ArticleBMJ public health2025
Integrating gender in health interventions for adapting to extreme heat in low- and middle-income countries: a scoping review.
Article in BMJ public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives: Climate change has intensified extreme heat events, disproportionately affecting women in low- and middle-income countries (LMICs) through pregnancy complications, higher mortality rates and compounded socioeconomic vulnerabilities. Despite numerous interventions, limited research evaluates health impacts or integrates gender considerations. This study identifies community-level heat adaptation interventions measuring health outcomes in LMICs and examines gender integration using a socioecological framework. Methods: We conducted a scoping review using the Joanna Briggs Institute guidelines. We searched MEDLINE, EMBASE, Global Health and Scopus. Primary studies, published between 2013 and 2024, that described community-level heat adaptation interventions in LMICs (as defined by the World Bank) and reported at least one human health outcome were included. The review was limited to English-language publications. Gender integration was assessed using the World Health Organization's (WHO) Gender-Responsive Assessment Scale, assigning each study an overall rating across five domains on the gender continuum. Results: Of 468 studies, 5 met the inclusion criteria, with 1 study each from India, Pakistan, Nicaragua, Burkina Faso and El Salvador. Participant numbers ranged from 16 to 18 000. The interventions described included cool roofing technologies, workplace interventions and community education programmes. Health outcomes measures included physiological indicators (eg, heart rate and sleep) and changes in knowledge, attitudes and practices related to heat stress. Three studies were classified as gender blind, one as gender sensitive and one as gender specific. Studies reported short durations, reliance on self-reported data and sustainability challenges. Conclusion: There is a limited number of studies reporting the effects of heat adaptation interventions on health outcomes in LMICs, and most of these do not sufficiently consider gender differences in either their design or implementation. Our findings emphasise the need for more research in this area with a focus on gender-integrated interventions to effectively mitigate heat-related health risks for vulnerable populations in LMICs.
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