Mar 30, 2026
Climate Change Impacts on Households and Healthcare Providers’ Mental Health, Maternal Health, Community and Health System Resilience in Ghana: A Scoping Review Protocol
- Justine Guguneni Tuolong1,2,3,
- Jean-Marc Goudet4,
- Mary Boatemah Appiah5,
- Valery Riddé6
- 1Postdoctoral Fellow, Centre Population Et Developpement (IRD, Université Paris Cité, Université Sorbonne Paris Nord, Inserm), Inserm, Paris, France;
- 2Department of Health Services Management and Administration, University of Business and Integrated Development Studies (UBIDS), Wa, Ghana;
- 3Research, Innovations and Consultancy Services, Brainbox Research Institute Ltd, Wa Ghana;
- 4Postdoctoral Senior Fellow, Centre Population Et Developpement (IRD, Université Paris Cité, Université Sorbonne Paris Nord, Inserm), Inserm, Paris, France;
- 5Masters Student, Department of Governance, and Development Management, University of Business and Integrated Development Studies (UBIDS), Wa, Ghana;
- 6Research Director, Centre Population Et Developpement (IRD, Université Paris Cité, Université Sorbonne Paris Nord, Inserm), Inserm, Paris, France
- Justine Guguneni Tuolong
Protocol Citation: Justine Guguneni Tuolong, Jean-Marc Goudet, Mary Boatemah Appiah, Valery Riddé 2026. Climate Change Impacts on Households and Healthcare Providers’ Mental Health, Maternal Health, Community and Health System Resilience in Ghana: A Scoping Review Protocol. protocols.io https://dx.doi.org/10.17504/protocols.io.n2bvj12y5vk5/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: January 24, 2026
Last Modified: March 30, 2026
Protocol Integer ID: 240839
Keywords: Climate change, mental health, maternal health, One Health, resilience, Ghana, scoping review, climate health interventions within ghana, health system resilience in ghana, resilience outcomes in ghana, climate health intervention, climate impacts with health, global threat to health, health system resilience, resilience indicator, resilience outcome, addressing climate, climate change impacts on household, climate change, maternal health, climate change impact, climate impact, analyses extension for scoping review, demographic health, mental health of household, mental health, health, preferred reporting items for systematic review, ghana, systematic review, african index medicus, wide scope of study, growing global threat, scoping review, responsive socio, related stressor, unicef
Funders Acknowledgements:
Campus France (Make Our Planet Great Again (MOPGA) program) through a postdoctoral fellowship funded by the French Ministry of Education and Foreign Affairs (MEAE).
Grant ID: 186858v
Abstract
**Introduction: Climate change is a growing global threat to health and well-being, particularly in low- and middle-income countries (LMICs). This scoping review protocol outlines a systematic approach to mapping the existing evidence on how climate change affects the mental health of households and healthcare providers and women’s maternal health, community, and health system resilience in Ghana.
**Methods: This review follows the Joanna Briggs Institute (JBI) framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. The review applies One Health and gender-responsive socio-demographic health (SDH) lens to understand these interlinked human-animal-environmental systems and to inform adaptation strategies. Searches will be conducted across databases, including PubMed, PubMed Central, Google Scholar, African Index Medicus, and institutional repositories of Government of Ghana, WHO and UNICEF, covering the literature from 2010 onwards to capture a wide scope of studies over a decade and a half. Eligible studies will include both peer-reviewed and grey literature addressing climate-related stressors, mental health, maternal health, and resilience outcomes in Ghana. The screening and data extraction processes will be managed using Covidence, with two independent reviewers ensuring rigor. Results will be synthesized narratively and visually, using thematic mapping and conceptual frameworks to link climate impacts with health and resilience indicators.
**Ethics and dissemination: As this review analyzed published and publicly accessible data, ethical approval was not required. Dissemination plans include publications in peer-reviewed journals, stakeholder workshops, and policy briefs designed to guide climate health interventions within Ghana and comparable settings.
Guidelines
Strengths and Limitations of this Study
**This study employs the Joanna Briggs Institute (JBI) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines for methodological transparency.
