Weather shocks, infant mortality, and adaptation: Experimental evidence from Uganda

Climate change is increasing the intensity of extreme weather events. Health is a primary channel through which climate change affects welfare. Yet, estimates of the mitigating effects of health system strengthening are largely missing. We combine data from a randomized trial inducing variation in healthcare access with naturally-occurring variation in growing-season precipitation to study the adaptive impact of community healthcare in a low-income country setting. The risk of infant death increases following low growing-season rainfall, but access to community healthcare reduces this risk by 46 %. Using our estimates coupled with projections from climatological models implies even larger potential adaptive effects. • Can community health workers (CHW) strengthen the climate resilience of health systems? • Infant mortality increases after low-rainfall seasons, but not in villages randomly assigned to CHW. • Climate change may lead to more frequent and severe droughts, increasing CHW benefits. • Primary healthcare investments can mitigate adverse weather shocks' impacts on infant mortality.