Neonate Deaths - Is extreme heat exposure the culprit? Analysis of high neonatal mortality burden counties in Kenya

Despite significant gains in infant and under-five survival in Kenya, neonatal mortality has remained largely stagnant over the past two decades. Emerging global evidence--primarily from high-income countries--shows a strong link between extreme heat exposure and adverse birth outcomes, including stillbirths, low birth weight, and premature births. Yet, little is known about this relationship in sub-Saharan Africa, even as the continent warms faster than the global average. This study investigates the correlation between extreme heat exposure and neonatal mortality in Kenyas five most-affected counties between 2000 and 2021. Using retrospective data from the World Bank Groups climate portal and the UN Inter-Agency Group for Child Mortality Estimation (UN-IGME), we analyzed trends in annual minimum and maximum surface air temperatures and relative humidity alongside neonatal death rates. Statistical analyses, including Pearsons (parametric) and Kendalls tau (non-parametric) correlation tests, were conducted using SPSS v25. In addition, we examined national and county-level mean annual temperature trends from 1963 to 2023. Findings revealed no statistically significant correlation between neonatal mortality and temperature or humidity during the study period. While Kendalls tau showed a weak positive relationship between neonatal mortality and temperature from 2000 to 2007, this shifted to a negative correlation in later years--most pronounced in 2016 and 2021. Similarly, humidity exhibited fluctuating associations, with weak or no consistent correlation to neonatal deaths. Consequently, the null hypothesis could not be rejected. These results point to the urgent need for improved data quality and granularity at the county level to enable more nuanced, long-term analyses. As Kenya continues to experience rising temperatures, further research is critical to unpack the complex pathways linking climate stressors to neonatal health outcomes. We recommend scaling up integrated approaches such as the Population, Health, and Environment (PHE) model, which offers a holistic framework for addressing health, climate resilience, and sustainable development. Strengthening county-level health surveillance systems and embedding climate adaptation into maternal and child health policies will be essential to meeting the countrys SDG targets and safeguarding future generations.