Implications of floods on women’s access to sexual and reproductive health services in Kasese district, Uganda

Abstract

Floods, as one of the most frequent and severe consequences of climate change, have increasingly become a challenge, especially in developing countries. In Uganda, Kasese District has been experiencing recurrent riverine and flash floods, which have significantly disrupted access to health care including sexual and reproductive health services, particularly for the women. During and after floods access to Sexual and Reproductive Health (SRH) services becomes highly compromised. This study examines the implications of floods on women's access to SRH services in Kasese District, Uganda, shedding light on the challenges faced by women during floods. Specifically, the research explores three main objectives: the impacts of floods on women’s access to SRH services, the factors that affect women’s access to sexual and reproductive health services during and after floods and the adaptation strategies that women employ to cope with and adapt to the negative impacts of floods on their access to SRH services. A mixed-method approach, combining household surveys, key informant interviews, and focus group discussions following exploratory, descriptive and interpretive research designs was employed to gather data from 201 households targeting women aged 15-49 years in the three divisions of Kasese Municipality. Qualitative data was analyzed through thematic analysis while quantitative data was analyzed through various statistical methods including descriptive statistics, logistic regression and chi-square test. The findings reveal that 98% of the respondents were affected with access to SRH services due to floods. The most affected SRH services were maternal and child health services reported by 68% of respondents and family planning services reported by 64% of respondents. Floods severely disrupt women’s access to SRH services through destruction of health facility infrastructures reported by 77.6% of respondents; compromised privacy, dignity and security reported by 58% of respondents; and interrupted access to SRH service delivery outreaches reported by 71% of respondents. Economic and socio-cultural factors including financial difficulties reported by 69.6% and levels of education reported by 35% of respondents also affected women’s access to SRH services. The adaptation measures adopted by women to cope with and adapt to effects of floods on access to SRH services were found to be dependent on specific communities. The study recommends that, the government, partners and private health care providers should conduct a risk assessment of all health facilities to permanently relocate all those found to be at risk of being affected by climate disasters such as floods to safer location. In addition, the government should procure and deploy mobile health clinics equipped to provide comprehensive SRH services, including contraception, prenatal care, and Sexually Transmitted Infections (STI) treatment in a safe, private and confidential manner particularly in areas severely affected by floods. The study contributes valuable knowledge relevant in implementing the Climate Change Act 2021, Health National Adaptation Plan, Kasese District Climate Change Action Plan, all of which contributes to Uganda's climate resilience efforts in line with the attainment of National Development Plan (NDP) III and Sustainable Development Goals (SDGs) related to Health, Gender Equality, and Climate Action.