Interventions to reduce the effects of air pollution and of extreme heat on maternal, newborn, and child health outcomes: a mapping of the literature

Abstract

Background: There is an increasing awareness of the ongoing and projected impacts of air pollution and of extreme heat on maternal, newborn, and child health (MNCH) outcomes, showing significant short and long-term health problems. There is a dearth of information available for policy makers on interventions that have been implemented to reduce the impact on MNCH, impeding the integration of action into health planning. This paper presents an inventory of interventions aimed at reducing the effects of these two climate hazards on MNCH.

Methods: We conducted a scoping review of articles published in three databases and grey literature to identify and map interventions implemented to address the impact of air pollution and/or extreme heat on MNCH. Items were included if published between January 2016 and November 2022, regardless of language, and as this is an inventory, regardless of if the intervention was evaluated. Over 32 700 journal items were reviewed for inclusion and a sample of grey literature from web-based searches.

Results: A final inventory of 76 items were included. Interventions identified were primarily based in the Global North (n = 51), with the largest proportion in the USA (n = 17), while 32 items were based in the Global South. Fifty-seven items focused on air pollution, 18 on extreme heat, and one on both. Interventions were categorised in four adapted socioecological components: (i) individual and household interventions (n = 30), (ii) community and service interventions (n = 18), (iii) structural interventions and urban landscape interventions (n = 15), (iv) policy interventions (n = 16). Most items were focused on child health outcomes (n = 65); 61 items were evaluated.

Conclusions: This scoping review maps interventions implemented and proposes a categorisation of these to initiate reflections and dialogue on what has been done and how to start building an evidence base. The review also highlights gaps in interventions and the knowledge base, with most interventions implemented to address air pollution, in the Global North and most addressing child health need. As country programmes seek to address the impact of climate change on MNCH, additional efforts are needed to better understand what has been done, document lessons learned, agree on common outcome measurements and feasible study designs for evaluation to start building the evidence base.

Figure 1

Flow diagram of included items.