Abstract
Objective To understand community perspectives on the effects of high ambient temperature on the health and
wellbeing of neonates, and impacts on post-partum women and infant care in Kilifi.
Design Qualitative study using 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 (CHVs) (n = 22) and stakeholders from health and government ministries (n = 16).
Settings We conducted our research in Kilifi County in Kenya’s Coast Province. The area is largely rural and during
summer, air temperatures can reach 37˚C and rarely go below 23˚C.
Data analysis Data were analyzed in NVivo 12, using both inductive and deductive approaches.
Results High ambient temperature is perceived by community members to have direct and indirect health pathways
in pregnancy and postpartum periods, including on the neonates. The direct impacts include injuries on the neonate’s
skin and in the mouth, leading to discomfort and affecting breastfeeding and sleeping. Participants described babies
as “having no peace”. Heat effects were perceived to be amplified by indoor air pollution and heat from indoor
cooking fires. Community members believed that exclusive breastfeeding was not practical in conditions of extreme
heat because it lowered breast milk production, which was, in turn, linked to a low scarcity of food and time spend by
mothers away from their neonates performing household chores. Kangaroo Mother Care (KMC) was also negatively
affected. Participants reported that postpartum women took longer to heal in the heat, were exhausted most of the
time and tended not to attend postnatal care.
Conclusions High ambient temperatures affect postpartum women and their neonates through direct and indirect
pathways. Discomfort makes it difficult for the mother to care for the baby. Multi-sectoral policies and programs are
required to mitigate the negative impacts of high ambient temperatures on maternal and neonatal health in rural
Kilifi and similar settings

Keywords Heat, Neonates, Kenya, Exclusive breastfeeding, Climate change, Maternal health, Infant care

Projects

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