9.8.2024 PRESENTATION ON MATERNAL HEALTH AND CLIMATE CHANGE.pptx

School of Public Health

1. Assignment Work: Maternal Health and Climate Change in Rwanda Prepared by: Group V members No Name Reg. number 1 RUGIRA Jean Baptiste 223000081 2 MANISHIMWE Philemon 223006506 3 UMURERWA Alodie 223000022 4 HABONIMANA Jean Petit  223000182 5 SAKINDI Diane 223009440 6 DUSHIMIMANA Jean de Dieu 11111783 7 NIZEYIMANA Jean Pierre 223007803 8 NYIRAMBYEYI Agathe 222022914

2. Key Outlines Introduction Key Impacts of Climate Change on Maternal Health Global Targets on Maternal Health and Climate Change Categories of hazards related to climate change on maternal health Indicators Related to Maternal Health and Climate Change in Rwanda COMPARISON RWANDA WITH NEIGHBORING COUNTRIES Rwanda's Success Stories in Maternal Health Potential Resilience Strategies Recommendations Takehome Message

3. 1. Introduction to Climate Change and Maternal Health Climate change significantly affects pregnant women through extreme weather events and environmental changes. Projected 250,000 additional annual deaths between 2030-2050 due to climate-related issues. Increased malnutrition, infectious diseases, and pregnancy-related complications. Extreme heat exposure is linked to higher risks of preterm births and low birth weights. Climate change affects agricultural productivity, worsening food insecurity. Rwanda is particularly vulnerable due to geographical, economic, and social conditions.

4. Maternal Health and Climate Change in Rwanda Pregnant women face increased risks from extreme weather events ; like floods and drought resulting in : Higher rates of malnutrition, infectious diseases, and pregnancy complications. Both climate and non-climate stressors affect maternal health. Need for understanding and addressing disproportionate risks faced by pregnant women

5. 2. Key Impacts of Climate Change on Maternal Health Increased incidence of infectious diseases (e.g., malaria). Air pollution leads to respiratory problems and adverse pregnancy outcomes. Heat stress causing dehydration, heat exhaustion, and exacerbating pre-existing conditions. Nutritional deficiencies due to food insecurity and reduced food production a higher prevalence of maternal anemia. Mental health issues from climate-related stressors. Water and sanitation problems lead to waterborne diseases and cause severe complications for pregnant women . Disrupted access to healthcare due to extreme weather events ; Increased risk of preterm labor, stillbirth, and miscarriage.

6. Challenges Faced by Maternal Health Systems Due to Climate Change Disruption of healthcare services due to extreme weather events. Damage to healthcare infrastructure and supply chain disruptions. Inadequate emergency preparedness for climate-related crises. Resource constraints, especially in low-resource settings. Increased demand for services due to population displacement. Geographic barriers and lack of transportation hindering access to care. Economic challenges preventing pregnant women from accessing healthcare. Lack of mental health and psychosocial support services.

7. 3. Global Targets on Maternal Health and Climate Change Sustainable Development Goals SDG 3: Reduce maternal mortality to less than 70 per 100,000 live births by 2030. SDG 13: Improve education and capacity on climate change mitigation and adaptation. Paris Agreement: Limit global warming to well below 2°C above pre-industrial levels. WHO Global Strategy on Health, Environment, and Climate Change. Every Woman Every Child (EWEC) global movement. Kigali Declaration: Call for immediate climate action and research.

8. RECENT INTERNATIONAL CONFERENCES AND AGREEMENTS RWANDA HAS PARTICIPATED IN FOCUSED ON MATERNAL HEALTH AND CLIMATE CHANGE United Nations Climate Change Conferences (COP) participation. International Conference on Population and Development (ICPD) commitments. Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP) initiative. Africa Health Forum Rwanda hosted the second WHO Africa Health Forum in 2019, Global Action Plan for Healthy Lives and Well-being for All (SDG3 GAP)

9. Progress Toward National Targets (Part 1) NST1: Significant improvement in maternal and child health outcomes ; Increased access to quality healthcare services, especially in rural areas. Decreased maternal mortality rate due to increased skilled birth attendance. Integration of climate considerations into health service delivery. Rwanda’s Vision 2050 Implementation of policies to reduce climate change’s impact on health. Promotion of clean energy and sustainable agricultural practices. Focus on building climate-resilient health infrastructure. Nationally Determined Contributions (NDCs): Development of early warning systems for climate-related health risks. Strengthening of the health sector’s capacity to respond to climate risks. Provision of mobile health clinics in areas affected by extreme weather.

10. Progress Toward National Targets (Part 2) Rwanda Biomedical Center (RBC) Initiatives: Scaling up of community health programs by RBC. Enhancement of maternal health services. Promotion of climate resilience in the health sector. Research and capacity-building efforts on climate change and maternal health. Expansion of telemedicine services to rural areas through the "Babyl" platform. Development of mobile health applications for pregnant women. Implementation of the "RapidSMS" system to improve maternal health outcomes. Improved maternal health services in border regions like Kagitumba-Mirama Hills.

11. Challenges met despites initiatives Regional disparities in healthcare access and quality. Strain on healthcare infrastructure due to climate-related events. Limited resources for financing infrastructure improvements. Increasing severity of climate change impacts.

