# Socio‐Ecological Factors Influencing Maternal and Child Health Outcomes During Floods in South Punjab Pakistan 2025: A Mixed‐Methods Approach

## TL;DR

This study explores how floods in South Punjab, Pakistan, in 2025 impacted maternal and child health through socio-ecological factors and access to healthcare.

## Contribution

The study combines quantitative and qualitative methods to reveal new insights into flood-related maternal and child health challenges in South Punjab.

## Key findings

- Limited clean water, food insecurity, and displacement significantly hinder maternal healthcare access.
- Qualitative analysis shows reliance on informal networks and environmental pollution as major issues.
- Mobile healthcare and community training are recommended to improve maternal and child health outcomes.

## Abstract

South Punjab, Pakistan, is located approximately nearby the Indus and Chanab rivers. Heavy monsoon and climate change make the situation worse every year, and these areas suffer from severe flooding. Millions of people face challenges in accessing the medical facility, hindered resource availability, damaged infrastructure and a potentially increased socio‐ecological problem.

The prime objective of the study was to examine socio‐ecological factors, hurdles to access healthcare facilities, and family coping methods that impact the child's and mother's health during the flood.

We used the mixed‐method approach, including a quantitative survey of 560 women aged 18–49 that lived in the flood‐affected region (Bahawalpur, Multan and Muzaffargarh) and thematic analysis of 42 participants with in‐depth interviews performed by using NVivo software. Binary logistic regression was used to analyse predictors of maternal healthcare challenges. All statistical analyses were performed using SPSS‐26 and R‐Studio.

Primary conclusive challenges to access to maternal healthcare are limited access to clean water (OR = 3.239, CI: 1.494–6.561, p = 0.01), food insecurity (OR = 3.239, CI: 1.378–7.604, p = 0.01) and displacement (OR = 2.792, CI: 1.798–6.013, p = 0.01). Qualitative themes highlight dependence on informal networks, environmental pollution, and institutional overload.

Water scarcity, food insecurity, and displacement significantly affected maternal and child health during the 2025 flood. Nutritional supplies, mobile healthcare and community training must be prioritised. Equitable health policies must be supported by future research into longitudinal recovery.

This mixed‐methods study examined the socio‐ecological factors affecting maternal and child health during the 2025 Punjab floods in Pakistan. This proves the statistical validity and illustrates diverse scenarios with quantitative and qualitative data. We learnt that health and environmental issues intersect. The quantitative survey began with 597 participants, 18–49‐year‐old women from flood‐ravaged South Punjab (Multan, Bahawalpur and Muzaffargarh). After eliminating 37 incomplete or inaccurate responses, 560 respondents remained. Their contribution is necessary for shaping the study design. Eight of the 50 participants in the qualitative phase declined or dropped out of the study. The final qualitative sample included 42 hospitals, public/private relief camps, roadsides, and school respondents. A qualitative study is used for thematic analysis to reach out to the reason behind the family being displaced from their homes. They strengthened the case for maternal and child health recommendations and helped identify flood victims.