Living through Cyclone Freddy: "Gendered Health Impacts and Coping Responses in Malawi".

Malawi has increasingly faced severe climate-related disasters, with Cyclone Freddy in 2023 among the most devastating in the country's history. While disasters are often considered gender-neutral events, their impacts are shaped by gendered social roles and structural inequalities, resulting in differentiated experiences among women and men.This study examined the gendered health impacts and the responsiveness of humanitarian interventions during and after Cyclone Freddy in Malawi. We conducted a cross-sectional qualitative study in Blantyre (urban) and Chiradzulu (rural) districts between August and September 2024. Forty-six in-depth interviews were held with survivors, complemented by eight key informant interviews with representatives of governmental and non-governmental organizations involved in the response. Thematic analysis was applied to explore gender-specific experiences, health challenges, and perceptions of response efforts. Findings revealed significant gendered disparities. Women reported heightened loss of reproductive health services, and severe disruption to menstrual hygiene management and exposure to gender-based violence. Maternal health needs were largely unmet, and mental health services were delayed and under-resourced, exacerbating psychological distress among women and girls. Men primarily emphasized loss of livelihoods contributing to psychological distress linked to provider roles. While some humanitarian actors adopted gender-responsive measures, such as dignity kits and separate sanitation facilities, these efforts were inconsistent, often reactive, and limited by funding and planning gaps. Cyclone Freddy underscored the urgent need for gender-sensitive disaster preparedness and response frameworks in Malawi. Integrating gender considerations into health, protection, and recovery strategies is essential to mitigate inequitable impacts across all genders.