Heat Adaptation for Pregnant women and Infants (HAPI) study
Protecting mothers and newborns from the growing health risks of extreme heat through research, innovation and community-led adaptation.
The Challenge
Climate change is increasing the frequency and intensity of heat exposure worldwide. Pregnant women and infants are among the most vulnerable populations, yet evidence on practical adaptation strategies remains limited, particularly in African settings.
Extreme heat has been linked to:
- Maternal dehydration
- Heat stress
- Adverse birth outcomes
- Pregnancy complications
- Newborn health risks
- Reduced wellbeing and quality of life
In many South African communities, indoor temperatures can exceed outdoor temperatures, exposing women and infants to prolonged heat exposure even within their homes.
Project Overview
The Heat Adaptation for Pregnant Women and Infants (HAPI) Project is a multi-disciplinary implementation research programme investigating how households, communities and healthcare systems can better protect pregnant and postpartum women from extreme heat. The project combines environmental monitoring, behavioural research, health systems strengthening and co-designed heat adaptation interventions.
Research Components
Household Heat Monitoring
Monitoring indoor and outdoor temperatures to understand real-world heat exposure experienced by pregnant and postpartum women.
Maternal Health Assessments
Investigating:
- Heat-related symptoms
- Hydration status
- Maternal wellbeing
- Pregnancy outcomes
Behavioural Adaptation
Understanding how women currently cope with heat and identifying feasible adaptation strategies.
Co-Designed Interventions
Individual Level
- Umbrella hats
- Water bottles
- Handheld rechargeable fans
- Heat-health education and awareness pamphlets
Household Level
- Desktop air conditioner with misting
- Portable solar panel
- Reflective roof paint
Facility Level
- Air conditioners
- Water filter dispensers
- Heat-health talks at ANC
- Heat-health education and awareness posters
- Healthcare worker capacity building in heat-health knowledge
- Roof insulation
- Reflective roof painting
Community Level
- Community Heat Champions
- Community tree planting
- Climate Information Cooling Hub
- JoJo tanks and shading
Key Findings to Date
Indoor Heat Exposure
- Indoor temperatures reached up to 41.5°C
- Average indoor temperatures were substantially higher than recommended comfort thresholds
- Homes often remained hot overnight
Housing Matters
Evidence shows that:
- Roof insulation significantly reduces indoor temperatures
- Vegetation and green infrastructure provide measurable cooling benefits
- Housing quality strongly influences heat exposure
Maternal Health Risks
Preliminary findings indicate widespread exposure to potentially harmful heat conditions among pregnant women in Tshwane communities.
Project Progress
Completed
✓ Baseline cohort recruitment
✓ Environmental monitoring
✓ Household assessments
✓ Stakeholder engagement
✓ Intervention co-design
Current Activities
- Intervention implementation
- Healthcare worker training
- Facility adaptation activities
- Post-intervention cohort assessments
Future Impact
HAPI will generate evidence to support:
- Climate-resilient maternal healthcare
- Heat-health policy development
- Community adaptation planning
- Facility design improvements
- National climate-health strategies
Key Partners
- Centre for Sexual Health, HIV and AIDS Research (CeSHHAR) Zimbabwe
- Department of Health (DoH), South Africa
- South African Weather Service (SAWS)
- University of Pretoria, Department of Architecture
- University of the Witwatersrand, Global Change Institute
Project Outputs
- Munyewende et al. (2025) at the Pan-African Conference on Environment, Climate and Health
- Study Blog & Video: HAPI: Heat Adaptation for Pregnant Women and Infants – HeatNexus
Contact Information
- Pamela Tshandu: Stakeholder Engagement Officer (Climate and Health)
- Principal Investigator: Associate Prof Sibusiso Mkwananzi
