Household vulnerability to climate impacts on WASH and risk mitigation in informal settlements of Eastern Uganda

Climate-related hazards such as floods and droughts disrupt household access to safe water, sanitation, and hygiene (WASH), undermining progress toward the Sustainable Development Goals (SDGs). Evidence on how household characteristics such as housing type, altitude, subjective social status, and disability status shape vulnerability to floods and drought and related risk mitigation in informal settlements remains limited. This study, therefore, assessed the vulnerability to climate impacts on WASH, risk mitigation, and its determinants among households in informal settlements in Eastern Uganda. This cross-sectional study applied nexus thinking and used an adapted questionnaire, informed by the World Health Organisation's climate vulnerability checklist, to collect data from 589 households in Eastern Uganda. Quantitative data on household characteristics, documented flood and drought impacts, as well as risk mitigation measures, were collected. Robust least squares regression was used to show predictors of climate impact scores as well as risk mitigation scores at 95% confidence level. Results show that 21.4% reported increased susceptibility to waterborne diseases due to contamination from animal faeces and sewage. Vulnerability to flood impacts was higher among households living in temporary housing or with disabled members, but lower among those in higher-altitude areas or with higher subjective socioeconomic status. Higher subjective social status was also linked to reduced drought impacts, whereas temporary housing reduced the capacity to mitigate drought risk. Overall, climate-related hazards compromise WASH in informal settlements, with cascading effects on health, education, food security, gender equality, and poverty reduction. These findings highlight the need to strengthen water governance, promote integrated (nexus) approaches, and build resilient WASH systems through multi-sectoral partnerships to mitigate climate risks in vulnerable communities.