Climate Change Driven Disruptions in Health Service Uptake and Gender Role Inequities in SubSaharan Africa: A Scoping Review

Ismail Ahmed , James Kariuki

Background

SubSaharan Africa (SSA) faces deeply intersecting crises in which high climate vulnerability interacts with entrenched gender role inequities, severely compromising population health and resilience. Climatedriven shocks including droughts and floodsdisrupt health systems and disproportionately affect women and girls due to preexisting socioeconomic and cultural disadvantages.

Objective

This scoping review aims to map the extent, range, and nature of evidence published since 2015 regarding climate changerelated disruptions to health service uptake, with a specific focus on the amplification of gender role inequities across SSA.

Methods

A PRISMAScRguided scoping review was conducted using the methodological framework developed by Arksey and O'Malley. Five databases and grey literature sources were searched for publications from January 2015 to November 2025. Eligibility criteria required studies to address both climate risk and health services or outcomes, with an explicit focus on gender dynamics in SSA. Data charting and synthesis followed a thematic analysis approach, and the methodological rigor of included quantitative observational studies was assessed using a modified STROBEInformed Appraisal.

Results

Fortyfive relevant studies were identified. Findings clustered into three primary thematic areas: (1) Physical and Systemic Disruption extreme weather events cause damage to health infrastructure, stockouts of critical supplies (e.g., medications and contraceptives), and impede patient and staff mobility, reducing overall uptake of routine services such as antenatal care (ANC) and childhood vaccinations; (2) Gendered Morbidity and Vulnerability climate shocks increase the burden of climatesensitive diseases including malaria and waterborne illnesses, with disproportionate impacts for women and girls encompassing disruptions to sexual and reproductive health and rights (SRHR) services, heightened malnutrition, and elevated exposure to genderbased violence (GBV) linked to displacement and resource scarcity; and (3) SocioEconomic Barrier Amplificationhousehold livelihood losses, compounded by restrictive gender norms, force women and girls to absorb greater unpaid labor burdens (including water and food collection), thereby constraining the time and financial resources available for healthseeking behavior.

Conclusion

The evidence confirms that climate change is a powerful multiplier of preexisting gender inequities within SSA health systems. Disruptions are nongenderneutral, resulting in diminished resilience and reduced health service uptake among vulnerable populations. Future research must prioritize contextspecific, longitudinal studies employing genderdisaggregated data to evaluate integrated, genderresponsive adaptation policies capable of supporting climateresilient health systems.