{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T19:32:11Z","timestamp":1790364731373,"version":"4.1.0"},"reference-count":60,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"unspecified","delay-in-days":15,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/igo\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2024,3,6]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>Malawi\u2014one of the low-income countries in Africa\u2014has witnessed a series of flood-related disasters in many years. The recent tropical cyclone Freddy (TCF) has indispensable effects on the unequal distribution of the social determinants of health with tendencies for increased disease outbreaks across the districts of the country. This narrative study aimed at unravelling the consequences of the TCF and its possible relationship with the already existing cholera epidemic in the fourteen affected districts. Additionally, it aimed to document the immediate humanitarian responses in the acute phase of the disaster. We identified, used and extracted information and data from relevant documents available from the government records, WHO and other multiagency documents, which were summarised along with the humanitarian actions and the associated implications of the entire event. Areas of TCF\u2019s main effects included health, shelter, education, nutrition, water sanitation and hygiene, agriculture and livelihood, transport and logistics including food security. The notable immediate humanitarian responses are donations, camp creation for accommodations, emergency life-saving response and essential healthcare services. Nsanje and Chikwawa districts experienced an increase in cholera cases and deaths post-TCF. The highest proportion of the disaster-impacted and intervention beneficiaries were women and children. The effects of the TCF on the social determinants of health in the affected districts and the associated negative impacts should be considered by the government and disaster management experts in evidence-based policy-making towards disaster risk reduction in the flood-prone districts using an all-hazard approach. This step might be useful in improving the vulnerable population\u2019s standard of living and achievement of related Sustainable Development Goals in Malawi.<\/jats:p>","DOI":"10.1136\/bmjph-2023-000512","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T13:21:01Z","timestamp":1713273661000},"page":"e000512","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Effects of tropical cyclone Freddy on the social determinants of health: the narrative review of the experience in Malawi"],"prefix":"10.1136","volume":"2","author":[{"given":"Fiona","family":"Braka","sequence":"first","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebenezer Obi","family":"Daniel","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6696-8503","authenticated-orcid":false,"given":"Joseph","family":"Okeibunor","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"},{"name":"Department of Sociology\/Anthropology, University of Nigeria, Nsukka, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neema Kimambo","family":"Rusibamayila","sequence":"additional","affiliation":[{"name":"World Health Organization Country Office, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9200-189X","authenticated-orcid":false,"given":"Ishata Nannie","family":"Conteh","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Otim Patrick Cossy","family":"Ramadan","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne","family":"Byakika-Tusiime","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chol Thabo","family":"Yur","sequence":"additional","affiliation":[{"name":"Nairobi Hub Emergency Preparedness and Response Programme, World Health Organization, Nairobi, Kenya"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel Maurice","family":"Ochien","sequence":"additional","affiliation":[{"name":"World Health Organization Country Office, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Kagoli","sequence":"additional","affiliation":[{"name":"Ministry of Health, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Chauma-Mwale","sequence":"additional","affiliation":[{"name":"Public Health Institute of Malawi, Lilongwe, Malawi"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Chamla","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdou Salam","family":"Gueye","sequence":"additional","affiliation":[{"name":"Emergency Preparedness and Response Programme, World Health Health Organization Regional Office for Africa, Brazzaville, Congo"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"2025083109551909000_2.1.e000512.1","unstructured":"World Health Organization Global Task Force on Cholera Control . 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