Extreme heat threatens choice

This spring, an extreme heat wave rolled across West Africa. Temperatures soared above 110 degrees Fahrenheit, reaching 113 degrees in Mali and 119 degrees in Burkina Faso. In fact, six countries where MSI works experienced deadly heat. 

For MSI clients, devastating heat like this—which is linked to human-caused climate change—is a real barrier to accessing the sexual and reproductive healthcare they need. Extreme heat is a challenge to choice that isn’t always considered, but service providers must adapt to ensure women can access care when a heat wave strikes. 

How heat impacts MSI teams 

When MSI arrives in a village, outreach teams perform services wherever they can. Usually, this means working out of a public health center, but it can mean providing services in a community building or even a tent. One thing these settings have in common: They almost certainly don’t have air conditioning. Sometimes, they don’t even have running water. 

Clients in Madagascar sit outside during group counselling.

One public health provider in Uganda told us that at their center, there’s no shade for clients waiting for a service. People who brave the heat have to sit in the blazing sun—consequently, many stay home. For time-sensitive contraceptives like the injectable or the pill, which must be taken on a regular basis, missing a day at the clinic due to heat could mean risking an unwanted pregnancy. It’s not the most innovative solution to a climate challenge, but something as simple as having a tent to bring to an outreach event for shade can help our teams serve more people.  

Other clients are forced to choose between risking a long walk in sweltering temperatures or missing the one day a month an outreach team is nearby. In 2023, 33% of MSI’s outreach clients had to travel more than an hour to reach the service site, and they often made the journey on foot. In extreme heat, such a trip isn’t just inconvenient, it’s dangerous. That’s just one of the reasons why MSI is constantly working to find more ways to put choice within easy reach.   

A woman visits a health center in Malawi.

Protecting access to contraception in times of crisis 

MSI estimates that over the next seven years, 14 million women are at risk of losing reproductive choice due to climate disruptions. The consequences will be dire for women and their families: Two million unintended pregnancies, one million unsafe abortions, and 5,800 pregnancy-related deaths. 

MSI team members know what it takes to provide services during climate disruptions. Our outreach teams have responded to catastrophic flooding in Pakistan and served communities facing drought in Madagascar. As climate disruptions become more severe, we’re committed to reaching the women who need us, with support from generous donors who understand how choice changes lives. 


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