Left to cope alone: how pregnant and postpartum women and their newborns manage extreme heat in coastal Kilifi, Kenya
12 affiliations
- 1Institute for Human Development, Aga Khan University, Nairobi, Kenya
- 2Environmental Health and Governance Centre, African International University, Nairobi, Kenya
- 3Wits Planetary Health Research Division, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, Gauteng, South Africa
- 4Public Health & Primary Care, School of Medicine, Trinity College Dublin, Dublin 2, Ireland
- 5Department of Paediatrics and Adolescent Health, Faculty of Medicine, University of Botswana, Gaborone, Botswana
- 6Division of Paediatrics and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- 7International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- 8Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
- 9Centre for Sexual Health and HIV AIDS Research (CeSHHAR), Harare, Zimbabwe
- 10Department of Infectious Disease Epidemiology and International Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- 11Departments of Emergency Medicine, Environmental & Occupational Health Sciences, and Global Health, University of Washington, Seattle, WA, United States
- 12Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, United Kingdom
Abstract
Background: In coastal Kenya, high seasonal temperatures compound structural challenges that include intermittent water access, resulting in health burdens from extreme heat. Women can experience limitations in the coping strategies available to them for protecting their health and wellbeing from high indoor and outdoor temperatures. This paper, drawing on the Climate Heat and Maternal Neonatal Health Africa (CHAMNHA) study, aims to describe how mothers and their newborns in rural Kilifi cope with extreme heat in their daily routines.
Methods: This qualitative study draws on key informant interviews, in-depth interviews, and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (n = 22), as well as frontline health providers, policy influencers, and government stakeholders (n = 16). Participants were recruited in Rabai and Kaloleni Counties in Kilifi, on Kenya's coast, during a season characterised by extreme heat and drought. Data were analysed using NVivo 12, applying a combination of inductive and deductive thematic approaches.
Results: Women described five main strategies for coping with extreme heat. These included reducing or removing clothing, seeking outdoor shade and fresh air, ventilating indoor spaces, bathing and drinking cold water, and reducing or rescheduling daily activities. These strategies were also adapted for infant care. Mothers reduced infants’ clothing, moved them into shaded outdoor spaces, bathed or sponged them more frequently, and used culturally familiar remedies to manage heat-related discomfort and rashes. These practices provided immediate but partial relief. Heat-retaining and poorly ventilated housing, unreliable electricity, water scarcity and contamination, and diminishing tree cover limited women's options. Some strategies also introduced additional risks. Sleeping outdoors increased exposure to mosquitoes and personal-safety concerns, while opening windows brought dust into homes. Expectations concerning modesty, women's domestic workloads, and appropriate newborn care further constrained coping and sometimes created tension with older household members. Coping therefore involved continuous trade-offs between short-term thermal relief and social, environmental, and health risks.
Conclusion: Pregnant and postpartum women in rural Kilifi manage extreme heat through individual and household practices shaped by cultural expectations and material constraints. These practices offer only temporary relief, increase caregiving demands and, in some cases, shift rather than reduce risk. Responsibility for adaptation therefore falls largely on women themselves. Protecting maternal and newborn health is likely to require heat–health guidance in routine antenatal and postnatal care, engagement of households and community actors, and investment in reliable water, cooler housing and shade.
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BibTeX
@article{lusambili2026left,
title = {{Left to cope alone: how pregnant and postpartum women and their newborns manage extreme heat in coastal Kilifi, Kenya}},
author = {Adelaide Lusambili and Fiona Scorgie and Matthew Chersich and Britt Nakstad and Stanley Luchters and Peter Khaemba and Veronique Filippi and Jeremy Hess and Sari Kovats},
journal = {Frontiers in Global Women's Health},
year = {2026},
month = oct,
doi = {10.3389/fgwh.2026.1825348},
url = {https://doi.org/10.3389/fgwh.2026.1825348},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Left to cope alone: how pregnant and postpartum women and their newborns manage extreme heat in coastal Kilifi, Kenya
AU - Adelaide Lusambili
AU - Fiona Scorgie
AU - Matthew Chersich
AU - Britt Nakstad
AU - Stanley Luchters
AU - Peter Khaemba
AU - Veronique Filippi
AU - Jeremy Hess
AU - Sari Kovats
PY - 2026
DA - 2026/10/12
JO - Frontiers in Global Women's Health
DO - 10.3389/fgwh.2026.1825348
UR - https://doi.org/10.3389/fgwh.2026.1825348
AB - Background: In coastal Kenya, high seasonal temperatures compound structural challenges that include intermittent water access, resulting in health burdens from extreme heat. Women can experience limitations in the coping strategies available to them for protecting their health and wellbeing from high indoor and outdoor temperatures. This paper, drawing on the Climate Heat and Maternal Neonatal Health Africa (CHAMNHA) study, aims to describe how mothers and their newborns in rural Kilifi cope with extreme heat in their daily routines. Methods: This qualitative study draws on key informant interviews, in-depth interviews, and focus group discussions with pregnant and postpartum women (n = 22), mothers-in-law (n = 19), male spouses (n = 20), community health volunteers (n = 22), as well as frontline health providers, policy influencers, and government stakeholders (n = 16). Participants were recruited in Rabai and Kaloleni Counties in Kilifi, on Kenya's coast, during a season characterised by extreme heat and drought. Data were analysed using NVivo 12, applying a combination of inductive and deductive thematic approaches. Results: Women described five main strategies for coping with extreme heat. These included reducing or removing clothing, seeking outdoor shade and fresh air, ventilating indoor spaces, bathing and drinking cold water, and reducing or rescheduling daily activities. These strategies were also adapted for infant care. Mothers reduced infants’ clothing, moved them into shaded outdoor spaces, bathed or sponged them more frequently, and used culturally familiar remedies to manage heat-related discomfort and rashes. These practices provided immediate but partial relief. Heat-retaining and poorly ventilated housing, unreliable electricity, water scarcity and contamination, and diminishing tree cover limited women's options. Some strategies also introduced additional risks. Sleeping outdoors increased exposure to mosquitoes and personal-safety concerns, while opening windows brought dust into homes. Expectations concerning modesty, women's domestic workloads, and appropriate newborn care further constrained coping and sometimes created tension with older household members. Coping therefore involved continuous trade-offs between short-term thermal relief and social, environmental, and health risks. Conclusion: Pregnant and postpartum women in rural Kilifi manage extreme heat through individual and household practices shaped by cultural expectations and material constraints. These practices offer only temporary relief, increase caregiving demands and, in some cases, shift rather than reduce risk. Responsibility for adaptation therefore falls largely on women themselves. Protecting maternal and newborn health is likely to require heat–health guidance in routine antenatal and postnatal care, engagement of households and community actors, and investment in reliable water, cooler housing and shade.
SN - 2673-5059
ER -