Gaps in integration of sexual and reproductive health and rights into climate change research in sub-Saharan Africa: A scoping review

Sub-Saharan Africa is faced with triple challenges of high vulnerability to climate change (CC) impacts, high levels of inequality and poor sexual and reproductive health and rights (SRHR) outcomes. Climate change can worsen SRHR situation for high-risk groups such as women, children, adolescent girls and people living with HIV. This scoping review takes stock of the state of research on the intersection between CC and SRHR in SSA with a view of identifying gaps and opportunities for effective evidence generation and integration in climate actions. The review followed Arksey and O’Malley framework. Data charting was conducted using Population, Exposure, Comparator, Outcome tool in Covidence. Thirty-seven (37) studies were reviewed, 57% were quantitative while 41% and 2% used qualitative and mixed methods respectively. SRHR components investigated include maternal newborn and child health at 43% (n=16), HIV at 19% (n=7), gender-based violence at 11% (n=4), and fertility intentions and outcomes at 11% (n=4). SRHR elements that are under-researched in the context of CC include access to and uptake of contraceptives, post abortion care, harmful practices (child marriages and female genital mutilation), menstrual health, pregnancy losses, bodily autonomy, and (in)fertility. Drought, floods, heat stress and rainfall seasonality have received fair attention in research, yet impacts of climate hazards like tropical cyclones, wildfires and salt-water intrusion are missing in research. There is inadequate research at the intersection of CC and SRHR hindering progress towards climate resilience and attainment of good health and well-being for all. Effective and equitable integration requires that SRHR issues be recognized, and deliberate investments (research, policies, programs, interventions and financing) put in place to address the critical SRHR gaps and climate vulnerabilities to enhance resilience.