Turning risk into resilience through flood insurance uptake and the adaptive capacity of urban households in Accra

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Amankwaa, Melissa Forson, Yaw Agyeman Boafo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7557493/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 13 You are reading this latest preprint version Abstract Flooding in Accra is a recurrent hazard, intensified by rapid urbanization, inadequate infrastructure, and climate variability. Enhancing the adaptive capacity of urban households is essential for reducing vulnerability, with insurance emerging as a key but underutilized risk transfer mechanism. This study investigates household perceptions of flood insurance in Accra, explores determinants of uptake among vulnerable populations, and assesses its potential to strengthen resilience. Using a mixed-methods approach, data were collected through 120 household surveys in flood-prone communities and three in-depth interviews with local government officials and an insurance executive. Results reveal low awareness and limited understanding of flood insurance, with many respondents unaware of available products or their benefits. Key determinants of uptake included awareness of flood risk and the perceived affordability of premiums. Despite low penetration, respondents recognized the potential value of insurance in reducing post-disaster losses. The study highlights that for flood insurance to contribute meaningfully to adaptive capacity, targeted interventions are required: increased public education, policy incentives to make premiums affordable, improved access to flood risk information, and efforts to build trust between insurers and communities. By framing insurance as a complement to other adaptation strategies, this research underscores its potential to strengthen urban resilience in Ghana and comparable African contexts. These findings provide evidence for designing inclusive, context-sensitive flood risk management strategies that integrate financial instruments into broader adaptation planning. Flood risk risk transfer flood insurance adaptive capacity urban resilience Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 1. Introduction Flooding remains one of the most critical natural hazards confronting human populations globally, posing a substantial threat to national development and urban resilience. The intensification of climate change and rapid, often unplanned, urbanization continues to exacerbate flood risks, particularly in densely populated areas (Rentschler et al., 2024). Poorly managed urban growth contributes significantly to this challenge by altering natural drainage systems and increasing surface runoff through the proliferation of impermeable structures such as roads and pavements (Amankwaa et al., 2024 ; Douglas et al., 2008 ). In urban environments, heavy rainfall, overflowing drainage systems, and storm surges frequently lead to infrastructure and property damage, water pollution, and disruptions to livelihoods and local economies (Gough et al., 2019 ; IPCC, 2014 ; Kayaga et al., 2021 ). Flooding is therefore not merely a hydrological problem but a deeply social and political challenge that reflects inequalities in planning, governance, and access to protection. Recent global flood events underscore the scale and consequences of the hazard. In the summer of 2021, parts of Germany, Belgium, and the Netherlands experienced catastrophic floods that claimed over 180 lives, injured 750 people, and destroyed infrastructure (Lehmkuhl et al., 2022 ). Similarly, the 2022 floods in Pakistan described as the worst in the nation’s history –affected 33 million people, destroyed more than a million homes, and resulted in over 1,100 deaths (Clarke et al., 2022 ). African cities, too, have increasingly been impacted by flash floods, overflowing rivers and blocked drainage channels. Between 2008 and 2020, West Africa witnessed recurrent flooding that devastated agriculture, water sources, infrastructure, housing, and health (Amankwaa and Gough, 2023 ; Codjoe et al., 2020 ; Gough et al., 2019 ; UNESCO, 2023 ; Wilby et al., 2021 ). Ghana has encountered some of its worst floods in recent decades, notably in 2007, 2010, 2011, 2015, and 2020, especially affecting large urban centres such as Accra (Owusu and Obour, 2021 ). In June 2015, a major flood and fire event in Accra claimed over 150 lives; displaced 8000 people, and destroyed built structures to the value of millions of dollars (Amankwaa and Gough, 2023 ). These examples demonstrate that flooding is not only a recurrent hazard but also a stress-test of cities’ ability to plan, adapt, and protect their most vulnerable populations. As the frequency and intensity of climate-induced events grow, the imperative for climate adaptation becomes even more urgent (Boafo et al., 2025a ; IPCC, 2022 ). Adaptive capacity refers to the ability of individuals or systems to design and implement effective adaptation strategies in response to evolving climate-related risks, thereby minimizing harmful outcomes (Boafo et al., 2025b ; Brooks and Adger, 2005 ). This capacity is shaped by access to economic and natural resources, social networks, governance structures, human capital and technology. Flood risk mitigation strategies are typically categorised into structural and non-structural measures. Structural interventions include embankments, levees, flood