The Intersectional Impact of Drought on Women’s Reproductive Health in the Ethiopian Highlands: A Review of Evidence and Policy Gaps

Abstract

Climate change, particularly prolonged drought, represents a critical, yet often neglected, threat to Sexual and Reproductive Health and Rights (SRHR) in agrarian Low-and Middle-Income Countries (LMICs). This review synthesizes the evidence on the intersectional pathways through which drought impacts women’s reproductive health in the Ethiopian Highlands. We delineate three principal interconnected causal routes: (1) Biological Stress and Morbidity (malnutrition, infectious disease), (2) Socio-economic Disruption (reduced healthcare access, financial barriers), and (3) Protection Risks (Gender-Based Violence (GBV) and harmful coping mechanisms). Findings demonstrate drought exacerbates adverse pregnancy outcomes (e.g., stillbirth, preterm birth), increases the unmet need for family planning (FP), and escalates GBV and child marriage. Crucially, while the Somali and Afar regions have some documentation, there is a distinct geographical evidence gap for the densely populated, food-insecure Amhara Highlands. We conclude that current Ethiopian climate and health policies lack explicit, integrated SRHR interventions in disaster response. Urgent, localized research and the adoption of gender-responsive, climate-resilient health programming are recommended to safeguard the progress made in maternal and reproductive health in the region.