CASE STUDY 20
Training Frontline Health Workers to Combat Maternal Heat Risk
India
Context
Extreme heat is now one of the deadliest climate risks worldwide. India, home to 1.4 billion people, is especially vulnerable, with states like Andhra Pradesh frequently experiencing temperatures above 40°C. Pregnant women, children, the elderly, outdoor laborers, and people with chronic illnesses are at disproportionate risk. Yet, frontline health workers—despite being the first point of contact for vulnerable communities—have historically lacked training and tools to address climate-driven health impacts. Swasti identified this critical gap and, in partnership with the Global Consortium on Climate and Health Education (GCCHE) at Columbia University, launched the Climate Care Champions Program (CCCP) to ensure frontline workers can integrate SRHR into climate-health responses.
Organization
Swasti Health Catalyst is a global public health organization based in India, with a mission to add 100 million healthy days to the lives of marginalized communities. For over two decades, Swasti has worked across more than 20 countries on HIV, women’s health, and social protection. In recent years, Swasti has deepened its work on the climate–health–SRHR nexus, recognizing that climate shocks such as heatwaves, floods, and droughts disrupt access to essential sexual and reproductive health services, intensify maternal and neonatal risks, and exacerbate gendered health inequities.
Approach
The CCCP uses a train-the-trainer model to embed climate-health resilience into local health systems by equipping frontline health workers (FLWs)—many of whom are women themselves and trusted sources for SRHR services—with knowledge and tools to address how climate stressors impact reproductive and maternal health. FLWs already trained in maternal and reproductive health are now trained to recognize how heat stress affects pregnancy, fertility, menstrual health, and newborn care. The Heat x Health curriculum was contextualized through focus groups, ensuring it reflected women’s lived experiences—for example, pregnant agricultural workers in Andhra Pradesh facing dehydration and miscarriages under extreme heat.
The Andhra Pradesh government financed training costs (travel, accommodation, logistics), making the program scalable and cost-efficient. Because FLWs are part of the government health system, they are already trusted by communities and salaried by the state. This ensures ongoing delivery of climate-health awareness even after external project funding ends.
Results to Date
In Anantapuramu district, 91 master trainers trained 2,266 frontline workers across 71 Primary Health Centers, reaching an estimated 4.57 million people with life-saving heat-health preparedness messages.
Training led to a 57% increase in knowledge of infant-specific symptoms and significant gains in recognizing pregnancy-related complications linked to heat stress.
Women reported adapting daily routines during pregnancy (e.g., resting in shaded spaces, increasing hydration) after FLWs raised awareness. Couples were counseled on contraception use during periods when accessing facilities was disrupted by heat.
Data generated from FLW training and community work fed into the development of a district-level Heat Action Plan in Anantapuramu. This plan, co-signed by the District Magistrate and multiple line departments (women and child, fire, livelihood mission, panchayati raj, education, health, water, electricity, disaster management), institutionalized climate-health priorities into governance, including provisions to safeguard maternal health services and prioritize pregnant and lactating women as high-risk groups.
“When extreme heat disrupts immunization or antenatal visits, it is women and newborns who suffer most. Our work ensures these services continue despite climate shocks.”
BEAUTEY KUMARRI
Project Lead, Swasti Health Catalyst
PDF Innovative Approaches to Addressing Climate Change Impacts on Sexual & Reproductive Health: Case Studies from Around the World