**Integrates the One Health perspective linking human, animal, and ecosystem health.
**Applies systematic Covidence screening procedures to ensure quality and reproducibility.
**Focuses on underexplored intersections of climate change, mental and maternal health, and resilience in Ghana.
**This may be limited by the exclusion of non-English literature, studies conducted outside Ghana and the
variability in data quality across studies.
Troubleshooting
Introduction
Climate change (CC) poses significant and multifaceted risks to health systems, especially in low- and middle-income countries (LMICs) (Bianco et al., 2024; Naser et al., 2024). In Ghana, increased temperatures, irregular rainfall patterns, and extreme weather events adversely affect livelihoods (Cobbinah & Anane, 2015; Assan et al., 2009), ecosystems (Baffour-Ata et al., 2021), healthcare delivery (Codjoe et al., 2020), health risks (Hussey & Arku, 2019), and health outcomes (Akakpo et al., 2024; Damte et al., 2022). However, the impact of these climatic stressors on psychosocial well-being and maternal health in Ghana has not yet been sufficiently investigated.
Diallo and Ridde (2024) conducted a study in Senegal focusing on the intersection of climate change and resilience of the Senegalese health system, particularly in response to flooding events in Keur Massar. Their findings underscore the complex interplay between climate change impacts and health outcomes, emphasizing that these effects are significantly modulated by a multifaceted array of factors, including the financial, organizational, social, and cultural dimensions. The researchers' analysis revealed critical insights into the limitations of the conventional health governance approaches. Traditionally, they
explained that health management strategies have often been characterized by a self-centered
perspective, prioritizing standardized problem-solving methodologies (Diallo & Ridde, 2024). However, this approach frequently fails to adequately account for nuanced local contexts, particularly the climate vulnerability index (CVI) of both households and health structures.
Recent scholarship has revealed a nascent, yet uneven, and regionally dispersed evidence base concerning climate-health interactions in Ghana (Akakpo et al., 2024). National-level mixed-methods study and working papers have documented climate shocks, adaptation strategies, and well-being outcomes (Owoo et al., 2024), whereas thematic reviews and policy briefs have begun to outline the broader health impacts of climate change (Akakpo et al., 2024; WHO, 2025). However, empirical research explicitly addressing mental health consequences (Acharibasam & Anuga, 2018; Adams & Nyantakyi-Frimpong, 2020; Hagan et al., 2025), maternal health outcomes (Boakye et al., 2025), and interconnected animal-environmental pathways within a One Health framework (Eyzaguirre et al., 2025; Tepa-Yotto et al., 2024) remains scarce and largely confined to localized contexts, such as qualitative community studies in Accra (Adams & Nyantakyi-Frimpong, 2020), coastal communities (Hagan et al., 2025) and the Upper East region (Abunyewah et al., 2023).
The exacerbation of mental health issues, such as psychosocial stress, trauma, and depression, due to extreme and slow-onset events (e.g., flooding, high temperatures, and unpredictable rainfall) necessitates the development of adaptive strategies for vulnerable communities and households (Kim, 2025). As it is crucial to investigate how these phenomena unfold, and to what extent stakeholders have explored these issues when formulating national policies to address the pressing concerns that exacerbate social inequalities in health systems. The situation becomes complex when considering maternal health, where women are at the center of the discourse regarding social inequalities in healthcare access. We argue in this protocol that confluence of factors could potentially worsen the mental health of women seeking maternal healthcare and further complicate the challenges associated with exclusive breastfeeding practices. For healthcare providers who work under these conditions, the cascading effect of climate change could also have an impact on their mental health.
Stone et al. (2022) conducted a scoping review in sub-Saharan Africa, examining the disproportionate impact of climate change on women. They highlighted a complex interplay of factors, including adverse mental health outcomes, gender-based violence, increased care responsibilities, and disruption of traditional land-based practices that affect women's health and safety. However, a significant gap remains in the literature regarding the analysis of climate change on mental health between men and women at both the household and healthcare provider levels. In Ghana, women face challenges in maintaining exclusive breastfeeding practices due to increased burden to household chores, work schedules, low breast milk production, swollen breasts or sore nipples, lack of access to food items and preparation or giving foods (Tampah-Naah et al., 2019). These have a subsequent impact on women's mental well-being and the development of community resilience strategies. However, using a One Health and gender-responsive health system approach in Ghanaian communities exploring the impact of climate change on women's mental health is understudied.
