Heavy Rainfall and Flooding Effects on Maternal Health Service Delivery During Pregnancy and Childbirth in LMICs: A scoping review protocol.

INTRODUCTION

Climate change is a major global health challenge of the 21 st century associated with the increasing frequency and severity of extreme weather events, including heavy rainfall and flooding. These extreme weather events are particularly disruptive in low- and middle-income countries (LMICs), as they damage infrastructure, impede access to healthcare, and destabilize service delivery. Such disruptions heighten risks of missed or delayed antenatal care, reliance on unskilled obstetric care, and interruptions in postpartum care, contributing to adverse maternal and newborn outcomes. Despite growing evidence linking climatic hazards to poor maternal health, the pathways through which extreme weather events, specifically heavy rainfall and flooding affect the delivery of maternal health services remain insufficiently mapped.

OBJECTIVE

To map and synthesize existing evidence on how heavy rainfall and flooding affect accessibility and quality of maternal health service delivery during pregnancy and childbirth in LMICs.

METHODS

This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping reviews. We will include quantitative, qualitative, and mixed-methods studies, as well as relevant reports and evaluations. A comprehensive search strategy will be developed in consultation with a research librarian, and implemented in MEDLINE, Global Health, and Web of Science, complemented by relevant grey literature sources, to identify articles published between 1990 and 2025. Screening will be conducted independently by two reviewers using Covidence, with discrepancies resolved through discussion. Data will be extracted using a standardized charting form and synthesized narratively to capture patterns and mechanisms of service disruption.

CONCLUSION

This scoping review aims to map and synthesize existing evidence on the effects of heavy rainfall and flooding on maternal health service delivery in LMICs. By identifying key patterns, challenges, and gaps in the literature, the review will inform future research and support policy and planning efforts to strengthen climate-resilient maternal health services.