As the climate crisis intensifies, its impact on sexual and reproductive health and rights (SRHR), is becoming increasingly concerning. However, there has been limited research on how this crisis specifically affects SRHR services and the health of vulnerable communities.
To bridge this gap, Ipas Africa Alliance partnered with the Pastoralist Community Initiative and Development Assistance (PACIDA) and the Samburu County Government to assess how the climate crisis is affecting SRHR services in Samburu County, Kenya. The findings reveal the urgent need to strengthen the resilience of both health systems and communities in the face of climate change.
Pictured above: Janet Lemerimuka working in her kitchen garden that she created through the PACIDA project. Learn more
The study specifically explored how the climate crisis influences the need for SRHR services within the community health system, focusing on the adaptability and resilience of health services in Samburu County. Extreme weather events like droughts, intense heat, and flooding are disrupting the delivery of essential SRHR services.
“Heatwaves, floods, and droughts—worsened by the climate crisis—are forcing pastoralist communities in Samburu to adapt in ways that directly affect their health, and SRHR is no exception,” says Sally Dijekerman, Ipas’s senior research scientist. She explains that as communities migrate further from health facilities in search of water and pasture, access to contraception and SRH services diminishes, leading to increased rates of STIs/HIV transmission, unintended pregnancies, and pregnancy complications.
A health facility manager in East Samburu also noted, “Many miscarriages happen during drought because people are migrating, and women experience back pains from walking long distances, which eventually leads to miscarriages.”
The climate crisis affects everyone, but not equally
This research is among the first to examine the effect of the climate crisis on men’s SRHR, particularly male pastoralist warriors, known as Morans. Although the climate crisis affects everyone, it does not do so equally. Alongside women and girls, Morans face significant challenges, including increased exposure to STIs/HIV, conflicts, and delayed initiation ceremonies, which, in turn, delay marriage.
The study highlights the need for targeted strategies to support both men and women as they navigate the impacts of climate change on their health and well-being.
It also underscores the critical need to integrate climate action with SRHR initiatives in Samburu County. While communities are slowly adjusting to the immediate impacts of droughts and floods, the health systems are ill-equipped to provide consistent, high-quality SRHR services.
Women in the study reported adverse health outcomes due to the burdens of migration and extreme weather. One female participant shared her story: “I lost my baby because I was overworked during the drought. The hospital advised me to stop working, but I had no help, and the work had to be done.”
What needs to happen
To address these challenges, the study participants—including community members and health providers—made the following recommendations:
- Institutionalize climate resilience into health systems planning and policies for long-term solutions
- Sensitization and training about climate change adaptation strategies and alternative livelihoods for everyone, including community members and health providers
- More partnerships between health systems, communities, and organizations
- Health education and more frequent outreach: integrated across partners and health topics, targeting men with family planning education
- Increase accessibility of health facilities / SRHR services, including more outreach, transportation, and Morans (young men) trained as community health workers
- Providing sanitary pads and soap to address hygiene issues
- More provider training and sensitization on SRHR & climate change
Case Study: Mary’s* journey through drought and pregnancy
* A pseudonym has been used to protect her identity
Mary, a 25-year-old woman from East Samburu, experienced an unintended pregnancy during a period of severe drought. After completing secondary school and working at a local shop, Mary became pregnant. The harsh economic conditions and lack of support made her consider terminating the pregnancy, but she ultimately decided to carry to term.
During her pregnancy, she had to walk 20 kilometers to fetch water, which caused significant back and stomach pain. At four months, she began attending prenatal checkups, but her local clinic lacked the necessary equipment to perform certain tests. She was eventually referred to a hospital in Wamba, where she was advised to stay close to the facility due to the likelihood of needing a C-section. While her mother stayed with her for a month, Mary struggled with missing her family and the difficulty of managing her pregnancy during such a challenging time.
Now, Mary supports herself and her child by selling mandazis and washing clothes. She dreams of having two more children but, given the poor economy, believes that now is not the right time.
The climate crisis and SRHR: detailed findings
Drought, floods, and extreme heat—symptoms of the climate crisis—are creating conditions that undermine the health and well-being of Samburu communities. The findings reveal that the climate crisis affects SRHR through several pathways, including:
- Economic hardship: More school dropouts, increased sex work, and the loss of traditional livelihoods
- Migration: People moving in search of water, pasture, and income opportunities face increased risks of SRHR-related issues, such as unplanned pregnancies and STIs
- Increased conflict between and within communities: Scarcity of resources leads to raids and violence, impacting community security, particularly for women and girls
- Worsening hygiene: Access to clean water and sanitation is disrupted, leading to poor menstrual hygiene and increased health risks for pregnant women
- Reduced healthcare access: Health services, particularly SRHR services, become less accessible as communities migrate or are hindered by poor infrastructure
- Worsening access to water, sanitation, and hygiene (WASH): Flooding interrupts healthcare seeking; Increased heat exposure of pregnant women while collecting water; malnutrition & dehydration; lack of clean water to bathe in, worsened menstrual hygiene
- Changes in sexual activity: Increased migration contributes to extramarital affairs, unprotected sex, the spread of HIV/STIs, unintended pregnancy; unintended/teenage pregnancy and Sexually Transmitted Infections – due to increased unprotected casual sex (extramarital affairs and transactional sex) and inaccessibility to family planning
- Changes in marriage and traditional practices: Forced & child marriage was used as a coping mechanism for the worsening economy, e.g. restocking animals or feeding family; delayed circumcision or initiation ceremonies for morans until rainy season