London School of Hygiene & Tropical Medicine

A new consortium involving the London School of Hygiene & Tropical Medicine (LSHTM) has launched to address key knowledge gaps around the quantification and monitoring of the direct and indirect impacts of heat exposure on maternal, newborn and child health.

LSHTM was awarded £1.7 million by UK Research and Innovation (UKRI) as part of €10 million in funding from the European Union (EU). The LSHTM research team will work closely with the World Health Organization and eight other partners across the EU and sub-Saharan Africa: Universiteit Gent, Belgium; Wits Health Consortium (Pty) Ltd, South Africa; Centre For Sexual Health and HIV and AIDS Research, Zimbabwe; Aga Khan Health Service Kenya Lbg, Kenya; Lunds Universitet, Sweden; Karolinska Institutet, Sweden; Danmarks Tekniske Universitet, Denmark; and Graz Universitaet, Austria.

Professor Debra Jackson, Takeda Chair in Global Child Health and MARCH Deputy Director, said: “Climate, Covid-19 and Conflict labelled the "3 C's" have been cited most recently at the World Health Summit in Berlin as the major barriers to reaching the Sustainable Development Goals. Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization, noted that the "climate crisis probably remains the largest and most complex existential challenge of our time that needs unparalleled action. A heating world in general is bad for health". Our HIGH Horizons research examining heat impacts on mothers, newborns and children across Europe and Africa, along with ways to adapt and mitigate these heat impacts, will be critical science to allow us to meet the SDGs for women and children.”

The Heat Indicators for Global Health (HIGH Horizons) project focuses on pregnant and postpartum women, infants and health workers, three groups that are heavily affected by the climate crisis.

Researchers at LSHTM will lead on evaluating indicators for quantifying and monitoring the global, EU and national-level health impacts of extreme heat at the population level.

The LSHTM team will also evaluate the effectiveness of an Early Warning System designed to provide individualised heat stress warnings and locally adapted messaging for protecting pregnant and postpartum women, infants and health workers via a smartphone app.

600 mothers and 60 health workers across Sweden, South Africa and Zimbabwe will be recruited to use the app. The research team at LSHTM will assess the adoption of behaviours promoted through the Early Warning System messages and the uptake of community resources highlighted. Its cost-effectiveness will also be evaluated.

In addition, researchers at LSHTM will identify cost-effective integrated adaptation-mitigation interventions designed to alleviate heat impacts on health workers and reduce carbon emissions associated with health care facilities in Sweden, South Africa and Zimbabwe.

Adaptation interventions are designed to reduce heat within health care facilities and could include the use of fans or air conditioners. Mitigation interventions are designed to reduce greenhouse gas emissions from facilities and could include solar panels or reducing emissions from waste.

Activities will also take place to document the impacts of heat exposure on the health, wellbeing and productivity of health workers. Understanding these impacts within maternal, newborn and child health settings is key to ensuring the delivery of high-quality health care.

Veroniqe Filippi, Professor of Maternal Health and Epidemiology at LSHTM, said: “Climate change can undo progress in maternal and neonatal survival made in the past 20 years. There is a growing epidemiological evidence that action is required. There is higher risk of preterm births among women exposed to heatwaves for example. How to act is complicated. We do not have yet clear interventions specific to the needs of pregnant women and babies, and the health providers working in maternity unit. HIGH Horizon will respond to the urgent needs of developing and testing climate change adaptation interventions relevant to maternal and newborn health.”

The HIGH Horizons project will take place over four years from 2022 until 2026.