The journal of climate change and health · 2026
Modeling extreme heat-induced neonatal mortality and inequities in relative vulnerabilities in Ghana: distributed lag panel analysis with counterfactual risk estimation; 2008-2025.
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Dwomoh Duah, Jones Monica Baaba, Otoo-Kati Frances Bafua, Aikins Ben Emunah, Boateng Ama Frimpomaa, Dzodzomenyo Mawuli
Аннотация
BACKGROUND: Climate change increasingly threatens maternal, neonatal, and child health, yet evidence on the effect of temperature extremes on neonatal mortality in sub-Saharan Africa remains limited. This study quantified the association between maximum temperature and neonatal mortality and identified high-burden communities across 261 administrative districts in Ghana.
METHODS: We conducted a longitudinal district-level panel analysis using monthly health and climate data from 261 districts between 2008 and 2025. Extreme temperature effects on neonatal mortality were estimated with Poisson, negative binomial, and quasi-Poisson models, using the number of deliveries as the offset. Counterfactual risk estimates were generated under a median maximum-temperature scenario to assess the contribution of above-median heat exposure to neonatal deaths.
RESULTS: A one-unit increase in combined maximum temperature across lags of 0-3 months was associated with a 9% increase in neonatal mortality rates (incidence rate ratio, 1.09; 95% CI, 1.04-1.13). Temperatures above 28.2 °C were linked to significantly higher neonatal mortality than median temperatures. Between 2008 and 2025, an estimated 652 neonatal deaths (95% CI, 516-788) were attributable to exposure above the median maximum temperature. Temperature-related risks varied substantially across districts and regions, with the greatest burden concentrated in Ghana's five northern regions, where median monthly temperatures consistently exceed the national average.
CONCLUSION: Higher maximum temperatures were associated with increased neonatal mortality in Ghana. Targeted heat-adaptive interventions, including enhanced neonatal monitoring during hot months and early warning systems for pregnant women and nursing mothers, should be prioritized in high-exposure districts to effectively reduce preventable heat-related neonatal deaths nationwide.
METHODS: We conducted a longitudinal district-level panel analysis using monthly health and climate data from 261 districts between 2008 and 2025. Extreme temperature effects on neonatal mortality were estimated with Poisson, negative binomial, and quasi-Poisson models, using the number of deliveries as the offset. Counterfactual risk estimates were generated under a median maximum-temperature scenario to assess the contribution of above-median heat exposure to neonatal deaths.
RESULTS: A one-unit increase in combined maximum temperature across lags of 0-3 months was associated with a 9% increase in neonatal mortality rates (incidence rate ratio, 1.09; 95% CI, 1.04-1.13). Temperatures above 28.2 °C were linked to significantly higher neonatal mortality than median temperatures. Between 2008 and 2025, an estimated 652 neonatal deaths (95% CI, 516-788) were attributable to exposure above the median maximum temperature. Temperature-related risks varied substantially across districts and regions, with the greatest burden concentrated in Ghana's five northern regions, where median monthly temperatures consistently exceed the national average.
CONCLUSION: Higher maximum temperatures were associated with increased neonatal mortality in Ghana. Targeted heat-adaptive interventions, including enhanced neonatal monitoring during hot months and early warning systems for pregnant women and nursing mothers, should be prioritized in high-exposure districts to effectively reduce preventable heat-related neonatal deaths nationwide.