The Impact Of Heatwaves On Healthcare Services In Developing Countries: A Systematic Review

Abstract

Heatwaves adversely affect human morbidity and mortality, especially in vulnerable groups, and ultimately strain the healthcare system. Prior studies have investigated the impact of heatwaves on healthcare services were conducted in developed countries, which are far superior in terms of financial budget and sophisticated healthcare system compared to developing countries. As a result, the impact of heatwaves on healthcare services in developing countries remains uncertain and inadequately comprehended. Therefore, this systematic review aims to address this gap specifically investigating the impact of heatwaves on healthcare services in developing countries. The study protocol was registered with PROSPERO (CRD42022365471). Primarily, extensive peer-reviewed research was conducted through the Web of Science (WoS), PubMed, and Scopus databases with adherence to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to collect and characterise key findings from the selected articles related to healthcare systems between January 2002 and April 2023. Subsequently, a thorough quality assessment was conducted using the Navigation Guide checklist. Based on the results, nineteen eligible studies were identified from the search process. Accordingly, it was found that heatwaves significantly increased the rate of Emergency Ambulance Dispatch (EAD), Emergency Department Visits (EDV), hospital admission, and outpatient department visits. Among the identified vulnerable groups severely affected by heatwave events were older people, children, males, outdoor workers, single, and those living in rural areas. Furthermore, various medical conditions were commonly associated with heat-related illnesses that required immediate healthcare services, such as kidney disease, mental disorder, infectious disease, cardiovascular disease, respiratory disease, heatstroke, perinatal, endocrine, nutritional, metabolic and skin problems. For evaluation of Risk of Bias (RoB), approximately 67% of the studies exhibited a 'definitely low' RoB, high quality of evidence (4+), and sufficient strength of evidence on the positive association between heatwave and their impacts on healthcare services. Overall, the duration and intensity of heatwaves showed a direct proportional relationship with the healthcare burden in developing countries. Therefore, policymakers and stakeholders must implement effective preparative planning and preventative efforts to ensure sustainability and efficient delivery of healthcare services, especially by allocating sufficient resources towards improving basic infrastructures and healthcare services.