Health-seeking amid conflict and climate stress: how climate disaster shapes maternal and child healthcare behavior in fragile and conflict-affected settings

Abstract Background Floods can have significant adverse health consequences, placing an additional burden on healthcare systems and altering healthcare-seeking behavior. However, its effects on the health-wellbeing of vulnerable groups, such as pregnant women and children, in resource-constrained and conflict-affected Nigerian communities remain underexplored. This study examines the impact of the 2024 floods in Borno State, Nigeria, on maternal and child healthcare-seeking behavior. Methods A qualitative phenomenological approach was employed, with semi-structured Focus Group Discussions serving as the primary data collection method. Participants were selected purposively, focusing on households with pregnant women and children under five years old. Six FGDs, each comprising eight participants, were conducted across six geopolitical constituencies. The data were transcribed, framed, coded and analyzed thematically using Nvivo. Results The 2024 flood in Borno exacerbated existing vulnerabilities in social and healthcare infrastructure, disrupting essential maternal and child healthcare services. Public healthcare facilities were overwhelmed, with some healthcare facilities being repurposed as shelters, which further compounded the hardships experienced by vulnerable populations. The flood led to massive displacement, emotional trauma and increased health risks, particularly among children and pregnant women. The flood led to outbreaks of infectious diseases, long-term deterioration in access to antenatal care and immunization services, destruction of healthcare facilities, loss of medical supplies, and damage and contamination of existing drugs, as well as the destruction of cold chain systems critical for vaccine preservation. Cultural beliefs and environmental mismanagement further intensified the crisis. Conclusion The findings underscore the urgent need for climate-resilient healthcare systems to improve disaster preparedness and management in the context of climate change. The resulting displacement, emotional trauma and health risks, particularly for marginalized groups, emphasize the need for integrated, climate-resilient systems that safeguard both infrastructure and vital public healthcare services.