**3.2 Indirect effects of climate change on health outcome**

Indirect climate change effects can arise from malnutrition due to food shortages from floods and droughts. Rising temperatures, rising sea levels, floods, and rainfall patterns can affect freshwater supply, predisposing people to infections and water-borne illnesses. Increased rainfall intensity, flooding, stagnated water, and polluted groundwater will increase diseases like hepatitis and malaria commonly experienced in Southern Nigeria [32–34]. Heavy rainfall events can also lead to contaminated drinking water from sewage, industrial and chemical waste, leading to the outbreak of infections.

In coastal eco-zones, windstorms, and extreme rainfall, rising sea levels, and floods can cause injuries, drowning, death, severe physical and mental trauma, particularly for citizens who live along major river deltas, on islands, and in lowlying coastal areas [35, 36]. For example, in parts of Southern Nigeria, flooding from sea level rise has contaminated freshwater aquifers, rivers, and stock-watering points. This has increased salinity in these bodies of water and polluted them with sediment and sewage [37].
