BACKGROUND:
In Ghana, extreme weather events such as flooding, heatwaves, and power disruptions are increasingly straining the sustainability and resilience of primary healthcare systems1,2. While the effects of climate change on maternal, newborn, and child health (MNCH) outcomes have received growing attention, far less is known about how recurrent climate shocks disrupt the delivery and continuity of MNCH services within Ghana’s decentralised primary care system. Moreover, experiences from frontline healthcare workers, who play a central role in sustaining MNCH services during these disruptions, remains limited3.

METHODS:
This exploratory qualitative study draws on 18 in-depth interviews with primary healthcare providers working in climate-vulnerable districts across Southern Ghana. Interviews were audio-recorded and transcribed verbatim. Data were analysed thematically using a hybrid deductive–inductive approach, guided by the World Health Organization’s Climate Change and Health Vulnerability and Adaptation Framework4.

RESULTS:
Extreme rainfall and flooding mostly disrupted MNCH service delivery, frequently forcing services to shift from planned activities to reduced or cancelled outreach, antenatal, and child welfare clinics. Flooded and poor roads limited movement for both health workers and patients, while seasons of high temperature contributed to power outages and equipment failures that disrupted vaccine storage and routine services. Although facilities often remained open, care was sustained mainly through short-term, informal solutions such as rescheduling services, using personal resources, and relying on community support. The absence of climate-responsive guidance, training, and planning mechanisms meant that these responses were difficult to sustain, highlighting gaps in the long-term resilience of primary MNCH services under increasing climate stress.

CONCLUSIONS:
These findings highlight the urgent need to move beyond informal coping strategies and embed climate resilience into the routine planning and delivery of MNCH services. Policymakers should prioritise investment in climate-resilient primary healthcare infrastructure, workforce preparedness, and clear operational guidance to safeguard MNCH service continuity under increasing climate stress.