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India’s heatwave response must focus on women’s health

May 19, 2025 06:29 PM IST

This article is authored by Suryaprabha Sadasivan, senior vice president, Chase India, New Delhi.

As India confronts yet another sweltering summer, heatwaves are emerging not merely as extreme weather events but as complex public health challenges—particularly for women. For millions of women working in informal sectors, living in under-resourced neighbourhoods, or carrying the bulk of unpaid care work, rising temperatures are not just uncomfortable—they are dangerous. Yet, heat-related risks to women’s health and well-being remain insufficiently recogniszed in our policy frameworks.

Heatwave (Sunil Ghosh /HT) PREMIUM
Heatwave (Sunil Ghosh /HT)

Between March and June this year, at least 733 deaths due to heatstroke were reported across 17 Indian states, according to Heat Watch 2024. Experts suggest this number may be underestimated, as many heat-related illnesses go unrecorded. What we do know is that the burden is not evenly distributed. Gender norms, occupational exposure, limited access to services, and physiological vulnerability mean that women often bear a disproportionate share of the impact.

Women account for nearly 59% of MGNREGA workers, many of whom work outdoors in high-heat conditions without access to shaded rest zones or hydration stations. In states like Kerala and Tamil Nadu, female participation in the scheme exceeds 80%. At home, many rural women cook using biomass on open stoves—a practice still common in nearly 57% of rural households. This adds to indoor heat exposure and respiratory stress, particularly during peak summer months.

For pregnant women, the risks are even more acute. A temperature rise of just 1°C can increase the risk of miscarriage by up to 42%. Heat impairs thermoregulation and exacerbates dehydration, sepsis, and gestational complications. Mental health, too, is a growing concern. According to the Asian Development Bank (ADB), prolonged exposure to extreme heat is associated with increased levels of fatigue, depression, and even higher suicide rates—particularly among women juggling work, caregiving, and household responsibilities. The Scorching Divide report by Arsht-Rock estimates that Indian women take on an additional 90 minutes of unpaid care work per day during heatwaves, underscoring how climate change compounds existing inequalities.

India has made meaningful progress in expanding access to healthcare through initiatives like Ayushman Bharat. However, current national guidelines under the Health and Wellness Centres (HWCs) do not explicitly recognise heatwaves as a health risk. While these guidelines outline infrastructure and service delivery goals, there is limited attention to heat-resilient design—such as shaded waiting areas or ventilation enhancements—or to early warning systems for extreme heat.

Similarly, while women constitute nearly half of all hospitalisations under the Ayushman Bharat – PM Jan Arogya Yojana (AB-PMJAY), the scheme lacks specific provisions for heat-related illnesses. Moreover, the absence of gender-disaggregated data on heat-related health outcomes hampers the ability to design targeted interventions or allocate resources effectively.

That said, there are encouraging signs of innovation and leadership. Ahmedabad’s Heat Action Plan, one of the earliest in South Asia, has been credited with reducing excess mortality during heatwaves by up to 27% through targeted outreach, early warnings, and medical preparedness. The Mahila Housing Trust’s work in Ahmedabad to paint rooftops with solar-reflective coatings for home-based women workers is another example of practical, gender-responsive adaptation.

Odisha has also emerged as a pioneer in this space. It is the first Indian state to establish a gender cell within its State Disaster Management Authority, with training underway for district-level officers to collect and act upon gender-disaggregated data during extreme weather events. With 21 district gender cells already operational, this model offers valuable lessons for other states looking to integrate gender into climate preparedness efforts.

Building on these foundations, India’s response to heatwaves can be made more inclusive and impactful. First, national and state-level Heat Action Plans should include gender vulnerability assessments and specific interventions targeting women in informal work, care roles, and maternal health. Cooling infrastructure—whether at health centres, workplaces, or public spaces—must be prioritised in high-risk districts, guided by India’s vulnerability atlas, which shows 13% of districts and 15% of the population are moderately to highly vulnerable to heatwaves.

Beyond government, the role of community institutions and the private sector cannot be overstated. The Self-Employed Women’s Association (SEWA), in collaboration with Climate Resilience for All and Swiss Re, has launched the Women’s Climate Shock Insurance and Livelihoods Initiative. This groundbreaking programme provides parametric insurance and direct cash assistance to women in the informal sector during extreme heat events. By compensating for income lost due to unsafe working conditions, it empowers women to make health-first choices without compromising their livelihoods. This model, blending social protection with climate resilience, is exactly the kind of innovation India needs at scale.

The private sector also has a crucial role to play. Employers in sectors like agriculture, construction, and manufacturing can implement workplace heat-safety protocols, provide hydration and rest facilities, and adjust work schedules during peak heat hours. Companies could also use their CSR budgets to support community cooling centres or fund initiatives on gender and climate-health intersections.

Community-level leadership is equally important. Women are not only at risk and are not just passive recipients of relief—they are frontline risk managers, health workers, caregivers, and community leaders; therefore, they are also central to building resilience. Inclusion of training for women in existing government schemes engaging them in disaster preparedness planning as peer educators on heat-health, and recognising their role in early warning dissemination can transform them from passive aid recipients into active agents of adaptation.

Extreme heat is no longer an abstract future threat—it is a lived and daily reality. And it is clear that without intentional, gender-informed planning, the impacts will continue to fall hardest on those least equipped to cope. By aligning our health, labour, and climate strategies with the lived realities of women, India can take a significant step toward inclusive climate resilience.

This article is authored by Suryaprabha Sadasivan, senior vice president, Chase India, New Delhi.

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