Non-communicable diseases in flood-affected India

Improving primary healthcare for patients with non-communicable diseases during severe flooding in India

Three men pushing a wheeled cart through knee-high floods in India.

India, grappling with the second-highest rates of diabetes and heart disease globally, faces exacerbated challenges during flood emergencies. Patients with chronic conditions often find their access to essential medicines disrupted, leading to worsening health conditions, hospitalizations, and even fatalities.

Funded by the National Institute for Health and Care Research (NIHR), a global health research team led by Dr. Semira Manaseki-Holland of Institute of Applied Health Research (IAHR) at the University of Birmingham, and Dr. Jeemon from Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum together with researchers from other prestigious public health institutions like:

  • Homi Bhabha Cancer Hospital and Research Center, Muzaffarpur
  • Mahavir Cancer Sansthan, Patna
  • Doctors For You-India
  • climate experts from University of Birmingham's School of Geography, Earth and Environmental Sciences
  • and Indian Institute of Technology (IIT), Roorkee

Together with a team of public health experts from prestigious Indian institutions, are developing innovative and integrated healthcare solutions to ensure access to healthcare amidst flood in rural India. The team are working in close collaboration with the Indian state governments of Bihar and Kerala. The work is overseen by an independent advisory steering group consisting of Indian and global experts in health, disaster, climate, and related research methods.

To improve the preparedness and resilience of patients and health systems during flood emergencies in India, this project addresses gaps in healthcare services for long-term conditions such as diabetes, heart, and lung diseases (non-communicable diseases (NCDs). By involving communities, healthcare providers, and stakeholders, the team aims to develop and test a practical, community-focused intervention to strengthen the health system. The initiative includes adapting existing processes, making effective use of digital health solutions, exploring innovative medicine delivery methods, and advancing flood forecasting. The project will be tested in flood-prone areas in Bihar and Kerala with planned adaptability assessments.

In this project we are trying to address the critical gaps in healthcare services exposed during seasonal flooding in India in regards to NCDs such as diabetes, hypertension, and chronic lung conditions. The aims of the project are:

Foster Collaboration with Communities and Health Workers

Doctors and nurses placing their hands on top of each other as a show of support

The team will:

  • Develop guidelines and planning protocols and provide training to the health worker to ensure health centres can prepare for continuation of NCDs related care provision during floods, more systematically. This will enable healthcare professionals to make critical decisions during flood events.
  • Promote culturally enhanced behaviour change and community empowerment to raise awareness and improve preparedness and response to floods among patients.

Ensure Access to Medicine and Diagnostics During Floods           

Access to Medicine new

The team will:

  •  Explore novel methods for delivering essential medicines, such as insulin, to flood-affected communities, and create flood-proof kits. This includes establishing links to existing primary care facilities during periods of flood-induced isolation.

Use Advanced Flood Forecasting

Advanced Flood Forecasting

The team will:

  • Collaborate with hydrologists and climate specialists to develop advanced flood forecasting models tailored to the needs of the healthcare system. This will provide an opportunity to test an integrated timely response model based on climate and healthcare data, contributing to a resilient health system in resource-poor settings.


Methods of Research

To achieve the aims the team will adopt a range of research methods including:

  • Conducting mixed-methods situation analysis.
  • Co-developing interventions through Theory of Change Workshops with communities and stakeholders.
  • Implementing and evaluating the complex-intervention model.

Cross-cutting Objectives

The research will prioritize:

  •  Stakeholder engagement.
  • Capacity building.
  • Comprehensive dissemination.
  • Equitable partnership.
Dr Semira Manaseki-Holland (third from the left) with doctors and researchers participating in the study on non-communicable diseases in flood-affected areas of India.
A flooded road in India with a man in a cycle rickshaw and three people on one motorbike are riding through