Effects of climate change-induced stressors on sexual and reproductive health and rights: adaptation and resilience among women in an urban coastal city in Ghana

Abstract Coastal urban communities are increasingly affected by climate change-induced stressors which interact with poverty, informal housing, and fragile service systems to shape women’s sexual and reproductive health and rights (SRHR). However, these outcomes remain largely under examined in climate adaptation and resilience research in Ghana. A cross-sectional survey of 387 women aged 18–35 years in coastal communities was conducted in the Effutu Municipality of Ghana. Six climate-related stressors (excessive heat, flooding, income loss, food insecurity, disruption of sexual and reproductive health services, and displacement) were examined in relation to four domains of SRHR (reproductive autonomy and fertility control, maternal health and service continuity, sexual safety and privacy, and psychosocial and bodily wellbeing). Multivariate logistic regression models were employed to assess association, adjusting for relevant sociodemographic factors. The findings show that economic and service-related stressors were the strongest predictors of SRHR disruptions. Loss of income (OR = 1.88; 95% CI: 1.42–2.49), food insecurity (OR = 1.67; 95% CI: 1.28–2.18), and disruption in SRHR services (OR = 2.11; 95% CI: 1.58–2.82) were significantly associated with reduced reproductive autonomy. Flooding (OR = 1.73; 95% CI: 1.29–2.33) and displacement (OR = 2.08; 95% CI: 1.53–2.83) were linked to increased risks to sexual safety and dignity. Excessive heat and livelihood-related stressors were consistently associated with psychosocial and bodily wellbeing disruptions, while women with disabilities experienced significantly higher odds of adverse outcomes (OR = 2.27; 95% CI: 1.21–4.26). Therefore, climate change-induced stressors affect women’s SRHR through interconnected economic, environmental, and service-related pathways. Integrating SRHR, equity, and disability inclusion into urban climate adaptation planning is essential for building just and resilient coastal communities.