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November 30, 2025Global Public HealthOpen Access

Health system response to climate-related shocks in a lower-middle-income country setting: A comparative study of floods and droughts in Pakistan

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Authors

MMMarianne MoussallemSZShehla ZaidiKGKate Gooding

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Overview

Qualitative comparative study reveals reactive and fragmented health system responses during floods and droughts in Pakistan, highlighting the urgent need for integrated resilience planning.

Key Points

  • To evaluate how health system planning, resource allocation, cross-agency coordination, and service delivery operate during floods and droughts in high-risk districts of Pakistan, and to understand community coping mechanisms.
  • Conducted an exploratory qualitative comparative study across national, provincial, district, and health facility levels in Pakistan.
  • Collected primary data through key informant interviews with health stakeholders, focus group discussions with community members and lady health workers, and documentary review.
  • Applied the Maintains program conceptual framework for shock-responsive health systems to evaluate operational capacities.
  • Floods prompted contingency planning, temporary medical camps, and emergency personnel deployments, but routine immunization, maternal care, and health reporting systems suffered severe disruptions.
  • Droughts exposed deeper structural deficits, including geographical isolation, infrastructural deficits, chronic undernutrition, and an absence of anticipatory planning or early response triggers.
  • Both shock types experienced late-triggered emergency financing, inconsistent interagency coordination, and non-standardized basic service packages, leaving fragile community coping mechanisms unable to replace state-led support.

Cite This Study

Moussallem et al. (2025) studied this question.

synapsesocial.com/papers/6a0fc7805725bbd5cc60157ahttps://doi.org/10.1080/17441692.2026.2675732
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Floods, Climate Change, and Public Health in Pakistan: A Call for Resilience2026 · 1 citations
  2. 2Climate Shocks as a Growing Pediatric Health Emergency in Pakistan: A Call to Action2025
  3. 3Understanding Challenges Women Face in Flood-Affected Areas to Access Sexual and Reproductive Health Services: A Rapid Assessment from a Disaster-Torn Pakistan2024 · 19 citations
  4. 4Utilizing a co-production strategy to identify multi sectoral priorities for enhancing preparedness against extreme weather events in vulnerable District Badin, Sindh-Pakistan2026
  5. 5Are rural health centers prepared for floods? An assessment using the WHO Hospital safety index in Khyber Pakhtunkhwa, Pakistan2026