Climate Change and Reproductive, Maternal, and Child Health Outcomes in Tanzania: Evidence from a Qualitative Study in Kilwa District, Lindi Region

Background Climate change continues to unfold at an unprecedented rate, affecting various forms of human life, including health and well-being. Evidence indicates that climate change affects maternal, reproductive, and child health outcomes in multiple ways. The increased risk of stillbirth, preterm birth, and miscarriage is indirectly associated with climate change, as extreme weather events can damage infrastructure, limiting access to essential healthcare services. Evidence of the nexus between climate change and maternal, reproductive, and child health in the Tanzania context is limited. This study was designed to explore the influence of climate change on maternal, reproductive, and child health outcomes in Kilwa District Council, Tanzania. Methods In October 2024, a cross-sectional qualitative study design was employed where 10 focus group discussions and 15 key informant interviews with women and healthcare workers in 10 flood-prone villages in Kilwa District were conducted. All discussions and interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo-12, both inductively and deductively. Results Study findings show that respondents were aware of climate variability such as changes in rainfall patterns, increase in temperature, and extreme weather events such as floods and tropical cyclones. Women and young girls were perceived to be more vulnerable due to their traditional responsibilities such as fetching water, firewood, and caregiving roles. Rising incidence of climate-sensitive diseases such as mmalaria, and diarrhoea is taking a toll on pregnant women and children under five years of age especially following heavy rainfall season. Recurring floods are claimed to limit access and delivery of healthcare services. Participants reported a few cases where pregnant women gave birth on the way to the facility or at their homes because of the destruction of roads and bridges. Floods and drought have led to reduced yield of food crops and therefore have contributed to food insecurity. Respondents expressed concerns about reduced food availability, which they linked to poor maternal nutrition, negatively impacting the health of pregnant women, children, and unborn babies, leading to adverse outcomes such as low birth weight. Some participants explained changes in fertility intentions caused by floods and prolonged drought; women expressed fear as these events reduced their capacity to support their families. Respondents reported several adaptation measures that included reducing the quantity and number of meals taken per day in response to food shortages, water, and food storage for use during the dry season, relocating from flood-prone areas, sleeping outside during hot nights, and staying at the so called maternity waiting homes to overcome delays to reach health care facilities during the rainy season. Conclusion The climate crisis is taking a heavy toll on maternal, reproductive, and children's health in Kilwa district. The findings from this study underscore the critical urgency for strengthening the climate resilience of the healthcare system and the need to mainstream maternal, reproductive, and child health into national climate policy frameworks in Tanzania.