**3.1 Direct effects of climate change on health outcome**

Direct health impacts stem from extreme events such as heatwaves, floods, droughts, windstorms, and wildfires. Currently, there are numerous news reports of excruciating heat waves across the country. In the last 5 years, the whole country has been experiencing intense heat waves [29]. For example, in the first 4 months of 2019, the Nigerian Meteorology Agency (NiMet) reported an increase in the mercury of up to 5° higher than average—around 35°C—in the humid commercial capital [30]. Also, there were recorded incidences of deaths from heatwave in the northern part of Nigeria [30, 31].

It is pertinent to note that high temperatures can trigger tropical diseases, such as heat cramps, heat strokes, cerebrospinal meningitis [32], and malaria. Increasing temperatures and drought can also reduce freshwater quantity, increase heat stress, compromise hygiene, and raise the risk of water-borne diseases such as typhoid fever, cholera, dysentery, diarrhea, and even polio. Air pollution from climate change can increase the incidences of respiratory and cardiovascular diseases.
