Process and outputs from a community codesign workshop on reducing impact of heat exposure on pregnant and postpartum women and newborns in Kilifi, Kenya.

Ambient heat exposure is increasing due to climate change and is known to affect the health of pregnant and postpartum women, and their newborns. Evidence for the effectiveness of interventions to prevent heat health outcomes in east Africa is limited. Codesigning and integrating local-indigenous and conventional knowledge is essential to develop effective adaptation to climate change. Following qualitative research on heat impacts in a community in Kilifi, Kenya, we conducted a two-day codesign workshop to inform a set of interventions to reduce the impact of heat exposure on maternal and neonatal health. Participants were drawn from a diverse group of purposively selected influencers, implementers, policy makers, service providers and community members. The key domains of focus for the discussion were: behavioral practices, health facilities and health system factors, home environment, water scarcity, and education and awareness. Following the discussions and group reflections, data was transcribed, coded and emerging intervention priorities ranked based on the likelihood of success, cost effectiveness, implementation feasibility, and sustainability. Twenty one participants participated in the codesign discussions. Accessibility to water supplies, social behavior-change campaigns, and education were ranked as the top three most sustainable and effective interventions with the highest likelihood of success. Prior planning and contextualizing local set-up, cross-cultural and religious practices and budget considerations are important in increasing the chances of a successful outcome in codesign. Codesign of interventions on heat exposure with diverse groups of participants is feasible to identify and prioritize adaptation interventions. The codesign workshop was used as an opportunity to build capacity among facilitators and participants as well as to explore interventions to address the impact of heat exposure on pregnant and postpartum women, and newborns. We successfully used the codesign model in co-creating contextualized socio-culturally acceptable interventions to reduce the risk of heat on maternal and neonatal health in the context of climate change. Our interventions can be replicated in other similar areas of Africa and serve as a model for co-designing heat-health adaptation.

由于气候变化，环境热暴露正在增加，并且已知会影响孕妇、产后妇女及其新生儿的健康。在东非，预防热相关健康问题的干预措施有效性的证据有限。共同设计并整合本土知识和传统知识对于制定有效的气候变化适应措施至关重要。 在对肯尼亚基利菲一个社区的热影响进行定性研究之后，我们举办了一个为期两天的共同设计研讨会，以制定一系列干预措施来减少热暴露对孕产妇和新生儿健康的影响。参与者来自有目的地挑选的各类有影响力的人物、实施者、政策制定者、服务提供者和社区成员。讨论的重点领域包括：行为实践、卫生设施和卫生系统因素、家庭环境、水资源短缺以及教育和意识。在讨论和小组反思之后，对数据进行了转录、编码，并根据成功的可能性、成本效益、实施的可行性和可持续性对新出现的干预重点进行了排序。 21名参与者参加了共同设计讨论。供水的可获取性、社会行为改变运动以及教育被列为最可持续且最有效的三项干预措施，成功的可能性最高。预先规划并结合当地情况、跨文化和宗教习俗以及预算考虑因素，对于增加共同设计取得成功结果的机会非常重要。 与不同群体的参与者共同设计热暴露干预措施对于确定和优先考虑适应干预措施是可行的。共同设计研讨会被用作一个在促进者和参与者之间建设能力的机会，同时也是探索干预措施以解决热暴露对孕妇、产后妇女和新生儿影响的机会。我们成功地使用共同设计模式共同创造了符合当地社会文化的干预措施，以降低气候变化背景下热对孕产妇和新生儿健康的风险。我们的干预措施可以在非洲其他类似地区复制，并作为共同设计热 - 健康适应措施的一个范例。