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June 17, 2026Open Access

Effects of climate change-related hazards on food security and health within refugee settlements in Uganda

MWMichael T. WagabaMakerere University JGJean-Pierre Van GeertruydenUniversity of Antwerp JNJustine NamakulaMakerere University

Key Points

This research aims to evaluate the effects of climate change-related hazards on food security and health in refugee settlements in Uganda.
Cross-sectional study conducted in Kiryandongo, Nakivale, and Rhino Camp refugee settlements.
Data collected from 600 heads of refugee households using structured questionnaires, complemented by qualitative interviews.
Quantitative data analyzed using STATA v16 with modified Poisson regression, qualitative data analyzed through thematic analysis.
60.6% of respondents were female; most had lived in the settlement for 10-19 years.
Climate change-related hazards linked to food insecurity included forest fires (aPR = 1.13, 95% CI = 1.08-1.23, p < 0.001), unreliable rainfall (aPR = 1.07, 95% CI = 1.01-1.15, p = 0.03), and landslides (aPR = 1.07, 95% CI = 1.01-1.14, p = 0.02).
Qualitative findings indicated that changes in weather patterns significantly impact agriculture, increasing food insecurity and the prevalence of vector-borne and waterborne diseases.

Abstract

BACKGROUND: Climate change presents more dire impacts on food security and health in Africa than any other region worldwide. These impacts are expectedly more pronounced in predominantly agrarian refugee settings like Uganda, which is also the largest refugee host in Africa. However, there is limited contextual evidence regarding the effects of climate change-related hazards in Uganda to guide context-relevant interventions amidst the ongoing aid cuts. We assessed the impact of climate change-related hazards on food security and the health of refugees in three settlements in Uganda. METHODS: We conducted a cross-sectional study using concurrent mixed methods in Kiryandongo, Nakivale, and Rhino Camp refugee settlements. We collected data from 600 heads of refugee households using a structured questionnaire, conducted 45 in-depth interviews with refugees, and held 14 key informant interviews with program implementers. Quantitative data were analysed using STATA v16, and a modified Poisson regression model was employed to determine significant associations. Qualitative data were analysed inductively using thematic analysis to complement the quantitative findings. RESULTS: Of the 600 respondents, 60.6%, 95% CI = 56.5-64.6) were female, while most (76.2%) had lived in the settlement for 10-19 years. Climate change-related hazards associated with food insecurity included forest fires (aPR = 1.13; 95% CI = 1.08-1.23, p < 0.001), unreliable rainfall (aPR = 1.07; 95% CI = 1.01-1.15, p = 0.03), and landslides (aPR = 1.07; 95% CI = 1.01-1.14, p = 0.02). Qualitative findings highlighted that shifts in weather patterns, temperature fluctuations, and precipitation variations were perceived to have a profound impact on agricultural activities and to increase food insecurity and the incidence of vector-borne and waterborne diseases in the refugee settlements. CONCLUSIONS: Climate change-related hazards can exacerbate food insecurity and contribute to health challenges by increasing the incidence of vector-borne and waterborne diseases. To enhance the resilience of refugee settlements against climate-related hazards, it is crucial to implement community-based disaster preparedness systems, invest in climate-resilient agriculture, upgrade water and sanitation infrastructure, and integrate climate risk assessments into public health planning.

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