In literature, research on maternal health in Ghana, especially regarding exclusive breastfeeding, highlights numerous challenges in addition to potential adaptive strategies (Lanyo et al., 2024; Manyeh et al., 2020; Nkrumah, 2016). Yet, climate change introduces complex risks that influence breastfeeding through
environmental, social, and health-related pathways (Cerceo et al., 2023). Currently, the exclusive breastfeeding rate in Ghana is around 50% for infants aged 0 to 6 months, with significant variation influenced by maternal age, education, and the presence of social support networks (Mohammed et al., 2023). This implies child malnutrition which make them susceptible to infectious diseases such as malaria is eminent in Ghana. According to literature, cultural norms, economic hardships, and practical barriers, such as perceived insufficient breast milk, family pressures, and broader socioeconomic factors further hinder optimal breastfeeding practices in Ghana (Tampah-Naah et al., 2019). Despite widespread awareness of the benefits of exclusive breastfeeding in Ghana, actual practice remains below the recommended levels due to persistent sociodemographic obstacles (Asare et al., 2018). Existing research emphasizes the critical need for structurally supportive interventions targeting healthcare systems, community frameworks, and workplace policies to enhance maternal resilience to climate-related adversities (Cerceo et al., 2023; Rylander et al., 2013). However, studies specifically linking climate change effects to breastfeeding practices in Ghana are limited, indicating the need for further empirical investigation in this area.
Systematic and scoping reviews of global literature emphasize that One Health investigation predominantly focuses on zoonotic and vector-borne diseases (Eyzaguirre et al., 2025), often overlooking the psychosocial and maternal health dimensions. This revealed a significant thematic gap in Ghana. Recent field reports and media coverage in Ghana highlight increasing local concerns regarding drought-induced anxiety and ecological grief among farming communities (Abunyewah et al., 2023; Acharibasam & Anuga, 2018). However, these observations remain fragmented and lack syntheses into scientific reviews, datasets, or integration into policy frameworks. Our review reveals an empirical gap that underscores (a) the need for a scoping review to quantify existing evidence by health outcomes, geographic areas, and methodological approaches, and (b) a strong rationale for primary research that adopts a One Health and socio-demographic health (SDH) perspective that incorporates gender-sensitive
analyses to address these critical gaps in Ghana.
This review protocol examines the links between health and CC in Ghana. Themes will be built on emerging evidence and organized according to dimensions such as environmental changes to mental health challenges, maternal health issues, and community resilience strategies using One Health and gender-responsive SDH framework. The findings support the development of integrated resilience policies, sustainable healthcare systems, and adaptation strategies applicable to Ghana and other LMICs.
Review Questions
What is known about climate change on households and health care providers’ mental health in Ghana?
What evidence exists regarding how climate change affects women’s maternal health, particularly exclusive breastfeeding practices and related coping strategies in Ghana?
How has existing research described the mechanisms within communities and health systems that mitigate climate-related stressors on mental and maternal health in Ghana?
Methods
This protocol follows the population, concept, and context (PCC) framework recommended by JBI evidence synthesis for scoping reviews (Khalil et al., 2020; Pollock et al., 2021, 2024) and draws on an established protocol used to develop a healthcare system to identify and classify patient-centered quality indicators (Jolley et al., 2017). The population of interest comprised households, healthcare providers, and
women of reproductive age (15–49 years), with particular attention paid to those affected by climate-induced stressors. This concept focuses on the mental health, maternal health, and resilience outcomes linked to climate change, including psychological distress, coping strategies, exclusive breastfeeding,
and health system responses within climate-impacted communities. The context is Ghana which has records of high climate vulnerability index of +1.0°C to +4.0°C (national, range across scenarios) (Siabi et al., 2023). The design employs the mixed-method appraisal tool (MMAT) framework to describe methods of quantitative, qualitative, and mixed-methods studies (Hong, Fàbregues, et al., 2018; Hong, Gonzalez‐Reyes, et al., 2018; Sale & Brazil, 2004).
