How is maternal, newborn, and child health addressed in Heat Health Action Plans? A scoping review and content analysis

Abstract

Background: Newborns, children, and pregnant and postpartum populations are among the most at risk from exposure to extreme heat. Heat Health Action Plans (HHAPs) are promoted by the World Health Organization to manage public health risks of heat. Still, limited research exists on how well current HHAPs address the needs of women and children in the context of increasingly frequent heat events.

Methods: We identified national and subnational HHAPs published between January 2004 and July 2024 using various search channels. We extracted content to assess whether and how HHAPs included actions and indicators related to pregnant, postpartum, or breastfeeding individuals; newborns; and children.

Results: We identified 83 eligible HHAPs from 24 countries, predominantly from high-income (49%) or lower-middle-income (47%) economies, with none from low-income economies. Most HHAPs identified children as a key population to protect (83%), with fewer naming pregnant individuals (52%). Even fewer mentioned newborns (39%) or postpartum and breastfeeding individuals (14%) as at-risk groups. We identified five broad activity categories targeting maternal, newborn, and child health (MNCH), with 'informing, education, and awareness raising' (77%) and 'improving care in health services or school settings' (59%) being the most common. However, no HHAP comprehensively addressed MNCH risks during extreme heat, and monitoring mechanisms were inadequate for assessing the impact of heat on MNCH.

Conclusions: This is the first review mapping MNCH content in HHAPs. Comprehensive action plans must incorporate targeted strategies for at-risk MNCH populations to ensure equitable health outcomes during heat events. While many HHAPs focus on behaviour change messages, structural and policy changes are needed to build broader resilience. Strengthened in-country monitoring mechanisms and global support for better documentation are essential to build an evidence base.

Figure 1

Distribution of heat-health plans by income group and temperature quantile.* Panel A. Income group. Panel B. Temperature quantile. *Temperature categories are constructed from climatology averages of annual average daily maximum temperature from 1991–2020 at a country-level aggregation [43] – low = <25th percentile, lower-middle = 25th–50th percentile, upper-middle = 50th–75th percentile, and high = >75th percentile.