Extreme weather effects on health services and communities in low and lower-middle income countries: a thematic systematic review

Abstract 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 low-income settings are lacking. A systematic review thematically summarising evidence about weather event-linked harms and responses in low- and lower-middle-income countries was conducted. Peer-reviewed and grey literature was systematically searched and selected. Data were extracted about harms, responses and outcomes relevant to six WHO building blocks of healthcare systems. Framework analysis was used to identify predominant themes related to harms, responses and the WHO building blocks. In total, 183 reports were included. Flooding and high winds were the most common types of extreme weather events documented. The main community experience themes identified were the 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. Extreme weather events can be highly disruptive and harmful to healthcare systems and communities in LMIC settings that are often already highly vulnerable.