Inclusion and Exclusion Criteria
The inclusion criteria will include quantitative, qualitative, or mixed-method studies that examine mental health, maternal health, or community resilience within the framework of climate change. Eligible publications are those from 2010 onwards to capture a wide scope of studies over a decade and a half,
written in English, and include both peer-reviewed and grey literature. Exclusion criteria apply to studies conducted outside Ghana or those unrelated to climate-health interactions, as well as non-scientific commentaries, editorials, or biomedical studies lacking contextual analysis.
Search Strategy
Searches will be conducted across multiple databases, including PubMed, PubMed Central, Google Scholar, African Index Medicus, and grey literature from institutional repositories or websites, such as the WHO, UNICEF, and Government of Ghana/Ministry of Health websites and/or unpublished works. The search strategy will integrate key terms combining concepts such as those recommended according to the MeSH keywords for CC: (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*) AND ("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*") AND ("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum) AND (Ghana*")). Boolean operators and truncation techniques will be applied to enhance search accuracy. For grey literature searches, the incognito mode will be used to prevent the duplication of search results when repeated searches are performed. The search strings will be divided into database specifics, as illustrated in Table 1.
Table 1: Databases and their corresponding search strings
| Database source | Platform | Search strings | Filters/Limits Applied | Results Retrieved | Date searched | Notes | |
| PubMed | NCBI | (((("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*)) AND (("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*"))) AND (("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum))) AND ((Ghana*")) | English, full article, 2010–2025 | 111 | 09/01/2026 | ||
| PubMed Central | NCBI | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*) AND ("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*") AND ("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum) AND (Ghana")) | English, full article, 2010–2025 | 11,331 | 09/01/2026 | ||
| Google Scholar | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*) AND ("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*") AND ("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum) AND (Ghana")) | Full articles, English, (2010-2025); First 1000 results | 1000 | 09/01/2026 | |||
| African Index Medicus | WHO | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*)) AND (("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*")) AND (("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum)) AND ((Ghana")) | English, full article, (2010-2025) | 6 | 09/01/2026 | ||
| Would Health Organization website for grey literature | WHO IRIS | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*)) AND (("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*")) AND (("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum)) AND ((Ghana")) | English, full article, 2010 - 2025 | 346 | 09/01/2026 | ||
| UNICEF website for grey literature | Google Search Engine | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*) AND ("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*") AND ("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum) AND (Ghana*"))site:https://www.unicef.org> | English, full article, 2010 – 2025, First 200 results screened | 26 | 09/01/2026 | ||
| Government of Ghana Institutional Reports | MoH, Ministerial Reports | (("climate change" OR "climatic change" OR "global warming" OR "climate variability" OR "climate crisis" OR "climate disruption" OR "climate alteration" OR "climate shift" OR "climate transformation" OR " climate instability" OR "climate emergency" OR "climate breakdown" OR "climate transition" OR "climate impact" OR "climate risk" OR "climate vulnerability" OR "heat exposure" OR "heatwave*" OR "extreme heat" OR drought OR flood* OR "heavy rainfall*" OR "extreme weather" OR "climate hazard*" OR "temperature rise" OR disaster*) AND ("mental health" OR "psychological distress*" OR "psychosocial stress" OR anxiet* OR depression OR trauma OR burnout OR "occupational stress" OR "climate anxiety" OR "climate distress*" OR resilience OR adapt* OR "coping strateg*") AND ("healthcare workers" OR household* OR mother* OR woman OR women OR maternal OR pregnancy OR perinatal OR postpartum) AND (Ghana*"))site:Government of Ghana reports> | English, 2010 – 2025, MoH/GHS Website | 2 | 09/01/2026 |
Source:
Authors’ Construct (2026)
Screening and Selection Process
All identified records will be exported as RIS or BibTeX files. If these formats are unavailable, the Mendeley and/or Zotero reference software manager will be used to export and convert the files into RIS or BibTeX. Subsequently, the records will be imported into the Covidence database for screening, where duplicates will be automatically removed. Two independent reviewers will evaluate the titles, abstracts, and full texts
according to the inclusion criteria and resolve any disagreements through discussion. When consensus is not reached, a senior advisor acts as a third-party adjudicator. The selection process will be documented using the PRISMA-ScR flow diagram, which is automatically generated from the Covidence database.
