Flood-Induced gendered health vulnerabilities and adaptive capacities in South Punjab, Pakistan
Keywords:
Floods, Gender, Inequalities, Healthcare, DiseasesAbstract
This study aims to explore the flood-affected people's experiences of healthcare services as a consequence of floods, how disasters disrupt women's mobility, and gender-specific health issues. This study seeks to explore how gender roles, access to healthcare, limited mobility, and care obligations influence health consequences and contribute to different vulnerabilities in flood-affected areas. A qualitative research approach and phenomenological research design were used. The participants were recruited from the Rajanpur District of Punjab, Pakistan. Thirty flood-affected individuals (fifteen females and fifteen males) were purposively selected for in-depth interviews, and thematic analysis was performed for analysis. Results show that there was a high level of gender inequality in the access to healthcare services and provision of reproductive health, as well as psychosocial well-being. Women reported feeling burdened by their caregiving responsibilities, experiencing a lack of privacy in shelters, and facing limitations in accessing medical help. Indigenous adaptive resilience did nevertheless occur in the form of community-based women’s networks and informal care systems. The study concludes that promoting gender-sensitive disaster health planning may help to reinforce inclusive adaptive capacities and enable equal health interventions in flood-affected areas
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References
Abid, M., Scheffran, J., Schneider, U. A., & Ashfaq, M. (2019). Farmer perceptions of climate change, observed trends and adaptation of agriculture in Pakistan. Environmental Management, 63(1), 110–123. https://doi.org/10.1007/s00267-018-1113-7
Abbas, H. W., & Guo, X. (2023). Climate-related vulnerability assessment toward disaster risk reduction: Insight from Pakistan. Journal of Homeland Security and Emergency Management, 20(3), 307-350. https://doi.org/10.1515/jhsem-2021-0046
Ahmad, M. S., Shah, R., Khan, S., Kizi, J. S. M., Fatima, T., & Malik, A. (2025). Exploring psychological recovery and coping mechanisms: post-flood mental health and resilience of women in Punjab, Pakistan. Discover Sustainability, 6(1), 107. https://doi.org/10.1007/s43621-025-00799-5
Alam, E., & Rahman, T. (2014). Women in natural disasters: A case study from southern coastal region of Bangladesh. International Journal of Disaster Risk Reduction, 8, 68–82. https://doi.org/10.1016/j.ijdrr.2014.01.003
Ashraf, M., Shahzad, S., Sequeria, P., Bashir, A., & Azmat, S. K. (2024). Understanding challenges women face in flood‐affected areas to access sexual and reproductive health services: A rapid assessment from a disaster‐torn Pakistan. BioMed research international, 2024(1), 1113634. https://doi.org/10.1155/2024/1113634
Azad, A. K., Hossain, K. M., & Nasreen, M. (2013). Flood-induced vulnerabilities and problems encountered by women in northern Bangladesh. International journal of disaster risk science, 4(4), 190-199. https://doi.org/10.1007/s13753-013-0020-z
Azhar, A., Amir, F., Shakeel, A., & Ali, S. H. (2023). A rising threat of urinary tract infections among the flood-affected women of Pakistan: challenges and recommendations. Medicine, Conflict and Survival, 39(3), 250-257. https://doi.org/10.1080/13623699.2023.2214954
Bhutto, S., Vighio, K., Bhutto, N., & Alam, S. (2024). Comprehensive analysis of health impacts arising from flood disasters: Evidence from Pakistan's Vulnerable Regions. Journal of Economics, Management & Business Administration, 3(2), 52-64. https://doi.org/10.59075/jemba.v3i2.501
Bradshaw, S. (2013). Gender, development and disasters. Edward Elgar Publishing, UK.
Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77–101. https://doi.org/10.1191/1478088706qp063oa
Caruso, B. A., Clasen, T. F., Hadley, C., Yount, K. M., Haardörfer, R., Rout, M., ... & Cooper, H. L. (2017). Understanding and defining sanitation insecurity: women’s gendered experiences of urination, defecation and menstruation in rural Odisha, India. BMJ global health, 2(4), e000414.
