‘Water is a good thing, but when it destroys it is not good’: The influence of changing weather patterns on access to antenatal care services in Western Kenya - A qualitative study

Increasing high temperatures, severe drought, altered rainfall patterns, and floods weaken essential infrastructure and services, increase risk of diseases, and disrupt women’s access to antenatal care. In Kenya, 2024 was the hottest on record with above normal rainfall, resulting in prolonged flooding. This paper describes the influence of adverse weather patterns on access to antenatal care in Kisumu and Migori Counties, adjacent to Lake Victoria. Qualitative data were primarily collected through focus group discussions (n = 16) with women aged 15–24 years (n = 62 participants) or 25–49 years (n = 87 participants), who had given birth in the last two years. Most participants recognize prolonged shifts in weather patterns, including unpredictability of rainfall, heavy rainfall and floods, prolonged dry spells, and rising temperatures which are increasingly affecting their daily lives. This includes damaged crops, loss of livelihood, financial challenges with food prices escalating, lack of safe drinking water, homes destroyed and loss of effects (due to flooding). Others reported how roads and bridges get washed away preventing women from accessing health care services resulting in poor uptake of antenatal care services. Climate change presents a complex and significant threat for vulnerable groups such as pregnant women. Mitigation strategies must focus on integrating women’s voices in climate-health policies to ensure continued access to healthcare, and reduce adverse health outcomes associated with climate change.