Interventions to address the effects of climate change on human health in sub-Saharan Africa: A scoping review

Abstract

Climate change poses disproportionate threats to human health in sub-Saharan Africa (SSA), yet comprehensive evidence on implemented interventions remains under-researched. Understanding the scope and characteristics of existing climate-health interventions is essential for informing policy priorities and action in the region. We conducted a scoping review following Arksey and O'Malley's framework and PRISMA-ScR reporting guidelines. We systematically searched Google Scholar, PubMed, Web of Science, and Scopus for peer-reviewed empirical studies on climate-health interventions in SSA, with no date restrictions. Two reviewers independently screened 3009 records. A total of 36 studies reporting 350 interventions were included. The majority of the studies (83.3%) focused exclusively on adaptation, while a smaller proportion (16.7%) combined both adaptation and mitigation strategies. Four overarching intervention categories were identified inductively from the included studies, each comprising distinct but conceptually related sub-categories: health systems strengthening and governance; disease surveillance, monitoring, and early warning; environmental health and infrastructure; and community resilience and social wellbeing. Vector-borne diseases, particularly malaria, constituted the primary health focus, while heat-related illnesses, occupational health, and mental health received limited attention. Studies mostly reported interventions in West Africa, East Africa, Southern Africa, and multi-regional settings, with Central Africa receiving limited attention. The evidence is predominantly rural-focused (n = 18; 50%), with urban-focused studies accounting for 10 studies (27.8%) and mixed urban-rural settings for the remaining 8 (22.2%). Notably, no dedicated study investigated interventions specifically targeting coastal areas. People-centred interventions predominated over nature-based solutions. Key evidence gaps included cross-sectional study designs limiting causal inference, insufficient cost-effectiveness evaluations, limited integration of indigenous knowledge, and inadequate attention to gender-specific and occupational vulnerabilities. Policy efforts must go beyond disease-specific responses toward integrated strategies addressing multiple climate-health pathways while prioritising underrepresented regions and mitigation opportunities to build comprehensive, equitable climate resilience across the region.