The impact of extreme weather events on the mental health of vulnerable populations in Africa (The WEMA project): a study protocol

Background: Extreme weather events (EWEs) are increasing in frequency and intensity due to climate change. EWEs negatively affect both physical and mental health, with vulnerable populations disproportionately impacted. Limited data on the specific effects of EWEs on mental health in Africa highlights the need for more research to guide policy and practice. The WEMA study aims to explore the impact of EWEs, in particular storms, cyclones, flooding, and heavy rainfall on common mental disorders (CMDs) in Burkina Faso, Kenya, Mozambique, and South Africa. Methods: This study will employ a transdisciplinary research approach integrating qualitative and quantitative methods to generate contextually grounded and policy-relevant evidence on the mental health impacts of EWEs in sub-Saharan Africa (SSA). We begin with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guided rapid literature review to synthesise existing evidence on the relationship between EWEs and mental health. Secondary analysis of health and demographic surveillance system (HDSS) data across multiple African sites will assess the temporal association between temperature, precipitation, and mental health-related morbidity and mortality, using time series regression with distributed lag non-linear models. In parallel, cross-sectional surveys will estimate the prevalence of CMDs among adults exposed and unexposed to flooding. Logistic regression, accounting for confounders, will be used to estimate odd ratios of the impact of flooding on CMDs. An embedded qualitative study will involve thematic analysis of digital stories produced by community-based co-researchers through participatory workshops, capturing lived experiences of EWEs. Findings from both components will be synthesised and disseminated through knowledge exchange meetings to bridge scientific and experiential insights and inform locally relevant interventions. Discussion: The pool of evidence generated through this transdisciplinary study will be widely shared to draw attention to the impact of EWEs on mental health and to inform relevant policy and practice. Through this work, we aim to advance locally relevant climate adaptation strategies to help reduce health inequalities and support the psychosocial well-being of affected communities.