walls, reservoirs, detention basins, drainage improvements, and afforestation, whereas non-structural strategies encompass flood zoning and proofing, early warning systems, land use regulations, and flood insurance as a means of risk transfer (Cashman et al., 2018 ). While structural solutions often dominate urban flood management, non-structural measures like insurance have gained increasing prominence in academic and policy debates because they directly address residual risks that cannot be engineered away. Insurance has emerged as a vital instrument for building both physical and financial resilience to climate hazards. Jarzabkowski et al. ( 2019 ) argue that a comprehensive adaptation framework must integrate financial tools like insurance to manage residual risks that cannot be prevented. The lack of accessible insurance solutions often creates a financial protection gap, forcing individuals, governments, and humanitarian organizations to absorb the full cost of disasters – worsening post-disaster recovery and socio-economic vulnerability. As Cashman et al. ( 2018 ) note, limited adaptive capacity only amplifies the visible impacts of climate hazards, making vulnerable populations even more susceptible to loss and hardship. In this sense, insurance is not simply a financial product but part of the broader political economy of adaptation, shaping who bears the costs of climate impacts and who is left behind. In Ghana, existing literature on household adaptation to flooding has primarily focused on coping strategies, adaptation choices, adaptive governance, and their effectiveness (Boafo et al., 2025a , 2025b ; Owusu and Obour, 2021 ; Twerefou et al., 2019 ). However, the role of flood insurance as a non-structural risk transfer mechanism has received limited attention. Antwi-Bosiako (2016) examined insurers’ responses to flood risk mitigation, while Jegede et al. ( 2020 ) assessed the role of policy frameworks in enabling insurance-based adaptation. Yet, these studies fall short of analysing how risk transfer through flood insurance can build household-level adaptive capacity, particularly among vulnerable urban populations. This gap is significant because financial protection is increasingly recognised as a cornerstone of climate resilience, but its real-world uptake and accessibility in African cities remain poorly understood. This study addresses this gap by exploring urban households’ perceptions of flood insurance in Accra, identifying key determinants of flood insurance uptake, and examining the potential of flood insurance to strengthen the adaptive capacity of vulnerable residents. By highlighting barriers to insurance access and trust, this study contributes to the growing discourse on risk transfer in urban flood management and offers practical insights to improve climate resilience in Ghana’s urban centres – especially among low-income communities most at risk. According to Jarzabkowski et al. ( 2019 ), insurance fundamentally functions as a financial arrangement in which a specified risk is transferred from the insured to the insurer, thereby enhancing the insured’s capacity to withstand financial shocks resulting from disastrous events. In flood-prone urban environments like Accra, insurance offers a potential risk management product that can help vulnerable households absorb and recover from climate-induced losses. By situating flood insurance within broader adaptation debates, this research highlights its dual role as both a financial instrument and a social contract that can either reinforce or reduce existing inequalities in urban resilience. 2. Rethinking Risk Transfer: Innovations and Challenges in Insurance for Urban Flood Resilience In an era of escalating climate hazards, insurance-based risk transfer mechanisms are gaining prominence as critical instruments for enhancing resilience to flood-related disasters, particularly in vulnerable urban settings. Traditionally seen as a post-disaster recovery tool, insurance is increasingly framed within a risk governance paradigm that prioritizes anticipatory action, financial preparedness, and inclusive adaptation (Maj et al., 2024 ; Wilkinson et al., 2020 ). However, its implementation in developing countries, including Ghana, remains limited due to affordability, poor integration into policy, and weak financial literacy (Antwi-Bosiako, 2016). At its core, climate risk insurance is designed to provide timely, contractually agreed payouts in response to climate shocks. According to Cashman et al. ( 2018 ), such instruments shift the focus from reactive aid to anticipatory planning, and when combined with reinsurance and risk pooling, offer systemic buffers against widespread losses. Yet the low insurance penetration across much of sub-Saharan Africa points to structural barriers in market development, including lack of data, pricing uncertainties, and limited product relevance to low-income households (Antwi-Bosiako, 2016). Recent scholarship expands this view by emphasizing parametric insurance and index-based models as innovative responses to these challenges (Attoh and Amarnath, 2025 ; Scherer and Shumba, 2025 ). Unlike traditional indemnity insurance, parametric insurance pays out based on pre-agreed triggers (e.g., rainfall thresholds, water levels), enabling faster disbursements and reducing the administrative burden of damage verification. As Bonazzi et al. ( 2025 ) note, parametric insurance has shown promise in African