Data Extraction and Charting
Table 2: Data-charting template
| SN | Authors | Authors institutional affiliation | Year of Pub. | Country Level of analysis | Methodology = MMAT | Study population Sampling | Principal findings | Climate metrics used | Thresholds | Weather data systems used | Determinants influencing mental and maternal health outcomes | Theoretical frameworks or models applied | Relevant climate variables | Reported adaptation strategies or resilience | Research challenges | Implication for public health | Lessons learned | |
Source: Authors Construct (2026)
Data Analysis and Presentation
Quantitative data will be presented using descriptive summaries, whereas qualitative findings will be analysed through thematic synthesis following Braun and Clarke’s (2006) six-phase framework (Özden, 2024; Saunders et al., 2023). The integration of these results will employ the “weaving” approach, which combines themes across both data types (Fetters et al., 2013; Lochmiller, 2021; Moseholm & Fetters, 2017; Wiltshire & Ronkainen, 2021). Qualitative Data Analysis (QDA) Miner software (version 3.0) will be used to support coding, categorisation, and re-categorisation of themes, and its visual mapping tools will be used to illustrate relationships between climate factors, psychosocial health, maternal health, and community and health system resilience outcomes. All findings will be structured within the One Health and SDH framework (Nyatanyi et al., 2017; Ridde et al., 2020, 2022; Sleeman et al., 2017), as shown in Figure 1 and Table 2.
Analytical Framework
Ethics and Dissemination
This scoping review will use secondary data; therefore, ethical approval is not required. Prior to conducting subsequent empirical fieldwork, ethical approval will be obtained from the Navrongo Health
Research Centre Institutional Review Board (NHRCIRB). This will be followed by obtaining authorization from Ghana Health Service’s regional and district directorates. Informed consent from the participants will be obtained both verbally and in writing before their involvement in the field interviews. The findings
from the scoping review and empirical results will be disseminated through publication in a peer-reviewed journal, targeting outlets such as F1000Research or BMJ Open alongside presentations at conferences and policy dialogues with stakeholders in Ghana and France. Output and deliverables will include
open-access datasets and graphical evidence maps developed in accordance with the Findability, Accessibility, Interoperability and Reuse (FAIR) data principles.
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Khalil, H., Bennett, M., Godfrey, C., Mcinerney, P., Munn, Z., & Peters, M. (2020). Evaluation of the JBI scoping reviews methodology by current users. International Journal of Evidence-Based Healthcare, 18(1), 95–100. https://doi.org/10.1097/xeb.0000000000000202
Kim, S.-H. (2025). Mental Health Challenges of Climate Change for Older Korean and Korean American Adults: Navigating Vulnerability, Isolation, and Resilience. Social Work in Public Health, ahead-of-print(ahead-of-print). https://doi.org/10.1080/19371918.2025.2557348
Lanyo, T. N., Williams, J., Ghosh, B., Apetorgbor, V. E. A., Kukula, V. A., Zielinski, R., Awini, E., Moyer, C., & Lori, J. R. (2024). Effect of Group Antenatal Care on Breastfeeding Knowledge and Practices Among Pregnant Women in
Ghana: Findings from a Cluster-Randomized Controlled Trial. International Journal of Environmental Research and Public Health, 21(12), 1587. https://doi.org/10.3390/ijerph21121587
Lochmiller, C. (2021). Conducting Thematic Analysis with Qualitative Data. The Qualitative Report. https://doi.org/10.46743/2160-3715/2021.5008
