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.

Introduction: Climate change, a global challenge with diverse manifestations, is often studied as a homogeneous phenomenon. Yet, different climate-change-induced hazards have differentiated implications for health system disruptions, social vulnerabilities, and reduced access to care. Understanding these links from a gendered perspective remains an urgent need. This study assesses the impacts of different hydro-meteorological hazards on gender-based violence (GBV) in India, identifying spatial hotspots where exposure converges with different forms of GBV. Our conceptualisation of GBV goes beyond traditional notions that focus on Intimate Partner Violence (IPV) to include the violation of rights in terms of early marriage or reduced access to reproductive health services. Materials and Methods: Data on exposure to extreme hydro-meteorological hazards and women's wellbeing are obtained from India's Council on Energy, Environment, and Water (CEEW) and the fourth and fifth rounds of the National Family Health Survey (NFHS), respectively. Hotspots with high climate exposure and GBV were identified through geospatial analysis. The association between different hydro-meteorological hazards and GBV was determined through pooled logistic regression analysis. Results: Exposure to cyclones, a sudden-onset hazard, is associated with a higher likelihood of dropout from the minimum recommended Antenatal Care (60 %), while exposure to drought, a slow-onset hazard, is likely to increase dropouts by 38 % compared to non-exposure. The likely increase in intimate partner violence (IPV) is similar for drought (26 %) and cyclones (27 %). The impacts of floods are found to be lower on all indicators of GBV, with further in-depth studies of flood-affected areas needed to identify the causes. Districts in northern India are vulnerable to all types of GBV; however, some southern Indian districts are hotspots for girl child marriage and IPV. Discussion: This study shows that the association of hydro-meteorological hazards with GBV varies according to the type of hazard and its potential impacts on economic and livelihood disruptions, displacement, stress, and gender norms. Conclusion: This study indicates the need for hazard-specific targeted interventions from a gendered perspective, particularly in spatial hotspots.