agriculture and is now being piloted in urban flood-prone areas, where data infrastructure can support real-time triggers. Moreover, anticipatory action frameworks, championed by actors like the International Federation of Red Cross and Red Crescent Societies (IFRC) and the World Food Programme (WFP), are increasingly combining forecast-based financing with insurance to enable pre-disaster risk reduction activities (InsuResilience Global Partnership, 2023 ). These models, though still experimental, illustrate how risk transfer can be embedded in multi-layered resilience systems that include social protection, early warning, and disaster preparedness (Wilkinson et al., 2020 ). The role of national and regional institutions is also expanding. Sovereign risk insurance tools, such as those offered by the African Risk Capacity (ARC), provide African governments with pre-arranged funding for disaster response (Attoh and Amarnath, 2025 ; InsuResilience Global Partnership, 2023 ). While designed primarily for drought, ARC and other mechanisms are exploring extensions into flood risk coverage. However, critiques by Kousky ( 2019 ) argue that sovereign insurance must be aligned with broader development goals to avoid disincentivizing local investment in long-term adaptation. In the Ghanaian context, insurance uptake remains fragmented and underleveraged. While Ghana has adopted climate adaptation strategies, the integration of climate insurance as a formal adaptation measure is still minimal (Jegede et al., 2020 ). As Antwi-Bosiako (2016) revealed, market anomalies – such as charging higher premiums for flood-mitigated properties – discourage proactive behavior and suggest a disconnect between actuarial models and ground-level realities. From a climate justice perspective, scholars like Bonazzi et al. ( 2025 ) and Khoo and Yong ( 2023 ) have cautioned that insurance is not a silver bullet. Poor and marginalized populations – who often contribute least to climate change – are also the least able to afford insurance or navigate complex claims processes. Calls for equitable financing models, including subsidies, community-based pooling, and public-private partnerships, are growing louder in both academic and policy circles (Scherer and Shumba, 2025 ). This discussion also intersects with the Loss and Damage agenda, particularly as operationalized through the new Loss and Damage Fund agreed upon at COP27 and launched at COP28. As Addison et al. ( 2022 ) note, there is increasing pressure on multilateral and national institutions to develop complementary risk transfer tools that serve vulnerable communities – not just governments or corporations. The OECD ( 2021 ) and related bodies have proposed guiding principles to steer the design of equitable and effective flood insurance systems, including universal access and affordability, integration with development planning, incentives for risk reduction, coordination with social protection systems, and the strategic engagement of public-private partnerships. These principles, though still aspirational in many contexts, offer a valuable blueprint. In effect, contemporary literature and policy directions consistently emphasize that risk transfer mechanisms – particularly climate insurance – can play a transformative role in enhancing adaptive capacity to flooding. Their success depends not only on technical soundness or market availability, but also on how well they are aligned with national policies, supported by institutional coordination, embedded in local realities, and inclusive of the urban poor and informal communities (Wilkinson et al., 2020 ). In Ghana, transforming insurance from a marginal or misunderstood product into a robust, socially responsive instrument of resilience will require a deliberate convergence of regulatory reform, market innovation, and community engagement. 3. Study area and methodology 3.1. Study area This study was conducted in flood-prone communities within the Accra Metropolitan Area (AMA), Ghana’s most urbanised zone and the core of the newly designated Accra-City Region–a functional urban agglomeration of 13 administrative districts. Bounded by Ga West to the north, Ga South to the west, La Dadekotopon to the east, and the Gulf of Guinea to the south, AMA is a magnet for economic activity and migration. With an estimated 2.66 million people and a density of 1,300 persons per km² (World Population Review, 2023), the city embodies the paradox of African urbanisation: while it generates opportunities, infrastructure and services–especially drainage, housing, and sanitation–lag far behind. Flooding is a perennial hazard in Accra, particularly during the rainy season. It is driven not only by intense rainfall but also by inadequate stormwater infrastructure, incomplete or poorly maintained drainage systems, and blocked canals choked with waste and silt. The situation is worsened by rapid and often unregulated land conversion, which replaces permeable surfaces with concrete and accelerates runoff. Flood risk in Accra is thus less a natural inevitability than a product of socio-ecological vulnerability and institutional neglect. To capture the diversity of urban flood experiences, the study focused on four vulnerable communities: Adabraka, Asylum Down, Glefe and Santa-Maria (see Fig. 1 ). Adabraka and Asylum Down, located near the Central Business District, exemplify inner-city flood risk. These densely populated neighbourhoods, with