Manyeh, A. K., Amu, A., Akpakli, D. E., Williams, J. E., & Gyapong, M. (2020). Estimating the rate and determinants of exclusive breastfeeding practices among rural mothers in Southern Ghana. International Breastfeeding Journal, 15(1). https://doi.org/10.1186/s13006-020-0253-6
Mohammed, S., Yakubu, I., Fuseini, A.-G., Abdulai, A.-M., & Yakubu, Y. H. (2023). Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15758-w
Moseholm, E., & Fetters, M. D. (2017). Conceptual models to guide integration during analysis in convergent mixed methods studies. Methodological Innovations, 10(2), 205979911770311. https://doi.org/10.1177/2059799117703118
Naser, K., Haq, Z., & Naughton, B. D. (2024). The Impact of Climate Change on Health Services in Low- and Middle-Income Countries: A Systematised Review and Thematic Analysis. International Journal of Environmental Research and Public Health, 21(4), 434. https://doi.org/10.3390/ijerph21040434
Nkrumah, J. (2016). Maternal work and exclusive breastfeeding practice: a community based cross-sectional study in Efutu Municipal, Ghana. International Breastfeeding Journal, 12(1). https://doi.org/10.1186/s13006-017-0100-6
Nyatanyi, T., Nyamusore, J., Binagwaho, A., Hakizimana, J. L., Kinani, J. F., Wilkes, M., Kibuuka, R., Mupfasoni, D., Omolo, J., Mcdermott, H., Kabeja, A., Rukelibuga, J., Rugigana, E., Mudakikwa, A., Kamugisha, J., Nzietchueng, S.,
Cotton, P., Gafarasi, I., Nkunda, R., … Farmer, P. (2017). Implementing One Health as an integrated approach to health in Rwanda. BMJ Global Health, 2(1), e000121. https://doi.org/10.1136/bmjgh-2016-000121
Özden, M. (2024). Content and Thematic Analysis Techniques in Qualitative Research: Purpose, Process and Features. Qualitative Inquiry in Education: Theory & Practice, 2(1), 64–81. https://doi.org/10.59455/qietp.20
Pollock, D., Pieper, D., Tricco, A. C., Evans, C., Peters, M. D., Brandão De Moraes, É., Campbell, F., Jia, R. M., Saran, A., Munn, Z., Godfrey, C. M., Khali, H., & Alexander, L. (2024). “How-to”: scoping review? Journal of Clinical Epidemiology, 176, 111572. https://doi.org/10.1016/j.jclinepi.2024.111572
Pollock, D., Tricco, A. C., Peters, M. D. J., Mclnerney, P. A., Khalil, H., Godfrey, C. M., Alexander, L. A., & Munn, Z. (2021). Methodological quality, guidance, and tools in scoping reviews: a scoping review protocol. JBI Evidence Synthesis, 20(4), 1098–1105. https://doi.org/10.11124/jbies-20-00570
Ridde, V., Guillard, É., & Faye, A. (2022). Le retour d’« une seule santé » et la santé mondiale : ne reproduisons pas les mêmes erreurs. Médecine Tropicale et Santé Internationale, 2(3). https://doi.org/10.48327/mtsi.v2i3.2022.255
Ridde, V., Pérez, D., & Robert, E. (2020). Using implementation science theories and frameworks in global health. BMJ
Global Health, 5(4), e002269. https://doi.org/10.1136/bmjgh-2019-002269
Rylander, C., Øyvind Odland, J., & Manning Sandanger, T. (2013). Climate change and the potential effects on maternal and pregnancy outcomes: an assessment of the most vulnerable – the mother, fetus, and newborn child. Global Health Action, 6(1), 19538. https://doi.org/10.3402/gha.v6i0.19538
Sale, J. E. M., & Brazil, K. (2004). A Strategy to Identify Critical Appraisal Criteria for Primary Mixed-Method Studies. Quality and Quantity, 38(4), 351–365. https://doi.org/10.1023/b:ququ.0000043126.25329.85
Saunders, C. H., Elwyn, G., Von Plessen, C., Yen, R. W., Goldwag, J., King, J. R., Kennedy, A. M., Saunders, R. K., Leviton, L. C., Marx, C. M., Pogue, J. A., Bernstein, S. L., Van Citters, A., Sierpe, A., & Leyenaar, J. K. (2023). Practical thematic analysis: a guide for multidisciplinary health services research teams engaging in qualitative analysis. BMJ, 381, e074256. https://doi.org/10.1136/bmj-2022-074256
Siabi, E. K., Awafo, E. A., Kabo-Bah, A. T., Derkyi, N. S. A., Akpoti, K., Mortey, E. M., & Yazdanie, M. (2023). Assessment of Shared Socioeconomic Pathway (SSP) climate scenarios and its impacts on the Greater Accra region. Urban Climate, 49, 101432. https://doi.org/10.1016/j.uclim.2023.101432
