UNDERSTANDING PUBLIC HEALTH AND HEALTH SYSTEM RESPONSIVENESS DURING THE 2022 FLOODS IN SINDH: LIVED EXPERIENCES, CHALLENGES, AND THE WAY FORWARD

Abstract

With Sindh Province suffering unequal public health effects, the 2022 floods in Pakistan set off a statewide humanitarian disaster. This qualitative study investigates the response of public health services during the floods via the lived experiences of affected populations and frontline health workers in Khairpur (Faiz Gunj, Thari Mirwah, Kotdiji) and Naushehro Feroz districts. Forty people—including displaced people, lady health professionals, civil society responders, and local healthcare administrators—were purposefully sampled and interviewed in depth. The intricate interaction between disaster impact and health system responsiveness was captured by thematically analysing data. Results show structural and operational weaknesses such as rundown rural health facilities, insufficient mobile health units, severe lack of clean drinking water, medications, and qualified staff members, and postponed emergency response systems. Participants noted major waterborne illness epidemics including diarrhoea, malaria, and skin infections. Marginalised groups—especially women, children, and the elderly—were disproportionately impacted; women lacked reproductive health services during displacement. Consistent disparities in government, infrastructure, and inter-agency cooperation showed themselves despite NGO efforts and community resiliency. It is recommended that the pressing need to localize health governance changes and institutionalize disaster preparedness inside Sindh's public health system to reduce next climate-induced disasters.