Lightning Talks: Research (Part 2)

Most countries have implemented public health measures, including lockdowns, during the COVID-19 pandemic. It has been speculated that the pandemic will affect fertility; however, the direction, magnitude, and mechanisms of these effects are not well understood. Using data from the National Health Management Information System and an augmented synthetic control methodology, we examined the impact of a lockdown in Kinshasa in April 2020 on the fertility of women, which we proxy by the number of births in health facilities months after the policy was implemented. Seven months after the lockdown, we see a large increase in births in Kinshasa compared to control areas, which at its peak represents an additional 5000 monthly births, or a 45% increase relative to baseline. We also observed increases in complimentary maternal health services but not in other health services. Increased births were observed among women, both older and younger than 20 years old. Lockdown policies are likely to affect fertility, and future pandemic preparedness plans should anticipate the effects of finding strategies to mitigate any negative unintended effects.

In low and middle income countries, climate change poses a serious threat to public health, particularly in regions with resource constrained health systems. In Eastern and Southern Africa, extreme climatic events can disrupt the delivery and utilization of essential maternal, newborn, and child health (MNCH) services. This study explored the association between climate hazards and MNCH service utilization across three countries under the Eastern and Southern Africa Regional Office (ESARO). By integrating routine data from DHIS2 with satellite based climate indicators, the study employed mixed effects regression models to account for variations at the facility level and differences across regions. Preliminary findings indicate that during climate hazard events, there is a statistically significant decline in MNCH service usage. Facilities located in areas with poor road infrastructure experienced particularly severe reductions in service volumes, highlighting the importance of considering geospatial factors when assessing the impact of climate variability. The study’s results emphasize that environmental shocks not only reduce access to crucial health services but also reveal vulnerabilities within health systems that can be addressed through targeted interventions. The promising potential of DHIS2 as a real time surveillance tool for monitoring environmental impacts on health services is underscored by these findings. Future research aims to refine the modeling approach by incorporating additional factors such as facility readiness and seasonal migration patterns. By embedding climate forecasts within routine health information systems, policymakers may proactively allocate resources and implement outreach initiatives in anticipation of hazardous conditions. Ultimately, this study advocates for infrastructure improvements and climate responsive service delivery strategies to enhance health system resilience amid increasing climate variability. They offer crucial direction for adaptive, climate-resilient health systems.