aging infrastructure and poor drainage, are highly exposed due to their proximity to the Odaw River, Accra’s largest stormwater channel. Glefe, a coastal settlement in western Accra, faces dual threats: tidal inundation and stormwater flooding. Characterised by unplanned housing and weak sanitation infrastructure, it represents the intersection of sea-level rise and poor urban planning. Santa Maria, on the northwestern fringe, is a rapidly urbanising low-income area. With limited formal drainage and a topography that channels runoff from surrounding highlands, it suffers repeated waterlogging and property damage during intense rains. Together, these communities reveal the multiple faces of urban flood risk – inner-city exposure, coastal vulnerability, and peri-urban sprawl – and highlight how poverty, infrastructure deficits, and environmental change converge to make Accra one of West Africa’s most flood-prone cities. By grounding the research in these sites, the study situates household adaptation and risk transfer within the lived realities of communities where flooding is both a seasonal certainty and a chronic developmental challenge. Source: Authors’ construct (2025) 3.2. Methods and analysis This study employed a case study-based mixed methods design to capture both quantitative and qualitative perspectives on flood insurance and household adaptive capacity in urban low-income communities. The rationale for adopting a mixed-methods approach was to triangulate data sources for deeper insights, enhanced validity, and capture both statistical trends and lived experiences. Quantitative data were collected through structured surveys administered to heads of households in the four selected flood-prone communities. The survey instrument captured variables such as awareness of flood insurance, perceptions of its benefits, affordability concerns, and willingness to enrol. To ensure representativeness, a systematic random sampling technique was employed. Each community was divided into four spatial clusters to minimise sampling bias and guarantee geographic spread. From each community, 30 respondents were sampled (total N = 120), with 7 respondents drawn from Clusters 1 and 2 and 8 from Clusters 3 and 4. Random starting points were used in each cluster to ensure fairness in selection. Survey data were coded and analysed using IBM SPSS version 21. Both descriptive statistics (e.g., frequencies, percentages) and inferential techniques (e.g., chi-square tests, correlations) were applied to examine household knowledge, affordability perceptions, and willingness to adopt flood insurance as a risk transfer mechanism. To complement household-level insights, in-depth interviews were conducted with three key informants: the head of an insurance company offering climate-related products, a representative of the National Disaster Management Organisation (NADMO), and a local government official responsible for flood response. Purposive sampling, specifically critical case sampling, was employed to select these informants, given their strategic roles in policy, institutional coordination, and product delivery. Semi-structured interview guides elicited perspectives on regulatory barriers, consumer engagement, institutional preparedness, and the future of climate-related insurance in Ghana. All interviews were manually transcribed and analysed using thematic analysis, which enabled the identification of recurring patterns and emergent issues. Findings from the qualitative and quantitative components were iteratively cross-referenced to generate a comprehensive understanding of household-level adaptive capacity and the role of insurance as a risk transfer mechanism. The study adhered to ethical research standards: verbal informed consent was obtained from all participants, and respondents were assured of confidentiality, anonymity, and the voluntary nature of participation. 4. Results and discussion 4.1. Key sociodemographic characteristics of respondents Out of the total 120 household heads selected from flood-prone communities in Accra for the study, 70.8% were female, and 29.2% were male. The majority of respondents fell within the 30–35–year bracket (18.3%), followed by those aged 50–55 years (17.5%). Respondents aged 65 years and above represented 5.8% of the sample, indicating a generally younger population of household heads particularly in low-income communities. In terms of educational attainment, 41.7% had completed primary education, whereas 34.2% had reached secondary education. Respondents with tertiary education accounted for 17.5%, while those with no formal education made up only 3.3%. This distribution reflects relatively moderate literacy levels, which could influence awareness and uptake of risk reduction strategies such as flood insurance. Regarding employment status, 47.5% of respondents were self-employed, 30% were formally employed, and 20% were unemployed. Only 2.5% were retired. Income levels varied, with 27.5% earning between GHC100–GHC1,000 monthly. Notably, 26.7% of respondents reported having no monthly income, while 19.25% could not estimate their monthly income – highlighting economic vulnerability that may limit their adaptive capacity to flood risks. Table 1 Estimated monthly income of surveyed respondents Estimated Monthly Income Number of people Percentage None 32 26.7% Can’t tell 23 19.2% GHC 100-1,000 33 27.5% GHC1,001–3,000 22 18.3% GHC3,001–10,000 10 