Sleeman, J. M., Nguyen, N., & Deliberto, T. (2017). Optimization of human, animal, and environmental health by using the One Health approach. Journal of Veterinary Science, 18(S1), 263. https://doi.org/10.4142/jvs.2017.18.s1.263
Stone, K., Blinn, N., & Spencer, R. (2022). Mental Health Impacts of Climate Change on Women: a Scoping Review. Current Environmental Health Reports, 9(2), 228–243. https://doi.org/10.1007/s40572-022-00346-8
Tampah-Naah, A. M., Kumi-Kyereme, A., & Amo-Adjei, J. (2019). Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS ONE, 14(5), e0215285. https://doi.org/10.1371/journal.pone.0215285
Tepa-Yotto, G. T., Zougmore, R., Agboton, C., Damba, O. T., Dalaa, M., Winsou, J. K., Moutouama, F. T., Gariba, A. A., Tonnang, H. E. Z., Kyere, R., Yeboah, S., Osae, M. Y., Adomaa, F. O., & Tamò, M. (2024). Implementation Outline
of Climate-Smart One Health: A System-Thinking Approach. Sustainability, 16(15), 6652. https://doi.org/10.3390/su16156652
Wiltshire, G., & Ronkainen, N. (2021). A realist approach to thematic analysis: making sense of qualitative data through experiential, inferential and dispositional themes. Journal of Critical Realism, 20(2), 159–180. https://doi.org/10.1080/14767430.2021.1894909
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Khalil, H., Bennett, M., Godfrey, C., Mcinerney, P., Munn, Z., & Peters, M. (2020). Evaluation of the JBI scoping reviews methodology by current users. International Journal of Evidence-Based Healthcare, 18(1), 95–100. https://doi.org/10.1097/xeb.0000000000000202
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Lochmiller, C. (2021). Conducting Thematic Analysis with Qualitative Data. The Qualitative Report. https://doi.org/10.46743/2160-3715/2021.5008
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Mohammed, S., Yakubu, I., Fuseini, A.-G., Abdulai, A.-M., & Yakubu, Y. H. (2023). Systematic review and meta-analysis of the prevalence and determinants of exclusive breastfeeding in the first six months of life in Ghana. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-15758-w
Moseholm, E., & Fetters, M. D. (2017). Conceptual models to guide integration during analysis in convergent mixed methods studies. Methodological Innovations, 10(2), 205979911770311. https://doi.org/10.1177/2059799117703118
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Nyatanyi, T., Nyamusore, J., Binagwaho, A., Hakizimana, J. L., Kinani, J. F., Wilkes, M., Kibuuka, R., Mupfasoni, D., Omolo, J., Mcdermott, H., Kabeja, A., Rukelibuga, J., Rugigana, E., Mudakikwa, A., Kamugisha, J., Nzietchueng, S.,
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Özden, M. (2024). Content and Thematic Analysis Techniques in Qualitative Research: Purpose, Process and Features. Qualitative Inquiry in Education: Theory & Practice, 2(1), 64–81. https://doi.org/10.59455/qietp.20
Pollock, D., Pieper, D., Tricco, A. C., Evans, C., Peters, M. D., Brandão De Moraes, É., Campbell, F., Jia, R. M., Saran, A., Munn, Z., Godfrey, C. M., Khali, H., & Alexander, L. (2024). “How-to”: scoping review? Journal of Clinical Epidemiology, 176, 111572. https://doi.org/10.1016/j.jclinepi.2024.111572
Pollock, D., Tricco, A. C., Peters, M. D. J., Mclnerney, P. A., Khalil, H., Godfrey, C. M., Alexander, L. A., & Munn, Z. (2021). Methodological quality, guidance, and tools in scoping reviews: a scoping review protocol. JBI Evidence Synthesis, 20(4), 1098–1105. https://doi.org/10.11124/jbies-20-00570
Ridde, V., Guillard, É., & Faye, A. (2022). Le retour d’« une seule santé » et la santé mondiale : ne reproduisons pas les mêmes erreurs. Médecine Tropicale et Santé Internationale, 2(3). https://doi.org/10.48327/mtsi.v2i3.2022.255
