Strategies for sustaining sexual and reproductive health services during recurrent flooding in Adamawa State, Nigeria. A qualitative study.
- 1International Rescue Committee
Abstract
Seasonal flooding in Adamawa State, Nigeria damages health facilities, breaks supply chains, and displaces health workers and communities, while increasing health needs. Sexual and reproductive health (SRH) services are often deprioritized, yet evidence on how they are sustained remains limited. We examined how SRH services were sustained during recurrent flooding. We conducted a qualitative descriptive study in the flood-prone Local Government Areas of Numan and Fufore. We held eight focus group discussions with women and girls and 20 key informant interviews with health providers, supply chain actors, and program implementers. Flooding closed or damaged health facilities, broke supply and cold chains, and displaced health workers. Participants linked these disruptions to unattended births and to rising hemorrhage, stillbirth, miscarriage, and genital infections. Service continuity depended less on the formal health system than on anticipatory, community-led adaptation across three phases. Before floods, stakeholders mapped risk, pre-positioned commodities, trained women in contraceptive self-injection, and dispensed medicines in advance. During floods, care shifted to mobile outreach, task-sharing, transport by canoe and boat, and community-led referral. Community health workers, traditional birth attendants, Ward Development Committees, and womens groups reached cut-off communities. Across seasons, adaptations evolved toward cash transfers, savings groups, local reusable-pad production, and decentralized commodity hubs. Continuity relied heavily on unpaid community labor and womens own resources. Sustaining SRH services in flood-prone settings requires institutionalized preparedness, decentralized supply, empowered communities, and protected health financing. Community-led models offer a transferable approach to health security in a changing climate.
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BibTeX
@misc{kimemia2026strategies,
title = {{Strategies for sustaining sexual and reproductive health services during recurrent flooding in Adamawa State, Nigeria. A qualitative study.}},
author = {G. W. Kimemia and I. Balami and N. Kozuki and A. J. Abubakar and J. Umar and M. A. Bakari and H. S. Muhammed and F. J. Ojemu},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364542},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364542v1},
note = {CC BY},
}
RIS
TY - UNPB
TI - Strategies for sustaining sexual and reproductive health services during recurrent flooding in Adamawa State, Nigeria. A qualitative study.
AU - G. W. Kimemia
AU - I. Balami
AU - N. Kozuki
AU - A. J. Abubakar
AU - J. Umar
AU - M. A. Bakari
AU - H. S. Muhammed
AU - F. J. Ojemu
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364542
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364542v1
AB - Seasonal flooding in Adamawa State, Nigeria damages health facilities, breaks supply chains, and displaces health workers and communities, while increasing health needs. Sexual and reproductive health (SRH) services are often deprioritized, yet evidence on how they are sustained remains limited. We examined how SRH services were sustained during recurrent flooding. We conducted a qualitative descriptive study in the flood-prone Local Government Areas of Numan and Fufore. We held eight focus group discussions with women and girls and 20 key informant interviews with health providers, supply chain actors, and program implementers. Flooding closed or damaged health facilities, broke supply and cold chains, and displaced health workers. Participants linked these disruptions to unattended births and to rising hemorrhage, stillbirth, miscarriage, and genital infections. Service continuity depended less on the formal health system than on anticipatory, community-led adaptation across three phases. Before floods, stakeholders mapped risk, pre-positioned commodities, trained women in contraceptive self-injection, and dispensed medicines in advance. During floods, care shifted to mobile outreach, task-sharing, transport by canoe and boat, and community-led referral. Community health workers, traditional birth attendants, Ward Development Committees, and womens groups reached cut-off communities. Across seasons, adaptations evolved toward cash transfers, savings groups, local reusable-pad production, and decentralized commodity hubs. Continuity relied heavily on unpaid community labor and womens own resources. Sustaining SRH services in flood-prone settings requires institutionalized preparedness, decentralized supply, empowered communities, and protected health financing. Community-led models offer a transferable approach to health security in a changing climate.
ER -