Seasonality, climate change, and food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda: Implications for maternal-infant health

Abstract

Background Climate change is expected to decrease food security globally. Many Indigenous communities have heightened sensitivity to climate change and food insecurity for multifactorial reasons including close relationships with the local environment and socioeconomic inequities which increase exposures and challenge adaptation to climate change. Pregnant women have additional sensitivity to food insecurity, as antenatal undernutrition is linked with poor maternal-infant health. This study examined pathways through which climate change influenced food security during pregnancy among Indigenous and non-Indigenous women in rural Uganda. Specific objectives were to characterize: 1) sensitivities to climate-associated declines in food security for pregnant Indigenous women; 2) women’s perceptions of climate impacts on food security during pregnancy; and 3) changes in food security and maternal-infant health over time, as observed by women. Methods Using a community-based research approach, we conducted eight focus group discussions—four in Indigenous Batwa communities and four in non-Indigenous communities—in Kanungu District, Uganda, on the subject of climate and food security during pregnancy. Thirty-six women with ≥1 pregnancy participated. Data were analysed using a constant comparative method and thematic analysis. Results Women indicated that food insecurity was common during pregnancy and had a bidirectional relationship with antenatal health issues. Food security was thought to be decreasing due to weather changes including extended droughts and unpredictable seasons harming agriculture. Women linked food insecurity with declines in maternal-infant health over time, despite improved antenatal healthcare. While all communities described food security struggles, the challenges Indigenous women identified and described were more severe. Conclusions Programs promoting women’s adaptive capacity to climate change are required to improve food security for pregnant women and maternal-infant health. These interventions are particularly needed in Indigenous communities, which often face underlying health inequities. However, resiliency among mothers was strong and, with supports, they can reduce food security challenges in a changing climate.

The Changing Climate and Pregnancy Health

“…The predicted trend of drought occurrence is less consistent [ 98 ], but recent evidence suggests that frequency, duration, and intensity have increased in parts of the Americas, Africa, and Asia, and this trend is expected to continue [ 99 , 100 ]. Like hurricanes, droughts lead to water and food insecurity and malnutrition due to reduced access to safe drinking water, massive livestock death, and crop failure [ 101 , 102 ]. In most sub-Saharan African countries where droughts are endemic, more than 20% of women are classified as malnourished, a maternal major risk factors for low birthweight and fetal growth restriction [ 103 ].…”

Socio-economic and environmental factors affecting breastfeeding and complementary feeding practices among Batwa and Bakiga communities in south-western Uganda

“…Also, according to Patterson et al [24], more than 90% of Batwa households are rated as "very highly food insecure". In 2017, Batwa mothers reported being malnourished and having malnourished children due to a scarcity of food [25].…”

“…Studies conducted in the same area show linkage between environmental factors and maternal and neonatal health. For example, Bryson et al [25] described the link between pregnancy outcomes and climate change in Kanungu District among Indigenous and non-Indigenous populations, highlighting the impact of environmental factors on food security and maternal diet. Also, MacVicar et al [22] found a causal pathway between weather, seasonal variability and birth weight among the same communities.…”

Children born during the hunger season are at a higher risk of severe acute malnutrition: Findings from a Guinea Sahelian ecological zone in Northern Ghana

“…The established underlying causes of malnutrition across all age groups likely follow a seasonal pattern, with consequences for morbidity and mortality across the life cycle (Bryson et al, 2021). Hence establishing the seasonal patterns in food availability and its effect on nutritional health or morbidity have policy implications in planning the distribution of scarce resources.…”