About Shahar Livne

Shahar is a PhD candidate and lecturer at the School of Public Health and the Tamar Golan African Studies Center at Ben Gurion University (BGU) in Israel. Her doctoral research examines the nexus between extreme weather events, health, and food insecurity using a mixedmethods design, with a particular focus on understanding climate change experiences within communities and health services in rural Malawi. Since 2020, she has conducted fieldwork in Malawi through a collaborative partnership with Partners in Health/Abwenzi Pa Za Umoyo (PIH/APZU), examining how cycles of extreme weather events shape the lived experiences of rural communities and healthcare providers. Additionally, for the last two years, she has been an active member of GAPS, an international and multidisciplinary research group focusing on disasters in the Malawian context, and the German “Lifeworlds in Crisis” research group, which uses a social science lens to research crises in the African context.

Research Title

The Continuity of Health System Response to Climate-Induced Food Insecurity in Malawi: Bridging Acute and Slow Onset Hazards with Routine Care

Abstract

For the last decade, Malawi has declared annual states of disaster, primarily driven by climatic hazards. The Southern Region has suffered successive devastation from Cyclone Ana in 2022 and Cyclone Freddy in 2023, followed by the 2024-2025 El Niño-induced drought. Given that 70% of Malawians rely on subsistence farming, this drought has already affected 9 million people, threatening both livelihoods and nutrition. Healthcare providers have historically played a central role in responding to severe food insecurity, with interventions range from hospital-based therapeutic care to community sensitization on food diversity and targeted nutrition support for at-risk groups like pregnant and lactating mothers, and displaced populations. However, the prevailing research paradigm often compartmentalizes health system responses based on single hazard types, neglecting how risk perceptions and interventions evolve across multiple, overlapping crises. There is a lack of understanding of how the healthcare workforce internalize and adapt to the shifting food insecurity landscape across the temporal spectrum of multi-hazards.

This research addresses this gap by moving beyond hazard specificality to explore the continuity of health interventions across the disaster-to-routine care spectrum. Moving beyond a disaster-centric view that treats food insecurity risks in a narrow case-study manner, this research links responses across the full continuum: acute disasters (Cyclones Ana and Freddy), slow-onset hazards (2024 drought), and routine malnutrition care in facilities and communities. The recent crisis period in Malawi provides a crucial context to explore this continuum from the perspectives of both healthcare providers and affected communities.

This mixed-methods study is based on data collected during 2024. A cross-sectional survey of 370 households and 146 healthcare providers in two disaster affected districts of Malawi, and 53 in-depth semi-structured interviews of 20 community members and 33 healthcare providers across different levels of the local health system. The findings will provide empirical evidence to inform the design of adaptive nutrition programming that moves beyond episodic responses, aligning with the all-hazards approach promoted by the Sendai Framework for Disaster Risk Reduction and Sustainable Development Goal 2.