Creswell, J. W., & Poth, C. N. (2018). Qualitative inquiry and research design: Choosing among five approaches (4th ed.). SAGE Publications.
Cutter, S. L., Burton, C. G., & Emrich, C. T. (2010). Disaster resilience indicators for benchmarking baseline conditions. Journal of homeland security and emergency management, 7(1). https://doi.org/10.2202/1547-7355.1732
Drolet, J., Dominelli, L., Alston, M., Ersing, R., Mathbor, G., & Wu, H. (2015). Women rebuilding lives post-disaster: Innovative community practices for building resilience and promoting sustainable development. Gender & Development, 23(3), 433-448. https://doi.org/10.1080/13552074.2015.1096040
Ellen, I. G., Mijanovich, T., & Dillman, K. N. (2001). Neighborhood Effects on Health: Exploring the Links and Assessing the Evidence. Journal of Urban Affairs, 23(3–4), 391–408. https://doi.org/10.1111/0735-2166.00096
Enarson, E., & Pease, B. (Eds.). (2016). Men, masculinities and disaster (1st ed.). Routledge. https://doi.org/10.4324/9781315678122t
Fatema, S. R. (2020). Women’s health-related vulnerabilities in natural disaster-affected areas of Bangladesh: A mixed-methods study protocol. BMJ open, 10(11), e039772. doi:10.1136/bmjopen-2020-039772
Guest, G., Namey, E. E., & Mitchell, M. L. (2013). Collecting qualitative data: A field manual for applied research. Sage Publications.
Haque, C. E., & Uddin, M. S. (2013). Disaster management discourse in Bangladesh: a shift from post-event response to the preparedness and mitigation approach through institutional partnerships. In Approaches to disaster management-examining the implications of hazards, emergencies and disasters. IntechOpen. DOI: 10.5772/54973
Ipcc. (2022). Climate Change 2022: Impacts, adaptation, and vulnerability. Cambridge University Press.
Joshi, D., Fawcett, B., & Mannan, F. (2011). Health, hygiene and appropriate sanitation: experiences and perceptions of the urban poor. Environment and Urbanization, 23(1), 91-111. https://doi.org/10.1177/0956247811398602
Kallio, H., Pietilä, A. M., Johnson, M., & Kangasniemi, M. (2016). Systematic methodological review: Developing a framework for a qualitative semi‐structured interview guide. Journal of Advanced Nursing, 72(12), 2954–2965. https://doi.org/10.1111/jan.13031
Liamputtong, P. (2010). Performing qualitative cross-cultural research. Cambridge University Press.
Memon, F. S. (2020). Climate change and violence against women: study of a flood-affected population in the rural area of Sindh, Pakistan. Pakistan Journal of Women's Studies: Alam-e-Niswan, 27(1), 65-85. DOI: 10.46521/pjws.027.01.0039
Nahar, S., & Pillai, V. K. (2025). Women’s reproductive health in the aftermath of natural disasters in Bangladesh: Prospects for empowerment. Health care for women international, 46(2), 198-213. https://doi.org/10.1080/07399332.2024.2341316
Neumayer, E., & Plümper, T. (2007). The gendered nature of natural disasters: The impact of catastrophic events on the gender gap in life expectancy, 1981–2002. Annals of the association of American Geographers, 97(3), 551-566. https://doi.org/10.1111/j.1467-8306.2007.00563.x
Nowell, L. S., Norris, J. M., White, D. E., & Moules, N. J. (2017). Thematic analysis: Striving to meet the trustworthiness criteria. International journal of qualitative methods, 16(1), https://doi.org/10.1177/1609406917733847
Patton, M. Q. (2015). Qualitative research & evaluation methods (4th ed.). SAGE Publications.
Saeed, U., & Piracha, Z. Z. (2016). Viral outbreaks and communicable health hazards due to devastating floods in Pakistan. World Journal of Virology, 5(2), 82. doi: 10.5501/wjv.v5.i2.82.