12. 4. Categories of hazards related to climate change on maternal health Category of hazard Associated maternal health outcomes Associated Fetal and perinatal health outcomes Associated newborn health outcomes High temperatures Hypertensive disorders of pregnancy, gestational diabetes, mental health, access to health services Miscarriage, stillbirth, congenital anomalies, preterm birth Low birth weight, small-for-gestational age, hospitalization, morbidity, mortality, sudden infant death syndrome, newborn feeding practices Ambient air pollution Hypertensive disorders of pregnancy, gestational diabetes, mental health, access to health services Miscarriage, stillbirth, intrauterine growth restriction, congenital anomalies, preterm birth Low birth weight, small-for-gestational age, hospitalization, morbidity, mortality, feeding practices Disasters (hydro-meteorological) Mental health, mortality Miscarriage, preterm birth, mortality Low birth weight, mortality, morbidity later in life, feeding practices Water quality and accessibility Hypertensive disorders of pregnancy Not documented Not documented Climate-sensitive food insecurity and dietary patterns Mental health Not documented Not documented Climate-sensitive infectious diseases Not documented Not documented Not documented

13. 5. Indicators Related to Maternal Health and Climate Change in Rwanda Maternal Mortality Ratio (MMR): 203 deaths per 100,000 live births. Preterm Birth Rate: Affected by extreme weather events. Low Birth Weight (LBW) Rate: Impacted by climate-induced food insecurity. Access to Skilled Birth Attendance: Limited in rural and climate-affected areas. Malaria Incidence Rate in Pregnant Women: Increased due to changing climate conditions. Food Security and Nutrition Indicators: Affected by climate change impact on agriculture.

14. 6. COMPARISON RWANDA WITH NEIGHBORING COUNTRIES Indicator Rwanda Uganda Burundi Tanzania Maternal Mortality Ratio (MMR) 203 deaths per 100,000 live births 375 deaths per 100,000 live births 548 deaths per 100,000 live births 524 deaths per 100,000 live births Preterm Birth Rate Similar challenges with extreme weather Higher rates due to droughts and floods Impacted by political instability and climate change Influenced by climate variability and socio-economic factors Low Birth Weight (LBW) Rate Significant impact of food insecurity High rates due to food insecurity and poor maternal nutrition Higher rates due to severe malnutrition and climate-related agricultural challenges Influenced by malnutrition and climate impacts on agriculture

15. COMPARISON CON’T Indicator Rwanda Uganda Burundi Tanzania Access to Skilled Birth Attendance 94% of births are attended by skilled personnel 74% of births are attended by skilled personnel 85% of births are attended by skilled personnel 64% of births are attended by skilled personnel Malaria Incidence Rate in Pregnant Women Increased risk due to climate change expanding mosquito habitats High incidence exacerbated by changing rainfall patterns A significant issue with increasing incidence rates due to climate change High rates influenced by climate variability Food Security and Nutrition Indicators Climate change impacts food security and nutrition, affecting maternal health Significant food security issues due to recurrent droughts and floods Severe malnutrition and food insecurity exacerbated by climate change Climate change affects agricultural productivity, leading to food insecurity

16. 7. Rwanda's Success Stories in Maternal Health MMR reduced from 476 per 100,000 live births in 2010 to 203 in 2023. Establishment of maternal health clinics with emergency obstetric care services. Community health workers instrumental in providing maternal care and education. Expansion of Mutuelle de Santé improved access to maternal health services. The preterm birth rate was reduced by 15% over five years in Bugesera District due to Enhanced antenatal care services and mobile health clinics being introduced. Low Birth Weight rate in Eastern Province decreased by 10% between 2015 and 2022. The Girinka initiative improved household food security and maternal nutrition. 91% of births are attended by skilled health personnel nationwide. Deployment of CHWs and establishment of health posts in hard-to-reach areas. Initiation of SAMU ( Emergency Medical Assistance Services ) in Health Facilities

17. Rwanda's Success Stories (Continued) Malaria incidence among pregnant women in Kirehe and Ngoma Districts dropped by 25% (2017-2022 ). Due to : Nationwide distribution of insecticide-treated mosquito nets and indoor residual spraying campaigns. Integration of malaria prevention into antenatal care services. Food security and nutrition: 12% increase in household food security in Musanze and Rubavu Districts over five years. Due to : Promotion of climate-smart agriculture practices. Implementation of social protection programs like Vision 2020 Umurenge Program. Establishment of community nutrition programs. Distribution of fortified foods to vulnerable households. Investment in climate-resilient healthcare infrastructure.

18. 8. Potential Resilience Strategies Implement climate-smart agriculture to improve food security. Strengthen healthcare infrastructure to withstand extreme weather events. Expand community-based health insurance programs. Enhance malaria prevention and control measures. Improve access to clean water and sanitation facilities. Develop early warning systems for extreme weather events. Integrate climate change considerations into maternal health policies. Promote education on climate change impacts on maternal health. Increase investment in research on climate change and maternal health.

19. con’t Strengthen community-based care through mobile clinics and community health workers. Integrate mental health and psychosocial support services into maternal healthcare. Enhance data collection and surveillance systems to monitor climate change impacts. Advocate for policies prioritizing maternal health in climate change adaptation plans. Engage communities in climate change adaptation efforts. Provide education on protecting maternal health during extreme weather events. Ensure backup power supplies and secure water and sanitation systems.

20. 9. Recommendations To Improve the resilience of healthcare facilities to climate change impacts, ensuring continuous access to maternal health services during extreme weather events. To Support sustainable agricultural practices to enhance food security and nutrition for pregnant women, reducing the risk of malnutrition and related health issues. To Enhance the training and deployment of skilled birth attendants, especially in rural and climate-affected areas, to improve maternal health outcomes. To Implement robust disease surveillance systems to monitor and prevent climate-related infectious diseases, such as malaria, that disproportionately affect pregnant women. To Encourage collaborations between the public and private sectors to fund and develop climate-resilient infrastructure and healthcare solutions. To Support research and development of innovative healthcare solutions tailored to the impacts of climate change on maternal health. To Encourage regional collaborations with East African countries to address transboundary climate and health issues, sharing knowledge and resources to improve maternal health outcomes.

21.  TAKE HOME THIS

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