Extreme weather events (EWEs) across the world are becoming increasingly frequent and severe due to climate change, posing significant challenges across various sectors.
The impacts are particularly acute for low- and middle-income countries (LMICs) like India, where limited adaptation capacities are compounded by socioeconomic pressures such as poverty, land degradation, and inadequate public health infrastructure. Rural communities, heavily reliant on climate-sensitive resources like water and food, are at the forefront of this crisis. Continuous droughts, floods, and declining agricultural productivity are worsening existing health challenges, including chronic illnesses, infectious diseases, injuries, and mental health issues. These vulnerabilities intersect with geographical isolation, economic instability, and social inequities, creating a complex web of challenges for rural India.
The backbone of rural healthcare in India is its network of primary care providers (PCPs), including doctors, nurses, and community health workers. However, these facilities are often under-resourced and ill-equipped compared to their urban counterparts. When EWEs strike, the delivery of essential services is disrupted, straining an already fragile health system. In climate-vulnerable states, the situation is dire. Frequent and severe weather events overwhelm healthcare systems, increase disease burdens, and amplify socioeconomic inequalities. Without urgent interventions, the gap between urban and rural health outcomes will continue to widen.
Impact of EWEs in rural areas
EWEs, therefore, significantly impact health outcomes and healthcare systems, particularly in rural and remote areas, by worsening illness burdens and disrupting access to care.
A 2024 systematic scoping review of 135 studies across 31 countries titled A Scoping Review of the Impact of Extreme Weather Events on Health Outcomes and Healthcare Utilization in Rural and Remote Areas, revealed a sharp rise in respiratory disorders, malnutrition, mental health issues, and vector-borne diseases after floods, storms, and droughts. While these immediate health crises demand urgent attention, secondary effects—such as displacement, poverty, and damaged healthcare infrastructure—further restrict access to routine and emergency care. Supply chain disruptions in remote areas leave patients with chronic conditions vulnerable to untreated illnesses, and financial pressures force many families to defer or neglect healthcare due to rising out-of-pocket costs.
Furthermore, marginalised groups, such as women and indigenous communities, bear a disproportionate share of these burdens. The Center for Strategic and International Studies in one of their lessons in India from 2024 stated that women face increased risks of displacement, gender-based violence, and caregiving responsibilities during crises, while indigenous communities grapple with the loss of livelihoods and food insecurity due to their dependence on climate-sensitive resources. Though critical, social support systems in rural areas are often constrained by economic limitations and lack of comprehensive policy frameworks. While communities often organise collective efforts to adapt to health challenges, their resilience remains limited without adequate government support.
India and climate change impact
India has implemented several policy measures to address climate change and its associated health risks. The National Action Plan on Climate Change (NAPCC) and its complementary programmes, such as the National Health Mission and Pradhan Mantri Ujjwala Yojana (PMUY), represent significant steps forward. These initiatives aim to reduce health risks associated with environmental degradation by improving access to clean water, healthcare, and clean cooking fuel.
However, these efforts often fall short of addressing the intersecting vulnerabilities faced by rural communities. The National Action Plan on Climate and Health, though well-intentioned, lacks sufficient community participation and fails to address local adaptability. Furthermore, the lack of integration between national policies and state-level implementation has hampered progress.
To strengthen rural India’s healthcare systems in the face of climate change, a multi-faceted approach is essential. Community-centered interventions must be prioritised, ensuring that local populations are actively involved in designing health programmes. Tailored public health campaigns, combined with protective behavioural strategies, can help rural communities adapt to the health challenges posed by EWEs. Building resilience also requires significant investments in healthcare infrastructure. Primary healthcare centers need enhanced resources, including personnel, medical supplies, and emergency protocols, to manage the increased demand during extreme weather events.
Climate change awareness
Education and training for healthcare providers are equally critical. By incorporating climate change awareness into medical education, healthcare professionals can be better equipped to address climate-related risks. Real-time surveillance and early warning systems must also be developed to identify vulnerable populations and provide timely alerts during EWEs. These systems should integrate local vulnerability indices to enable proactive responses and ensure that healthcare interventions reach those most in need.
Inclusive and equitable policies are fundamental to climate resilience in rural healthcare. Vulnerable groups, particularly women and Indigenous communities, must be at the centre of these efforts. Gender-sensitive strategies and the inclusion of indigenous knowledge can bridge gaps in healthcare access and strengthen community resilience. Collaboration across health, environmental, and social sectors is vital to address the broader determinants of health and create a coordinated response to climate challenges.
India’s rural healthcare system is at a critical juncture. Climate change threatens to worsen existing vulnerabilities, widening the gap between urban and rural health outcomes. Strengthening healthcare systems to withstand the impacts of EWEs is not just a matter of public health but a social and economic imperative. By adopting inclusive, community-centered, and adaptive strategies, rural India can mitigate the health impacts of climate change and ensure a more equitable and resilient future. The time to act is now, as building climate-resilient healthcare systems is about survival and empowering communities to thrive in an uncertain world.
Moumita Barman is a Research Associate at the Centre for Development Policy and Practice (CDPP) in Hyderabad. CDPP is an independent research organisation working to influence public policy with focus on the development of vulnerable populations.
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