Effects of flooding on women’s access to sexual and reproductive health services in Kasese district, Uganda

Flooding, one of the most frequent and severe consequences of climate change, has become an increasingly serious challenge, especially in developing countries. In Uganda, Kasese District experiences recurrent riverine and flash floods, which result in economic, social and geographical constraints limiting access to sexual and reproductive health services, particularly for women. This study examined the effects of flooding on women’s access to sexual and reproductive health services in Kasese District. The study employed a mixed-methods approach, integrating both qualitative and quantitative techniques. For the qualitative component, 28 in-depth interviews were conducted with purposively selected participants. The quantitative component involved a cross-sectional survey using a structured questionnaire, administered to 192 respondents aged 15–49 years. The results indicated that both women’s education level and income were significantly associated with access to SRH services. Furthermore, flooding severely disrupted women’s access to SRH services through the destruction of health facility infrastructure (aOR = 0.08; 95% CI: 0.02–0.44; p = 0.004), compromised privacy, dignity, and security (aOR = 0.16; 95% CI: 0.03–0.88; p = 0.034), and interruption of community health outreaches integrating SRH services (aOR = 0.15; 95% CI: 0.03–0.72; p = 0.018). These findings highlight the need for the government, through the Ministry of Health (MoH) and other stakeholders, to prioritize integrating comprehensive SRH service packages into flood preparedness and response mechanisms and to flood-proof health systems against flood-related damage.