8.3% Total 120 100% 4.2. Awareness, knowledge and experience of flood risk 4.2.1 Awareness of flood risk The results illustrate the level of understanding of flood risks among respondents from four flood-prone communities in Accra–Adabraka, Asylum Down, Glefe, and Santa Maria–as well as the overall distribution across all areas. The five categories measured are: very low, low, moderate, high, and very high (see Fig. 2 ). Across all communities, nearly half of respondents reported either a high (47.5%) or very high (39.2%) level of awareness of flood risks, suggesting relatively strong awareness overall. However, significant variation exists across communities. Adabraka had the highest share of respondents with a ‘very high’ awareness (13%). Asylum Down recorded the highest proportion with a ‘high’ awareness (21%) but none at the very high level. Glefe followed with strong scores in both ‘high’ (16%) and ‘very high’ (9%) awareness. Santa Maria had the highest proportion of respondents recording very high awareness overall (18%), despite lower scores in other categories. This awareness level is critical for enhancing adaptive capacity, as understanding flood hazards has been shown to encourage preparedness and proactive behavior (Bubeck et al., 2012 ). The proportion of respondents with ‘very low’ to ‘moderate’ awareness levels remains small (all below 6% in the overall assessment), pointing to potential information gaps that could jeopardize community resilience. Alarmingly, more than two-thirds (67.5%) of respondents across all study areas reported never receiving any information about flood risks (see Fig. 3 ). This lack of communication is particularly pronounced in Glefe (20%) and Asylum Down (20.83%), where ‘Never’ is the dominant response. Only a handful of respondents indicated that they frequently receive flood risk information (7.5% overall), with Santa Maria (6.7%) and Adabraka (6.67%) reporting slightly higher figures than other areas. A moderate percentage of respondents reported receiving information occasionally (18.3%), suggesting some outreach efforts are in place but are not consistent or widespread. This finding underscores a significant gap in local government outreach and public education strategies regarding flood risk communication, especially considering the vulnerability of these urban communities. As Jegede et al. ( 2020 ) argue, effective dissemination of risk information is central to disaster risk reduction (DRR) efforts, underscoring the need for more regular, and accessible flood risk education and early warning systems to enhance community preparedness and adaptive capacity. In terms of the primary sources through which respondents receive information about flood risks and preparedness, a striking 64.2% of respondents overall reported not receiving any information about flood risks, with the highest rates in Asylum Down (22.5%), Glefe (20%), and Adabraka (12.5%) (see Fig. 4 ). This underscores a serious information gap that could compromise household preparedness and community resilience. Among those who do receive information, local news media is the most commonly cited source (19.2% overall), followed by government announcements (5.8%) and friends/family (5.8%). Reliance on social media remains low (3.3%), and community meetings combined with media were the least utilized (1.7%). These results reveal a heavy reliance on passive or indirect information channels, with minimal engagement in structured or official preparedness programs. The low figures for government announcements and community-based platforms highlight an opportunity for local authorities, NGOs, and media outlets to strengthen outreach strategies and engage communities directly through trusted and accessible channels. An interview with the NADMO Director for Korle Klottey Municipal Assembly confirmed the existence of a “Disaster Preparedness Action Plan” and community-based risk reduction education efforts. “ Flood risk is a recurring challenge in our municipality, primarily because the area is low-lying. Every rainy season, we are saddled with flooding. As the NADMO department within the municipality, we implement an annual Disaster Preparedness Action Plan. At the beginning of each year, we conduct training sessions on disaster risk reduction for staff, relevant agencies, and Assembly officers. Since disaster management is a coordinated effort, we engage these stakeholders to ensure readiness for emergencies. We also reach out to communities directly through public education and sensitization campaigns on disaster risk reduction” - NADMO Director, Korle Klottey Municipal Assembly. The statement illustrates that although local authorities have established annual disaster preparedness programs, including community education and inter-agency coordination, the flow of information to households remains limited. The data suggests significant gaps in the effectiveness and reach of outreach initiatives. According to Aerts et al. ( 2018 ), limited access to timely and accurate information significantly impairs communities' ability to respond to and recover from flood events. Only 7.5% of households reported receiving flood related information regularly, and 18.3% reported receiving it occasionally. While this suggests some degree of engagement, the inconsistency in information dissemination likely diminishes the effectiveness of adaptive actions. As Amankwaa et al. ( 2024 ) argue, inclusive community engagement and participation is critical for fostering public acceptance and implementing successful flood risk management strategies. 