Abstract for: Building Resilience to Floods and Heat in Brazil’s Maternal and Child Health System: The Case of Palmares/Pernambuco

This article presents initial modelling work as part of the REACH project, aimed at strengthening maternal and child health systems in Brazil and Zambia. Using system dynamics, it explores how climate-related shocks affect health system capacity, service utilization, and recovery, providing insights to support preparedness and improve responses to extreme weather events. Data were collected through interviews, focus groups, and field visits to understand local context and perceived impacts. The CLD will be simplified to enable model development. Key variables will be selected, and additional sectors, including demographics and healthcare financing, will be incorporated to support a comprehensive system model. The CLD highlights the impacts of floods and heatwaves on health systems. Floods disrupt road access, affecting service utilization and increasing demand due to fear and disease risks. Heatwaves reduce service availability, particularly for outdoor activities, and increase vulnerability to heat-related illnesses. They also hinder access to health facilities, contributing to reduced continuity and utilization of care. Service supply will be disaggregated into physical capacity, workforce, and operational functionality to capture differential impacts of climate shocks. Antenatal care and delivery will be modeled separately due to their distinct temporal dynamics. Some variables, such as risk perception and behavioral responses, will not be included directly in the initial model but incorporated indirectly through measurable constructs, ensuring parsimony while preserving key system dynamics. Translation tool