Impact of extreme precipitation events on facility-based births in 21 sub-Saharan African countries

What does climate change look like at the door of a maternity ward?

New paper out at “Nature Communications”, now available online as an early-access article: "Impact of extreme precipitation events on facility-based births in 21 sub-Saharan African countries."

When it rains heavily in the days just before women go into labor, reaching a health facility in time becomes significantly less likely. We linked Demographic and Health Survey data (2015–2021) to daily 5 × 5 km precipitation across 21 countries and analysed 256,101 live births at 12,948 locations.

What we found:

→ Each additional day of heavy rainfall in the 3 days before birth is linked to about 11 more live births per 1,000 happening outside a health facility.

→ Sustained moderate-to-heavy rainfall over several days has a comparable effect.

→ In a single year across the 21 countries, we estimated roughly 30,000 additional births took place outside a facility because of extreme rainfall (2015).

That's tens of thousands of women and newborns exposed to preventable risks because the weather made it harder to travel.

The implication is practical: climate-resilient roads, transport, mobile units, and early-warning systems linked to maternal services belong in the maternal health and in the climate change conversation.

Huge thanks to my co-authors @Fleur Hierink, @Cameron Taylor, @Peter M. Macharia, @Lenka Beňová, @Jérémy Laurent-Lucchetti, and @Nicolas Ray.

Read the article: https://doi.org/10.1038/s41467-026-72547-w

Child public health interventions for conflict-affected populations: A systematic review | PLOS Global Public Health

Children living through armed conflict are among the most vulnerable populations on earth, yet the evidence base guiding interventions to protect their health remains strikingly thin and this gap is highlighted in this piece.

Published in PLOS Global Public Health, this systematic review screened over 3,600 records spanning more than a decade of literature, ultimately identifying only 51 studies that met inclusion criteria: a number that speaks volumes about how neglected this field remains.

Beyond the sheer scarcity of evidence, the review exposes a deeper structural problem: the absence of consistent definitions and outcome frameworks across the field makes it extraordinarily difficult to compare findings, build cumulative knowledge, or design adequate policies for conflict-affected children. Nowhere is this gap more glaring than in paediatric neglected conditions such as tuberculosis: of all studies reviewed, only two addressed TB interventions in children, and neither reported outcome data. This near-total absence of evidence for one of the leading infectious killers of children in humanitarian settings is both alarming and actionable. By rigorously mapping what exists and what does not, this paper makes a critical contribution to the emerging discipline of Humanitarian Paediatrics, and lays the essential groundwork for a dedicated, larger-scale systematic review of paediatric TB interventions in conflict, resource-limited, and humanitarian settings. In a field where children have long been invisible in the data, this work insists they can no longer be.

Daniel Martinez Garcia 

Determinants of Nurturing Care Behaviours in Malawi: An Ethnographic Study - PMC

" In Malawi, where one in three children under five is stunted due to chronic malnutrition, understanding and addressing the drivers of malnutrition is a public health priority. This study goes beyond statistics to uncover the lived realities of mothers of young children in rural villages. By spending four days and nights embedded within households, researchers gained rare, first-hand insight into the daily struggles mothers face as they strive to nourish and care for their young children. The findings reveal how chronic poverty and food insecurity, recurrent climate and economic shocks, entrenched gender inequality, and limited access to quality health services, are affecting mother’s ability to provide adequate care during the critical first years of life. This research reinforces global and national recommendations for multi-sectoral action to address malnutrition and advance equitable health outcomes worldwide." 

Natalie Roschnik 

"Measuring what matters: key indicators for performance and resilience in fragile, low-income contexts. A scoping review"

https://link.springer.com/article/10.1186/s12961-025-01410-z

" This paper brings clarity to a complex area: how we measure health system performance and resilience in fragile, low income settings. By bringing together and organizing a wide range of existing indicators, the paper helps take stock of what is currently used, what is practical, and what is missing. This work supports an approach to more thoughtful measurement of resilience in places where strong, resilient health systems are most needed." 

Maisoon Elbukhari Ibrahim

Chemsex and uptake of HIV Pre-Exposure Prophylaxis among adult cisgender gay, bisexual and other men who have sex with men worldwide: a systematic review with meta-analysis 

published in eClinicalMedicine

This systematic review and meta-analysis provides the first global synthesis of evidence on the relationship between chemsex engagement and PrEP uptake among adult cisgender gay, bisexual, and other men who have sex with men. The findings suggest that chemsex engagement is associated with higher PrEP use, while also highlighting important geographic gaps in the evidence base and the importance of expanding culturally adapted HIV prevention and harm-reduction strategies alongside improved access to PrEP and supportive policy implementation, particularly in low- and middle-income settings. Strengthening these approaches will be key to advancing progress toward global HIV elimination goals.

Crimean-congo hemorrhagic fever in Iraq, 2021–2024: epidemiological and clinical data analysis with proposed severity indicators for resource-constrained settings

https://link.springer.com/article/10.1186/s12879-026-12759-z

https://pubmed.ncbi.nlm.nih.gov/41629835/ 

I believe this study makes a meaningful contribution to global health research by addressing a critical gap between epidemiological evidence and bedside clinical decision-making in resource-constrained settings. Using one of the largest nationally harmonized datasets on Crimean–Congo hemorrhagic fever (CCHF) in Iraq, the study systematically identifies mortality predictors and evaluates the real-world feasibility of existing severity scores.

Importantly, it demonstrates that very simple clinical indicators—particularly epistaxis and jaundice—can predict poor outcomes with performance comparable to more complex laboratory-dependent tools. By proposing and validating simplified severity scores that can be applied at the point of care, this work directly supports earlier triage, risk stratification, and prioritization of supportive care in low-resource and outbreak settings.

Beyond CCHF, the findings have broader relevance for global health by illustrating how surveillance data can be translated into pragmatic clinical tools, strengthening health system resilience and improving outcomes for patients with severe infectious diseases in endemic regions.

Chiori Kodama