Ridde, V., Pérez, D., & Robert, E. (2020). Using implementation science theories and frameworks in global health. BMJ
Global Health, 5(4), e002269. https://doi.org/10.1136/bmjgh-2019-002269
Rylander, C., Øyvind Odland, J., & Manning Sandanger, T. (2013). Climate change and the potential effects on maternal and pregnancy outcomes: an assessment of the most vulnerable – the mother, fetus, and newborn child. Global Health Action, 6(1), 19538. https://doi.org/10.3402/gha.v6i0.19538
Sale, J. E. M., & Brazil, K. (2004). A Strategy to Identify Critical Appraisal Criteria for Primary Mixed-Method Studies. Quality and Quantity, 38(4), 351–365. https://doi.org/10.1023/b:ququ.0000043126.25329.85
Saunders, C. H., Elwyn, G., Von Plessen, C., Yen, R. W., Goldwag, J., King, J. R., Kennedy, A. M., Saunders, R. K., Leviton, L. C., Marx, C. M., Pogue, J. A., Bernstein, S. L., Van Citters, A., Sierpe, A., & Leyenaar, J. K. (2023). Practical thematic analysis: a guide for multidisciplinary health services research teams engaging in qualitative analysis. BMJ, 381, e074256. https://doi.org/10.1136/bmj-2022-074256
Siabi, E. K., Awafo, E. A., Kabo-Bah, A. T., Derkyi, N. S. A., Akpoti, K., Mortey, E. M., & Yazdanie, M. (2023). Assessment of Shared Socioeconomic Pathway (SSP) climate scenarios and its impacts on the Greater Accra region. Urban Climate, 49, 101432. https://doi.org/10.1016/j.uclim.2023.101432
Sleeman, J. M., Nguyen, N., & Deliberto, T. (2017). Optimization of human, animal, and environmental health by using the One Health approach. Journal of Veterinary Science, 18(S1), 263. https://doi.org/10.4142/jvs.2017.18.s1.263
Stone, K., Blinn, N., & Spencer, R. (2022). Mental Health Impacts of Climate Change on Women: a Scoping Review. Current Environmental Health Reports, 9(2), 228–243. https://doi.org/10.1007/s40572-022-00346-8
Tampah-Naah, A. M., Kumi-Kyereme, A., & Amo-Adjei, J. (2019). Maternal challenges of exclusive breastfeeding and complementary feeding in Ghana. PLoS ONE, 14(5), e0215285. https://doi.org/10.1371/journal.pone.0215285
Tepa-Yotto, G. T., Zougmore, R., Agboton, C., Damba, O. T., Dalaa, M., Winsou, J. K., Moutouama, F. T., Gariba, A. A., Tonnang, H. E. Z., Kyere, R., Yeboah, S., Osae, M. Y., Adomaa, F. O., & Tamò, M. (2024). Implementation Outline
of Climate-Smart One Health: A System-Thinking Approach. Sustainability, 16(15), 6652. https://doi.org/10.3390/su16156652
Wiltshire, G., & Ronkainen, N. (2021). A realist approach to thematic analysis: making sense of qualitative data through experiential, inferential and dispositional themes. Journal of Critical Realism, 20(2), 159–180. https://doi.org/10.1080/14767430.2021.1894909
Acknowledgements
Funding Statement: This study received support from Campus France through a postdoctoral fellowship funded by the French Ministry of Education and Foreign Affairs (MEAE). The research was conducted within the framework of the Make Our Planet Great Again (MOPGA) program under the postdoctoral visiting early career research fellowship at the Centre Population Et Développement (CEPED/IRD), University Paris Cité. Justine Guguneni Tuolong is an awarding fellow supported by a monthly stipend under Campus France, the MEAE funding.
Data Access Statement: The research data supporting this publication will be accessible at the protocol repository.
Conflict of Interest declaration: The authors declare that they have no conflicts of interest concerning the publication of this protocol and subsequent manuscript.
Author Contributions: JGT, JMG, MBA and VR contributed to the research design and implementation. VR will provide technical support for resolving conflicts in data charting and review, data analysis, and manuscript preparation. JGT originated the concept, is supported by MBA and JMG on data charting and reviews, and is supervised by VR under the MOPGA postdoctoral fellowship.