Growing evidence suggests that heat exposure during pregnancy can contribute to adverse outcomes, including preterm birth. While the health effects are increasingly documented, the economic burden associated with these outcomes remains less understood.
This was the focus of a panel discussion convened by the Lancet Countdown Africa Regional Centre, hosted at Future Africa at the University of Pretoria, and Wits Planetary Health Research ahead of the 18th World Congress on Public Health in Cape Town, South Africa.
The session, Climate Change and Health in Africa: From Epidemiology to the Economics of Heat-Attributable Birth Outcomes, brought together experts in epidemiology, health economics and public health to examine how evidence on heat-related health risks can inform policy and investment.
Discussions focused on some of the populations most vulnerable to rising temperatures: pregnant women, infants and children.
Beyond Health Outcomes
A key message of the session was that the effects of preterm birth extend far beyond immediate health concerns. Health systems may face increased costs through longer neonatal admissions, more intensive care and ongoing treatment. Families can experience additional healthcare expenses, transport costs and lost income and for children, the effects may continue into later life, affecting their health, education and earning potential.
The session therefore examined how evidence on heat-attributable birth outcomes can be translated into meaningful estimates of economic cost.
Linking Epidemiology and Economics
Participants discussed an approach to estimating the costs of heat-attributable preterm births at country level. This would combine estimates of the proportion of preterm births linked to heat exposure, national birth data and the additional costs associated with each case.
Importantly, the discussion emphasised that estimates should capture only the additional costs attributable to heat-related cases, rather than the full cost of preterm birth, to avoid overstating the burden.
Professor Olufunke Alaba, Working Group 4 Lead of the Lancet Countdown Africa Regional Centre, highlighted that this approach reframes costs not merely as expenditure, but as investments in reducing risk, strengthening health systems and preventing future heat-related health impacts. Economic estimates can help inform decisions about where limited resources can have the greatest impact.
Existing international studies demonstrate that climate exposures, health outcomes and economic impacts can be linked, but Africa-specific approaches are needed to reflect local health systems and data realities.
Turning Evidence into Action
Reliable estimates of the health and economic burden of heat-attributable preterm birth could help governments identify high-risk areas, allocate resources more effectively and strengthen climate adaptation and health-system planning.
Professor Tafadzwanashe Mabhaudhi, Professor of Climate Change, Food Systems & Health at London School of Health & Tropical Medicine (LSHTM) and Director of the Lancet Countdown Africa Regional Centre hosted at Future Africa, University of Pretoria, highlighted the need for systems thinking and collaboration across disciplines and sectors. Climate-health challenges span policy, research and practice, requiring coordinated efforts to build evidence and translate it into action.
The discussion underscored an important opportunity to make the often-overlooked impacts of heat on pregnancy and birth outcomes more visible and to use that evidence to drive equitable, informed responses to climate-related risks.