Pre-Implementation Protocol Outline: Climate-Aware Maternal Health Early Warning Pilot in Urban Nigeria

Abstract

"This is a pre-implementation protocol outline [Version 1.0]. A feasibility pilot is proposed pending funding. No funding has been received yet for implementation." Climate change is increasing heat and flood-related risks for pregnant women in low-resource urban settings, yet routine antenatal care lacks integrated climate alerts. This record outlines a pre-implementation protocol for a 4-month feasibility pilot to integrate automated heat and flood early warnings into routine maternal health surveillance at two urban primary healthcare centers in Port Harcourt, Nigeria. Objective: To test the feasibility of linking climate alerts to clinic workflows to enable preventive counseling, flexible scheduling, and community follow-up for high-risk pregnancies. Methods Outline: The proposed system combines (1) automated daily alerts derived from open meteorological data [ECMWF, NIMET] with thresholds for heat index >38°C and 48-hour flood probability >70%, (2) a simple triage flagging approach for gestational age and vulnerability, and (3) brief, context-adapted counseling integrated into routine ANC. Alert levels [Green/Yellow/Red] will trigger standardized actions ranging from precautionary counseling to rescheduling and phone check-ins. Implementation feasibility will be assessed using delivery rates, counseling coverage, time-to-action, and staff acceptability, supported by qualitative interviews. Status: Pre-implementation. No data has been collected. The full protocol, open-source alert code, counseling materials, and anonymized feasibility results will be released here upon completion under CC-BY-4.0. Keywords: maternal health, climate adaptation, heat, flood, early warning system, Nigeria, digital health, surveillance License: CC-BY-4.0