Abstract
Heavy Rainfall and Flooding Effects on Maternal Health Service Delivery During Pregnancy and Childbirth in LMICs: A scoping review protocol
Bahati, V.
Nyanchoka, M.
Karing'u, P.
Wanyama, C.
McKnight, J.
Maina, M.
NIHR Open Res. 2026; 6121
Permanent descriptor
https://doi.org/10.3310/nihropenres.14311.1INTRODUCTION: Climate change is a major global health challenge of the 21 (st) century associated with the increasing frequency and severity of extreme weather events, including heavy rainfall and flooding. These extreme weather events are particularly disruptive in low- and middle-income countries (LMICs), as they damage infrastructure, impede access to healthcare, and destabilize service delivery. Such disruptions heighten risks of missed or delayed antenatal care, reliance on unskilled obstetric care, and interruptions in postpartum care, contributing to adverse maternal and newborn outcomes. Despite growing evidence linking climatic hazards to poor maternal health, the pathways through which extreme weather events, specifically heavy rainfall and flooding affect the delivery of maternal health services remain insufficiently mapped. OBJECTIVE: To map and synthesize existing evidence on how heavy rainfall and flooding affect accessibility and quality of maternal health service delivery during pregnancy and childbirth in LMICs. METHODS: This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews. We will include quantitative, qualitative, and mixed-methods studies, as well as relevant reports and evaluations. A comprehensive search strategy will be developed in consultation with a research librarian, and implemented in MEDLINE, Global Health, and Web of Science, complemented by relevant grey literature sources, to identify articles published between 1990 and 2025. Screening will be conducted independently by two reviewers using Covidence, with discrepancies resolved through discussion. Data will be extracted using a standardized charting form and synthesized narratively to capture patterns and mechanisms of service disruption. CONCLUSION: This scoping review aims to map and synthesize existing evidence on the effects of heavy rainfall and flooding on maternal health service delivery in LMICs. By identifying key patterns, challenges, and gaps in the literature, the review will inform future research and support policy and planning efforts to strengthen climate-resilient maternal health services. This study explores how heavy rainfall and flooding affect access to and quality of maternal healthcare services in low- and middle-income countries (LMICs). Maternal healthcare includes services such as antenatal care during pregnancy, skilled birth attendance, emergency obstetric care and postnatal care. Climate change is associated with an increase in the frequency and severity of rainfall and flooding. Particularly in regions with already limited healthcare infrastructure, increased frequency and severity of rainfall and flooding can damage roads, disrupt transport systems, and disrupt the functioning of health facilities, making it more difficult for pregnant women to access timely and quality care. This research will review already published studies to understand how heavy rainfall and flooding affect maternal healthcare services. It will also explore how health systems are disrupted, including challenges such as damaged infrastructure, shortages of healthcare workers and supplies, and delays in reaching care. The findings will help identify gaps in current knowledge and support efforts to improve healthcare systems so that they can respond better to climate-related challenges and ensure continuity of maternal care. eng