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Impact of extreme weather conditions on healthcare provision in urban Ghana

journal contribution
posted on 09.06.2020, 10:10 by Samuel N.A. Codjoe, Katherine Gough, Robert Wilby, Raymond Kasei, Paul W.K. Yankson, Ebenezer F. Amankwaa, Mercy A. Abarike, D. Yaw Atiglo, Sam Kayaga, Peter Mensah, Cuthbert K. Nabilse, Paula Griffiths
Extreme weather events pose significant threats to urban health in low- and middle-income countries, particularly in sub-Saharan Africa where there are systemic health challenges. This paper investigates health system vulnerabilities associated with flooding and extreme heat, along with strategies for resilience building by service providers and community members, in Accra and Tamale, Ghana. We employed field observations, rainfall records, temperature measurements, and semi-structured interviews in health facilities within selected areas of both cities. Results indicate that poor building conditions, unstable power supply, poor sanitation and hygiene, and the built environment reduce access to healthcare for residents of poor urban areas. Health facilities are sited in low-lying areas with poor drainage systems and can be 6 °C warmer at night than reported by official records from nearby weather stations. This is due to a combination of greater thermal inertia of the buildings and the urban heat island effect. Flooding and extreme heat interact with socioeconomic conditions to impact physical infrastructure and disrupt community health as well as health facility operations. Community members and health facilities make infrastructural and operational adjustments to reduce extreme weather stress and improve healthcare provision to clients. These measures include: mobilisation of residents to clear rubbish and unclog drains; elevating equipment to protect it from floods; improving ventilation during extreme heat; and using alternative power sources for emergency surgery and storage during outages. Stakeholders recommend additional actions to manage flood and heat impacts on health in their cities, such as, improving the capacity of drainage systems to carry floodwaters, and routine temperature monitoring to better manage heat in health facilities. Finally, more timely and targeted information systems and emergency response plans are required to ensure preparedness for extreme weather events in urban areas.

Funding

British Academy under the Cities and Infrastructure Programme CI170211

History

School

  • Social Sciences
  • Sport, Exercise and Health Sciences
  • Architecture, Building and Civil Engineering

Department

  • Geography and Environment

Published in

Social Science and Medicine

Volume

258

Issue

August 2020

Publisher

Elsevier

Version

AM (Accepted Manuscript)

Rights holder

© Elsevier Ltd

Publisher statement

This paper was accepted for publication in the journal Social Science and Medicine and the definitive published version is available at https://doi.org/10.1016/j.socscimed.2020.113072.

Acceptance date

17/05/2020

Publication date

2020-05-22

Copyright date

2020

ISSN

0277-9536

eISSN

1873-5347

Language

en

Depositor

Prof Paula Griffiths. Deposit date: 8 June 2020

Article number

113072

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