Post-Flood WASH (Water, Sanitation, and Hygiene) Crises and Women's Health: A Case Study of District Nowshera, Pakistan

Abstract

Climate-induced disasters disproportionately affect vulnerable populations, particularly women in low-and middle-income regions where socio-cultural and infrastructural barriers compound disaster impacts. This study examines the physical, psychological, and reproductive health impacts of the 2022 climate-induced floods on women in District Nowshera, Khyber Pakhtunkhwa, Pakistan, and also evaluated community response and coping mechanisms during post-disaster recovery. The study used a mixed-methods designfocused on the flood-affected area of Mohib Banda, primary quantitative data were gathered through structured surveys (n = 64) from affected women, supplemented by qualitative insights from two focus group discussions (FGDs) and key informant interviews (n = 3) with healthcare professionals and NGO personnel. Geographic Information System (GIS) tools (ArcGIS and Google Earth/WGS 84 datum) were utilized for spatial visualization and study area mapping.The empirical findings revealed severe, multidimensional health risks faced by women following forced displacement. Physical health issues were reported by 84% of respondents, primarily consisting of skin rashes (38%), high-grade fever (33%), diarrhea (21%), and physical injuries. Pre-existing or acute chronic conditions worsened significantly, affecting 81% of respondents, with high blood pressure (49%) and asthma (25%) being the most prevalent. Furthermore, 75% of women experienced psychological distress,exhibiting symptoms of depression (36%), panic attacks (34%), and PTSD-related anxiety (30%) driven by displacement, loss of shelter, and asset destruction. Reproductive and menstrual health vulnerabilities were equally severe: 56% reported reproductive complications, including acute physical pain among pregnant women and a spike in premature deliveries was also observed, while 54% faced critical challenges in maintaining menstrual hygiene. Regarding relief distribution, 50% of immediate assistance was provided by informal local community networks. In contrast, non-governmental organizations (31%) provided delayed essential aid, highlighting a notable institutional deficit in immediate state-level intervention.The study demonstrates that disaster vulnerabilities are fundamentally gendered and exacerbated by the breakdown of local Water, Sanitation, and Hygiene (WASH) infrastructure. To mitigate future climate-driven health crises, disaster management policies must shift from gender-neutral relief toward gender-responsive frameworks. Operational priorities should include establishing permanent, flood-resilient Women’s Comprehensive Healthcare Centers staffed by female medical professionals, alongside gender-budgeted shock-responsive financial assistance in high-risk rural zones.