Through their lens: A photovoice study exploring pregnant and postpartum women’s experiences, coping strategies and barriers to heat adaptation in an urban township in South Africa
1
Wits RHI, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
2
Wits Planetary Health Research Division, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
3
Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin, Ireland
4
Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
5
Neurology, TUM University Hospital and Center for Global Health, School of Medicine and Health, Technical University of Munich, Munich, Germany
Popul. Med. 2026;8(Supplement Supplement 1):A420
ABSTRACT
BACKGROUND:
Rising global temperatures and heatwaves pose major health risks, particularly for pregnant women, infants and other vulnerable groups. In urban African townships, these risks are exacerbated by informal housing, dense living conditions and inadequate infrastructure. Using Photovoice, we aimed to foreground how pregnant and postpartum women in an urban township in Tshwane, South Africa, experience and cope with heat stress.
METHODS:
Fourteen women participated in two structured workshops held during the hot season (December 2023-January 2024). The first included reflective discussions about coping with heat, and basic photography training. Over two weeks, the women captured images on heat-related themes using a disposable camera or mobile phone. Photographs were reviewed and discussed in a follow-up workshop. Photographs and workshop transcripts were analysed thematically.
RESULTS:
The women submitted over 300 images. Their narratives and images centred around three key themes: health impacts, coping strategies and environmental and structural challenges. Mothers felt emotionally distressed from being unable to soothe overheated infants. Women felt most comfortable staying home during hot days, where they had greater control over their environment. Coping strategies included direct cooling (e.g., bathing, wet cloths), cooling the environment and adjusting behaviour. Significant barriers to cooling were identified, including the use of heat-trapping housing materials, the absence of cool or green spaces, inability to open windows owing to mosquitoes or odours from nearby rubbish dumps, and limited access to water and electricity.
CONCLUSIONS:
Women’s coping strategies was often undermined by structural and environmental constraints, reflecting a state of “un-coping”—where adaptation efforts are insufficient or counterproductive. Viewed through the women’s “lens”, their experiences highlight the need for systemic interventions that go beyond individual adaptation and address the social determinants of heat vulnerability. Targeted policies and infrastructural improvements are essential for protecting maternal and child health and building climate resilience in vulnerable communities.
Rising global temperatures and heatwaves pose major health risks, particularly for pregnant women, infants and other vulnerable groups. In urban African townships, these risks are exacerbated by informal housing, dense living conditions and inadequate infrastructure. Using Photovoice, we aimed to foreground how pregnant and postpartum women in an urban township in Tshwane, South Africa, experience and cope with heat stress.
METHODS:
Fourteen women participated in two structured workshops held during the hot season (December 2023-January 2024). The first included reflective discussions about coping with heat, and basic photography training. Over two weeks, the women captured images on heat-related themes using a disposable camera or mobile phone. Photographs were reviewed and discussed in a follow-up workshop. Photographs and workshop transcripts were analysed thematically.
RESULTS:
The women submitted over 300 images. Their narratives and images centred around three key themes: health impacts, coping strategies and environmental and structural challenges. Mothers felt emotionally distressed from being unable to soothe overheated infants. Women felt most comfortable staying home during hot days, where they had greater control over their environment. Coping strategies included direct cooling (e.g., bathing, wet cloths), cooling the environment and adjusting behaviour. Significant barriers to cooling were identified, including the use of heat-trapping housing materials, the absence of cool or green spaces, inability to open windows owing to mosquitoes or odours from nearby rubbish dumps, and limited access to water and electricity.
CONCLUSIONS:
Women’s coping strategies was often undermined by structural and environmental constraints, reflecting a state of “un-coping”—where adaptation efforts are insufficient or counterproductive. Viewed through the women’s “lens”, their experiences highlight the need for systemic interventions that go beyond individual adaptation and address the social determinants of heat vulnerability. Targeted policies and infrastructural improvements are essential for protecting maternal and child health and building climate resilience in vulnerable communities.
| eISSN: | 2654-1459 |
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