Challenges and opportunities to addressing non-communicable diseases after climate-related disasters in Mozambique: a qualitative study

INTRODUCTION: Low- and middle-income countries are facing a new double burden: an increasing frequency of extreme weather events that disrupt healthcare services for people living with non-communicable diseases (NCDs) and a rising prevalence of NCDs. In Mozambique, NCDs are the second leading cause of death among adults, and climate-related disasters, occurring with increasing intensity, exacerbate this problem. OBJECTIVE: This study aims to understand the challenges and opportunities for addressing the needs of persons living with NCDs in the aftermath of extreme weather events in Mozambique between 2019 and 2023. METHODS: This qualitative study employed a combination of focus group discussions (FGD) and in-depth interviews in five provinces severely affected by cyclones. A total of 36 in-depth interviews were conducted with key stakeholders and individuals living with NCDs. Five FGDs were held with community members. Rapid qualitative analysis was used to identify themes, which were presented using the socioecological model (SEM) framework. RESULTS: Three main themes and 14 subthemes emerged. The main themes were: (1) an overall lack of disaster preparedness leading to challenges for the general population; (2) persons with NCDs could not adequately manage their condition; and (3) the need to integrate NCD management into disaster preparedness and response plans. Barriers to NCD management were identified at all levels of the SEM, with the majority at the organisational level. Participants identified recommendations that can serve as models for addressing some identified barriers. CONCLUSION: Persons living with NCDs cannot adequately manage their conditions during extreme weather events in Mozambique due to barriers at all levels of the SEM. Addressing this challenge requires multilevel strategies that integrate NCD management into disaster preparedness and response plans, leverage existing programmes and strengthen health system resilience. Future work needs to evaluate the implementation of integrated disaster response plans to inform scale-up and scale-out.