Safajou, F., Nahidi, F., & Ahmadi, F. (2024). Reproductive health challenges during a flood: A qualitative study. Nursing Open, 11(1), e2044. https://doi.org/10.1002/nop2.2044
Solomon, S. (2019). Understanding the impacts of climate change on water access and the lives of women in Tharparkar District, Sindh Province, Pakistan: A Literature Review, 1990-2018.
Sultana, F. (2022). Critical climate justice. The Geographical Journal, 188(1), 118-124. https://doi.org/10.1111/geoj.12417
Sultana, F. (2014). Gendering climate change: Geographical insights. The Professional Geographer, 66(3), 372-381. https://doi.org/10.1080/00330124.2013.821730
Sultana, F. (2010). Living in hazardous waterscapes: Gendered vulnerabilities and experiences of floods and disasters. Environmental Hazards, 9(1), 43-53. https://doi.org/10.3763/ehaz.2010.SI02
Tufail, Z., Ahmer, W., Gulzar, S., Hasanain, M., & Shah, H. H. (2023). Menstrual hygiene management in flood-affected Pakistan: Addressing challenges and ensuring women's health and dignity. Frontiers in global women's health, 4, 1238526. https://doi.org/10.3389/fgwh.2023.1238526
Unfpa. (2023). UNFPA Pakistan dignity kits. UNFPA Pakistan. Retrieved June 12, 2025, from https://pakistan.unfpa.org/en/publications/unfpa-pakistan-dignity-kits#:~:text=Dignity%20Kits%20help%20women%20and%20girls%20maintain,critical%20component%20of%20the%20UNFPA%20humanitarian%20response.
Unfpa. (2022). Women and girls bearing the brunt of the Pakistan Monsoon floods. UNFPA Pakistan. Retrieved June 8, 2025, from https://pakistan.unfpa.org/en/news/women-and-girls-bearing-brunt-pakistan-monsoon-floods
Unicef. (2025). Gender equality: WASH and menstrual health and hygiene. Retrieved June 10, 2025, from https://data.unicef.org/topic/gender/water-sanitation-and-hygiene-wash/
Un Women. (2019). Promoting gender equality in sexual, reproductive, maternal, newborn, child and adolescent health. UN Women, New York, USA. https://www.unwomen.org/sites/default/files/Headquarters/Attachments/Sections/Library/Publications/2019/Promoting-gender-equality-in-SRMNCAH-Programming-guide-en.pdf
Van Manen, M. (2016). Researching lived experience: Human science for an action sensitive pedagogy (2nd ed.). Routledge.
Van Daalen, K. R., Chowdhury, M., Dada, S., Khorsand, P., El-Gamal, S., Kaidarova, G., ... & Rajan, D. (2022). Does global health governance walk the talk? Gender representation in World Health Assemblies, 1948–2021. BMJ Global Health, 7(8). https://doi.org/10.1136/bmjgh-2022-009312
Vohra, L. I., Aqib, M., Jamal, H., Mehmood, Q., & Yasin, F. (2023). Rising cases of dengue and malaria in flood affected areas of Pakistan: A major threat to the Country’s healthcare system. Disaster Medicine and Public Health Preparedness, 17, e323. doi:10.1017/dmp.2022.293
WHO. (2023). Protecting maternal, newborn and child health from the impacts of climate change: a call to action by WHO, UNICEF and UNFPA. World Health Organization. https://www.unfpa.org/sites/default/files/resource-pdf/HRP%20CLIMATE%20CHANGE%20IMPACT_WEB_V18_SPREADS_final.pdf
Wisner, B., Gaillard, J. C., & Kelman, I. (2012). Handbook of hazards and disaster risk reduction. Routledge. https://doi.org/10.4324/9780203844236
Yavinsky, R. W., Lamere, C., Patterson, K. P., & Bremner, J. (2015). The impact of population, health, and environment projects: A synthesis of the evidence. Population Council. Doi: 10.31899/rh9.1056.
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Copyright (c) 2025 Muhammad Uzair, Prof. Dr. Ra’ana Malik (Author)

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