abstract: 'Maternal and newborn health disparities and the health impacts of

  climate change present grand challenges for global health equity, and

  there remain knowledge gaps in our understanding of how these challenges

  intersect. This study examines the pathways through which mothers are

  affected by seasonal and meteorological factors in sub-Saharan Africa in

  general, and Kanungu District (Uganda), in particular. We conducted a

  community-based study consisting of focus group discussions with mothers

  and interviews with health care workers in Kanungu District. Using a

  priori and a posteriori coding, we found a diversity of perspectives on

  the impacts of seasonal and weather exposures, with reporting of more

  food available in the rainy season. The rainy season was also identified

  as the period in which women performed physical labour for longer time

  periods, while work conditions in the dry season were reported to be

  more difficult due to heat. The causal pathways through which weather

  and seasonality may be affecting size at birth as reported by Kanungu

  mothers were consistent with those most frequently reported in the

  literature elsewhere, including maternal energy balance (nutritional

  intake and physical exertion output) and seasonal illness. While both

  Indigenous and non-Indigenous mothers described similar pathways,

  however, the severity of these experiences differed. Non-Indigenous

  mothers frequently relied on livestock assets or opportunities for less

  taxing physical work than Indigenous women, who had fewer options when

  facing food shortages or transport costs. Findings point to specific

  entry points for intervention including increased nutritional support in

  dry season periods of food scarcity, increased diversification of wage

  labour opportunities, and increased access to contraception.

  Interventions should be particularly targeted towards Indigenous mothers

  as they face greater food insecurity, may have fewer sources of income,

  and face greater overall deprivation than non-Indigenous mothers. (C)

  2017 Published by Elsevier Ltd.'
affiliation: 'MacVicar, S (Corresponding Author), McGill Univ, Dept Geog, Burnside
  Hall Bldg,Room 705, Montreal, PQ H3A 0B9, Canada.

  MacVicar, Sarah; Berrang-Ford, Lea; Ross, Nancy, McGill Univ, Dept Geog, Burnside
  Hall Bldg,Room 705, Montreal, PQ H3A 0B9, Canada.

  Harper, Sherilee; Steele, Vivienne, Univ Guelph, Sch Populat Med, Ontario Vet Coll,
  Guelph, ON N1G 2W1, Canada.

  Lwasa, Shuaib, Makerere Univ, Coll Agr \& Environm Sci, Sch Forestry Environm \&
  Geog Sci, Dept Geog Geoinformat \& Climat Sci, POB 7062,Arts Bldg, Kampala, Uganda.

  Bambaiha, Didacus Namanya, Ugandan Minist Hlth, Dept Community Hlth, Plot 6,Lourdel
  Rd,POB 7272, Kampala, Uganda.

  Twesigomwe, Sabastien, Batwa Dev Programme, Kinkizi, Kanungu, Uganda.

  Asaasira, Grace, IHACC Res Team, Kinkizi, Uganda.'
author: MacVicar, Sarah and Berrang-Ford, Lea and Harper, Sherilee and Steele, Vivienne
  and Lwasa, Shuaib and Bambaiha, Didacus Namanya and Twesigomwe, Sabastien and Asaasira,
  Grace and Ross, Nancy and Team, IHACC Res
author-email: 'sarah.macvicar@mail.mcgill.ca

  lea.berrangford@mcgill.ca

  harpers@uoguelph.ca

  vivienne@uoguelph.ca

  lwasa\_s@caes.mak.ac.ug

  didamanya@yahoo.com

  twesigomwe.sabastian@yahoo.com

  graceasaasira@gmail.com

  nancy.ross@mcgill.ca'
author_list:
- family: MacVicar
  given: Sarah
- family: Berrang-Ford
  given: Lea
- family: Harper
  given: Sherilee
- family: Steele
  given: Vivienne
- family: Lwasa
  given: Shuaib
- family: Bambaiha
  given: Didacus Namanya
- family: Twesigomwe
  given: Sabastien
- family: Asaasira
  given: Grace
- family: Ross
  given: Nancy
- family: Team
  given: IHACC Res
da: '2023-09-28'
doi: 10.1016/j.socscimed.2017.06.021
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: 'Uganda; Perinatal health; Climate change; Weather; Season; Indigenous

  health'
keywords-plus: 'LOW-BIRTH-WEIGHT; CLIMATE-CHANGE; QUALITATIVE RESEARCH; PARTICIPATORY

  RESEARCH; CRITICAL REALISM; FETAL ORIGINS; PRETERM BIRTH; VULNERABILITY;

  DETERMINANTS; TEMPERATURE'
language: English
month: AUG
number-of-cited-references: '98'
orcid-numbers: 'Lwasa, Shuaib/0000-0003-4312-2836

  Ford, James/0000-0002-2066-3456'
pages: 39-48
papis_id: e4b90e0579b674cf9d5f8de0b0508ab0
ref: Macvicar2017howseasonality
researcherid-numbers: 'Lwasa, Shuaib/G-3723-2014

  Ford, James/A-4284-2013'
times-cited: '13'
title: 'How seasonality and weather affect perinatal health: Comparing the experiences
  of indigenous and non-indigenous mothers in Kanungu District, Uganda'
type: article
unique-id: WOS:000407405100005
usage-count-last-180-days: '1'
usage-count-since-2013: '22'
volume: '187'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2017'