The figure illustrates the complex interplay between climate extremes, such as floods and heatwaves, and their impacts on the health system's supply, demand, and overall performance. Climate extremes are represented in a red cluster labeled "Climate Extremes (Floods and Heatwaves)," detailing specific impacts such as facility damage, contaminated water, travel disruption, dehydration, power grid strain, and workforce fatigue. These events directly affect core elements of the health system, creating significant challenges for both the supply and demand of healthcare services. Climate Extremes and Their Direct Effects Flood impacts, such as facility damage, directly strain healthcare infrastructure by reducing the operational capacity of health facilities and disrupting service delivery. Similarly, floods displace health workers, disrupt supply chains, and lead to delays in accessing critical medical products. Contaminated water sources exacerbate health and nutrition risks, increasing the prevalence of waterborne diseases. On the other hand, heatwaves pose a different set of challenges, such as dehydration, which overwhelms healthcare facilities, and power grid strain, which jeopardizes cold storage for vaccines and other medical supplies. Workforce fatigue caused by prolonged exposure to extreme heat further reduces staff productivity and availability, directly impacting service delivery. Impacts on Health System Supply The blue cluster, representing System Dynamics Model (SDM) components, captures key supply-side factors such as infrastructure, medical products, the health workforce, financing, and health information systems. These components are interconnected with service delivery, which is directly influenced by disruptions in infrastructure, workforce availability, and medical supply chains. For instance, facility damage caused by floods affects infrastructure and service delivery, while supply chain disruptions limit access to medical products. Impacts on Health System Demand The green cluster, representing Agent-Based Model (ABM) components, focuses on demand-side factors such as health and nutrition risks, behavioral factors, demographics, and population state. For example, contaminated water during floods increases health and nutrition risks by spreading waterborne diseases, while dehydration caused by heatwaves leads to higher healthcare utilization. Behavioral challenges, such as delays in seeking healthcare due to extreme heat or restricted mobility caused by travel disruptions during floods, further exacerbate demand-side pressures. Systemic Interactions and Governance The yellow cluster, labeled as Hybrid (ABM-SDM), acts as a bridge between supply and demand, capturing systemic interactions such as workforce optimization, efficient medical product management, and integrated financing. These hybrid components reflect the combined influence of systemic supply-side and demand-side factors on critical outcomes, such as maternal and child health (MCH) service utilization. For instance, disruptions in workforce availability due to climate extremes feed into workforce optimization challenges, while financing systems are strained by increased emergency spending. Feedback Loops and Indirect Impacts Dashed red arrows in the figure represent indirect impacts and feedback loops. For example, facility damage caused by floods can exacerbate governance challenges, such as coordination gaps and delayed responses, which further strain systemic interactions and financing. Similarly, workforce fatigue during heatwaves reduces direct service delivery capacity and affects leadership and governance by delaying decision-making. These feedback loops highlight how systemic weaknesses compound the direct impacts of climate extremes, reducing the health system’s resilience.