Enduring the storm - A qualitative examination of primary healthcare providers' journeys through disasters

Background

Climate change is increasingly intensifying the frequency and severity of extreme weather events worldwide, with Low- and Middle-Income Countries bearing a disproportionate share of its health and social consequences. India ranks among the ten countries most affected by climate change, and has experienced over 400 extreme weather events between 2022 and 2025, resulting in an estimated 80,000 fatalities. Odisha, an east‑coastal state of India, is particularly vulnerable due to its geographic exposure and has endured more than ten cyclones in the past decade, alongside recurrent flooding. These climate‑related disasters have contributed to substantial disease burden, disrupted essential services, and exacerbated existing vulnerabilities within the health system.

Primary healthcare providers, who operate at the forefront of disaster response and recovery, often face prolonged exposure to psychological challenges and burnout due to heightened workloads during and after such events. Despite this, existing research in India has largely focused on infrastructure damage, service disruption, and health system preparedness, with much of the broader evidence base originating from high-income settings. There remains a critical gap in understanding the lived experiences and impact of climate related disasters on mental health and wellbeing of primary healthcare providers, who play dual role of responders as well as victims of such events. Addressing this gap is essential to inform contextually relevant interventions and strengthen health system resilience in disaster-prone regions.

Aims

To prioritise primary healthcare workers’ well‑being during and after climate‑related disasters, the study will:

• Explore the lived experiences of primary healthcare workers with the context of persistent cyclone and riverine flood risk in Odisha.
• Understand the coping strategies adopted by healthcare workers (HCWs) in managing stress under crisis conditions.
• Map existing support mechanisms and identify needs from the perspectives of healthcare workers and key system-level stakeholders involved in disaster planning and response.

Research methodology

• Study design: A qualitative study using in-depth interviews and focus group discussions to understand the lived experiences and mental health impacts of climate-related disasters on primary healthcare providers.
• Study setting: The study will be conducted in disaster-prone blocks (Bhograi, Baliapal, and Basta) of Baleshwar district, Odisha, with selected Primary Health Centres affected by recent floods and cyclones.
• Participants: Primary healthcare workers across cadres (doctors, nurses, paramedics, Accredited Social Health Activists, Auxiliary Nurse Midwives, Community Health Officers) and key stakeholders will be selected using purposive sampling.
• Data analysis: Interview recordings will be transcribed, translated, and qualitative data analysis will be conducted.