“Burnt by the scorching sun”: climate-induced livelihood transformations, reproductive health, and fertility trajectories in drought-affected communities of Zambia

Abstract

Background Climate-induced disruptions like drought can destabilize household and community livelihoods, particularly in low- and middle-income countries. This qualitative study explores the impact of severe and prolonged droughts on gendered livelihood transitions, women’s social and financial wellbeing, and sexual and reproductive health (SRH) outcomes in two Zambian provinces. Methods In September 2020, in-depth interviews (n = 20) and focus group discussions (n = 16) with 165 adult women and men in five drought-affected districts, as well as key informant interviews (n = 16) with civic leaders and healthcare providers, were conducted. A team-based thematic analysis approach, guided by the Framework Method, was used to code transcript text segments, facilitating identification and interpretation of salient thematic patterns. Results Across districts, participants emphasized the toll drought had taken on their livelihoods and communities, leaving farming households with reduced income and food, with many turning to alternative income sources. Female-headed households were perceived as particularly vulnerable to drought, as women’s breadwinning and caregiving responsibilities increased, especially in households where women’s partners out-migrated in search of employment prospects. As household incomes declined, women and girls’ vulnerabilities increased: young children increasingly entered the workforce, and young girls were married when families could not afford school fees and struggled to support them financially. With less income due to drought, many participants could not afford travel to health facilities or would resort to purchasing health commodities, including family planning, from private retail pharmacies when unavailable from government facilities. Most participants described changes in fertility intentions motivated by drought: women, in particular, expressed desires for smaller families, fearing drought would constrain their capacity to support larger families. While participants cited some ongoing activities in their communities to support climate change adaptation, most acknowledged current interventions were insufficient. Conclusions Drought highlighted persistent and unaddressed vulnerabilities in women, increasing demand for health services while shrinking household resources to access those services. Policy solutions are proposed to mitigate drought-induced challenges meaningfully and sustainably, and foster climate resilience.

Climate Change and Gender in Africa: A Review of Impact and Gender-Responsive Solutions

“…Grace et al (2015) examined the relationship between birth weight, precipitation, and temperature in 19 African countries and showed that climate affects birth weight in ways that were correlated with the dependence on the dominant food production strategy. Rosen et al (2021) have demonstrated direct economic consequences of drought on women; from diminishing household assets to food insecurity, to increased risk of poor sexual and reproductive health outcomes.…”

A Scoping Review to Assess Sexual and Reproductive Health Outcomes, Challenges and Recommendations in the Context of Climate Migration

“…While none of the included documents explicitly addressed the SRH needs of men, access to family planning, contraception, and STI prevention are pertinent to men both within and outside of marriage, and men and boys are important to include in SRH interventions, programming and solutions ( 38 , 39 ). Furthermore given climate-induced migration often involves the movement of men seeking employment, it is important to consider how this impacts them as well as their families' altered household structure ( 40 ). Achieving full and equitable SRH for the entire population, including in climate migration contexts, is not possible without engaging all genders and addressing gender inequality in societal and political structures ( 17 ).…”

The Relationships between Drought Exposure, Fertility Preferences, and Contraceptive Behaviors: A Multicountry Study

“…Uncertainty has been linked with family planning preferences among Mayan women in Mexico (Kramer et al 2021) and another study in the United States reported an increase in contraceptive use as a result of the Great Recession of 2008 . Indeed, evidence from a qualitative study of women experiencing drought in Zambia showed that women expressed preferences for smaller families, fearing the drought would constrain their ability to support more children (Rosen et al 2021). Moreover, Thiede et al (2022) show that exposure to high temperatures and drought corresponds with a reduction in fertility-at least in the short term.…”

“…That is, being exposed to drought could lead women to want to accelerate childbearing to protect against what may be perceived as a persistent threat to their family that will only worsen with time. The disruption and uncertainty that drought generates in people's lives could, paradoxically, facilitate women's desire to have a(nother) child sooner than later (Bielawska-Batorowicz, Zagaj, and Kossakowska 2022;Dessy et al 2019;Rosen et al 2021).…”