ABSTRACT:
Floods are increasing in frequency and severity across Southern Africa, severely affecting public health through increased transmission of waterborne and vector-borne diseases. Lupane District in Zimbabwe, characterised by highly variable rainfall, fragile infrastructure, and dispersed rural settlements, faces recurrent flooding whose health impacts remain under-studied. Guided by the IPCC (2022) risk framework, this study maps flood vulnerable and assesses associated health risks to inform equitable, climate-resilient planning. The core methodology involves Spatial Multi-Criteria Decision Analysis (SMCDA), utilizing the Analytical Hierarchy Process (AHP) to systematically derive relative weights for all input criteria. For Hazard dimension, historical flood extents derived from Sentinel-1 SAR is used and water-extent mapping using the AWEISH index. Sensitivity is modelled using population density and gender ratio. Exposure is modelled using proximity to water bodies and elevation. Finally, Adaptive Capacity is assessed using road network density and proximity to Primary Health Care Facilities. Results reveal that the most vulnerable areas occur along low-lying alluvial plains, especially in wards bordering seasonal rivers, where high exposure intersects with weak housing structures and limited access to health facilities. The integration of climate, environmental, and socio-demographic data demonstrates how climate-driven flood hazards amplify pre-existing health inequities. This study provides actionable evidence to guide district-level disaster planning, health resource allocation, and climate adaptation strategies. It underscores the need for targeted interventions, such as resilient infrastructure, early warning systems and community-based preparedness, to reduce climate-related health risks in rural Zimbabwe.