Health system strategies for adaptation to drought: A global scoping review

Drought poses substantial risks to population health and to the capacity, continuity, and performance of health systems. This scoping review aimed to systematically identify, map, and categorize the available evidence on health-system adaptation strategies for drought and to highlight major gaps in the evidence base.

Following JBI guidance for scoping reviews and the PRISMA-ScR reporting guideline, Web of Science, PubMed, Scopus, Google Scholar, and selected gray-literature sources were searched without date restrictions up to March 2025. Two reviewers independently screened records and full-text sources against predefined eligibility criteria. Data were charted using a standardized form and analyzed through inductive qualitative content analysis and thematic categorization. Critical appraisal was conducted to describe the methodological characteristics of the included evidence and support cautious interpretation; appraisal findings were not used as exclusion criteria.

Of the 7,334 records identified, 36 evidence sources met the eligibility criteria and were included. The evidence base comprised peer-reviewed studies and reviews, a book chapter, an institutional report, and gray-literature documents. Thematic categorization identified ten domains: assessment and monitoring; mental health and social support; water-resource management; food security and agriculture; health-infrastructure resilience; intersectoral coordination and governance; education and awareness; emergency response and crisis management; innovation and technology; and economic support and policy.

This review provides a structured map of reported health-system adaptation strategies for drought and demonstrates the breadth and multidimensional nature of the available evidence. However, evidence regarding implementation, effectiveness, scalability, and applicability in low-resource settings remains limited.