Women and their unvoiced health needs.
Image for representation purposes only. Women in Deogarh in the morning, Orissa, India. Image Source: Simon Williams / Ekta Parishad).
Climate change is often discussed in terms of rising temperatures, extreme weather events and environmental degradation. Yet its impacts are also deeply personal. When floods destroy homes, droughts dry up water sources, or cyclones disrupt entire communities, the consequences extend beyond infrastructure and livelihoods. They shape people's health, safety and access to essential services.
For women, these impacts are rarely experienced equally. Existing social inequalities linked to caste, class and gender often determine who bears the greatest burden. In many parts of India, women are responsible for securing water, fuel and food for their households. When climate-related disasters strike, these responsibilities intensify, while access to healthcare and support systems becomes more difficult.
A recent open access study authored by Saif Nihal, Anjali Sharma, Amit Mitra, Soumya Swaminathan and Nitya Rao titled ‘Impacts of climate-induced hydro-meteorological hazards on women’s reproductive and maternal health in India: An assessment of gender-based violence across stages of women's lives, published in The Journal of Climate Change and Health, goes beyond the traditional understanding of GBV to look at how floods, droughts and cyclones can affect rights of women in terms of early marriages, intimate partner violence (IPV), poor reproductive health outcomes or reduced access to reproductive health services.
The study uses two key data sources, namely, district-level data from the Council on Energy, Environment, and Water (CEEW) published in 2021 for 640 districts, and individual-level data from the fourth and fifth rounds of the National Family Health Survey (NFHS) conducted in 2015–16 and 2019–21 for the analysis.
The study found that 40% of the women were exposed to climate change and its associated hazards in India in the timespan of 2010-2019. Of these majority were exposed to droughts, followed by floods and cyclones.
Women affected by different hazards.
The prevalence of girl child marriages was highest among women in hazard-affected areas, followed by a high rate of dropout from the minimum recommended Antenatal checkups (ANC), showing inability to access health care services, exposure to intimate partner violence and experience of miscarriage or stillbirths among women.
Percentage of women affected by climate change
Most districts of Andhra Pradesh, Bihar, and parts of Maharashtra were major hotspots with a high prevalence of girl child marriages while having high exposures to extreme hydro-meteorological hazards such as droughts, floods and cyclones. Parts of southern West Bengal, Madhya Pradesh, Uttar Pradesh and Telangana also found that they showed a high prevalence of girl child marriages in areas that were exposed to hydrometeorological hazards. Prevalence of girl child marriages was also associated with high poverty and low education levels, alongside patriarchal socio-cultural norms.
Girl child marriages by climate hotspots.
The spatial overlap of high IPV and high exposure to extreme hydro-meteorological hazards were particularly clustered in southern India, including Karnataka, Andhra Pradesh, Telangana, Tamil Nadu and parts of Maharashtra. In northern India, parts of Bihar and Uttar Pradesh showed high climate change hotspots associated with IPV. Southern India thus remains a paradox of high IPV with low poverty as well as high levels of women’s education.
Hotspots of Intimate partner violence.
Maternal health indicators such as high miscarriages/stillbirths and dropout from the minimum recommended ANC visits were associated with areas that were high in exposure to hydrometeorological hazards and were concentrated in the states of Uttar Pradesh and Bihar.
Poor maternal health in high hazard areas was concentrated in the northern states of Uttar Pradesh and Bihar.
Compared to floods and droughts, exposure to cyclones leads to a higher level of drop-out from the minimum recommended ANC check-ups, increased prevalence of intimate partner violence (IPV) and marginally higher vulnerability to girl-child marriage and miscarriages/stillbirths.
Droughts were strongly associated with higher levels of gender-based violence. Crop failures, economic losses, resource scarcity and increased workloads placed significant pressure on households and women. Women often had to spend more time collecting water, fuel and fodder, increasing both physical and emotional stress.
Districts exposed to droughts were more likely to report child marriage. Intimate partner violence was 26 percent more likely among women exposed to drought conditions, particularly among those who were financially dependent. The prevalence of miscarriage and stillbirth was 6 percent higher among women exposed to droughts. Researchers link these outcomes to increased workloads, poor nutrition, dehydration, heat stress, hypertension, insomnia and reduced access to healthcare.
Notably, improved water infrastructure alone did not reduce the risks of intimate partner violence, miscarriage, stillbirth or inadequate antenatal care. The study notes that water infrastructure often fails to guarantee reliable access to clean water during prolonged droughts when taps run dry.
As many as 38 percent of women in drought-affected areas did not complete the minimum recommended antenatal care visits. Women from the poorest households faced the highest levels of vulnerability across most indicators.
Cyclones had some of the most severe impacts on women's health and wellbeing. Exposure to cyclones increased child marriage by 10 percent, particularly among the poorest households. Rural women and women belonging to Scheduled Castes emerged as the most vulnerable groups, with floods and cyclones amplifying existing social disadvantages. Intimate partner violence increased by 7 percent among populations exposed to floods and by 27 percent among those exposed to cyclones.
Cyclone exposure was also associated with a 26 percent increase in miscarriage and stillbirth and a 60 percent increase in women missing the minimum recommended antenatal care visits. Floods increased the likelihood of inadequate antenatal care by 7 percent. Women in flood-affected areas also faced heightened risks of vaginal infections, adding another dimension to reproductive health challenges during extreme weather events.
The study argues that climate adaptation policies must move beyond treating women as a single vulnerable category. Different hazards create different risks, requiring responses that are tailored to specific contexts.
For cyclone-prone regions, ensuring continuity of reproductive healthcare services during and after disasters should be a priority. Measures to prevent and respond to gender based violence must also be strengthened.
In drought-affected regions, long-term investments are needed to improve healthcare access, strengthen community resilience and address the underlying social and economic factors that contribute to child marriage and gender-based violence.
For flood-prone areas, researchers call for deeper investigation into the social and environmental factors driving gender-based violence and reproductive health challenges.
The study highlights an important reality: climate disasters do not simply damage infrastructure or disrupt economies. They also shape the health, safety and futures of women in profound ways. The findings demonstrate that climate vulnerability is closely intertwined with social inequality. Rural women, women from poorer households and Scheduled Caste communities often face the greatest risks, not only from the hazards themselves but also from limited access to healthcare, education and social support.
As climate-related disasters become more frequent and intense, building resilience will require more than disaster preparedness. It will demand policies that recognise how different hazards affect women across their lives and address the structural inequalities that make some communities far more vulnerable than others. Only then can climate adaptation become truly inclusive and equitable.