Extreme weather impacts on health services and communities in lower income countries : A thematic systematic review

Background Most previous research about the dangers of extreme weather events was applicable to populations in high income countries. Data summarising harms related to extreme weather events in lower income settings are lacking. Methods A systematic review thematically summarised evidence about weather-event-linked harms and responses in low- and lower-middle income countries. Peer review and grey literature were systematically searched and selected. Data were extracted about harms, responses and outcomes relevant to six WHO Building Blocks of health care systems. Framework analysis was used to identify predominant themes related to harms, responses and the WHO Building Blocks. Results Included reports numbered 183. Flooding and high winds were the most common type of extreme weather event documented. The main community experience themes identified were displacement of populations and disruption. The main themes identified for health service delivery were: Vulnerability, Disruption and Resilience. Documented examples of resilience or recovery were far fewer for all six WHO healthcare system Building Blocks than descriptions of vulnerability and disruption. Conclusions Extreme weather events can be highly disruptive and harmful to health care systems and communities in LMIC settings that are often already highly vulnerable.