and rapport between workers and patients and encourages continuation of health-seeking behaviour from the patient.
Leveraging technology
Technology is already widely adopted worldwide to reduce disparities in access to care and to help train healthcare providers. The Climate Change and Human Health Extension for Community Healthcare Outcomes (ECHO) programme is just one example of a digital training initiative that aims to reduce disparities in care with far-reaching impact. Set up by the US government in collaboration with nongovernmental organisations12 digital health can positively impact the care of women in LMICs. Providers should be encouraged to use digital tools to their advantage, particularly in a climate crisis when in-person care is challenging. Using digital health to enhance care, whether providing better access or upskilling providers with relevant climate and health knowledge, would aid in increasing resilience to climate-related elements in the routine care of women.
Strengthening emergency preparedness for women through data, policy and funding
While adapting the healthcare workforce through improved skills may produce significant positive impact for women’s health during adverse climate events, systemic support is needed. There is a demand for better data and early warning systems to support the healthcare workforce and anticipate women’s health needs in a climate emergency. Early warning systems are currently very weather-focused, but investment is needed to integrate them with health data. Critically, it will be essential to capture data from both the public and private sectors to capture a fuller and more accurate picture of potential increases in demand for healthcare. Private sector data is needed, as there are countries where more than 50% of the population access care through the private sector.
Strong integrated national policy and emergency preparedness plans can also facilitate better management of women’s healthcare needs. Integrating health, particularly women’s health, into emergency preparedness plans is critical. Currently, emergency response preparedness is siloed and separate from healthcare. Even within healthcare, women’s health services are rarely included.
From a financial perspective, government, private, and international investment is often fragmented and siloed, so breakthroughs in integration are also needed here. It is important to understand that multisector work is difficult to achieve when funding is earmarked for particular projects. Earmarked and siloed funding makes wider health system strengthening efforts, such as addressing health workforce issues, difficult. In turn, this could create disparities in health outcomes for women. Flexible funding solutions allow for a more systemic approach to adaptation.
“Providers should be encouraged to use digital tools to their advantage, particularly in a climate crisis when in-person care is challenging.”
Alison Malmqvist is a Vice President with PSI and leads PSI’s climate and health portfolio.
Conclusion
Women are disproportionately impacted by climate change in LMICs, with poorer health outcomes and disrupted access to women-focused healthcare services. A multipronged approach is needed, starting with upskilling and adequately equipping the healthcare workforce, utilising technology, and training community health workers. Integrated early warning systems and robust policies prioritising the delivery of people-centred care can support climate change response efforts to improve women’s health outcomes in climate crises.
Alison Malmqvist is a Vice President with PSI and leads PSI’s climate and health portfolio. For more than 25 years, she has partnered with governments and stakeholders in the public and private sectors to develop and deliver integrated, evidence-driven health programmes connecting communities to life-saving healthcare in fragile settings across Africa and the Caribbean. To meet today’s challenges, she is focused on innovative solutions to help build resilient and sustainable health markets, while reaching beyond the health sector through collaborative approaches to help address the effects of climate change and limited access to education, food, and decent work on people’s abilities to lead dignified, healthy lives.