4.2.2 Knowledge of flood risk Out of the household heads surveyed, 45.8% reported having a clear understanding of the necessary steps to protect their family and property in the event of a flood (see Fig. 5 ). This level of knowledge is essential for effective flood preparedness and response. Prior studies indicate that households with a comprehensive knowledge of flood risks and mitigation strategies are better equipped to take appropriate action, thereby reducing their vulnerability (Maj et al., 2024 ). Knowledge of protective measures empowers communities to make informed decisions and implement proactive strategies. In contrast, 23.3% of respondents indicated uncertainty about what actions to take during a flood. This knowledge gap presents a significant risk, as it can result in inadequate preparation and increased exposure to harm. As Amankwaa et al. ( 2024 ) argue, insufficient knowledge often results in lower levels of preparedness and a heightened impact during disaster events. Bridging this gap through targeted educational and community-based outreach is therefore crucial for enhancing overall flood resilience. The study also revealed varied levels of confidence in respondents' ability to respond effectively to flooding. While 34% of respondents expressed confidence in their response capabilities, 13% reported being extremely confident, and 15% admitted to lacking confidence altogether. These variations in perceived preparedness are critical, as confidence has been shown to influence the likelihood of taking precautionary measures. Terpstra et al. ( 2009 ) found a strong correlation between perceived self-efficacy and preparatory behaviors in flood-prone areas. Individuals who feel capable of responding are more likely to engage in proactive planning, while those with low confidence may delay or avoid action altogether. The findings highlight the need for comprehensive educational interventions that build both knowledge and confidence. Programs that provide clear, actionable guidance and practical training can enhance preparedness across all levels of awareness. This does not only reduces overall risk but also result in more coordinated and effective community responses to flood hazards. 4.2.3 Experience of flood risk The findings indicate that a significant proportion of households (70.8%) in flood-prone areas of Accra have experienced flood-related damage to their property. This high prevalence underscores the critical need for effective flood risk mitigation strategies and highlights the vulnerability of urban residents. As noted by Amankwaa et al. ( 2024 ), recurrent flooding not only threatens household safety but also undermines community resilience and economic stability. Respondents reported varying frequencies of flood damage: 22.5% experienced damage twice annually, 15.8% once a year, 11.7% three times a year, and 2.5% during major flood events. These differences suggest varying degrees of exposure and vulnerability, likely shaped by location-specific factors such as elevation, drainage capacity, and housing quality. Regarding the types of household items damaged, the data reveals that 7.5% of households experienced damage to everything on the ground, indicating widespread destruction of household items during flood events. Additionally, 3.3% of household heads reported damage to mattresses, which are particularly vulnerable due to their proximity to the floor. A further 2.5% experienced damage to clothes, fans, and mattresses, reflecting the multi-faceted impact of floodwaters on both personal belongings and electrical appliances (see Fig. 6 ). These findings highlight the economic and emotional toll of flooding on urban households and underscore the need for proactive flood risk management and protective measures at the household level. As Codjoe et al. ( 2020 ) emphasize, repeated exposure to floods can elevate stress levels, impose financial burdens, and reduce household capacity to recover or adapt. Several structural and environmental factors contribute to these recurring impacts. Poor drainage systems, rapid and unregulated urban expansion, and changing climate patterns have exacerbated flood risks in Accra. According to Ghosh et al. ( 2018 ), weak urban planning, particularly the inadequate development of drainage infrastructure, has made flood-prone areas more susceptible to damage. Investing in resilient infrastructure and adopting integrated urban planning strategies are therefore essential for long-term flood risk reduction. While most flood-related damages were linked to frequent, smaller events, some respondents (2.5%) attributed their losses to large-scale floods. These major events often cause extensive property damage, displace communities, and overwhelm emergency response systems (Boafo et al., 2025b ). The experiences of households affected by these extreme events underscore the need for robust emergency preparedness and rapid response mechanisms. In-depth interviews with key officials from NADMO in the Korle Klottey and Ga Central Municipal Assemblies revealed persistent institutional challenges in managing flood risk. The Hydromet Officer at the NADMO department of the Ga Central Municipal Assembly revealed two central issues: poor waste management and public attitudes toward flood risk and prevention, as illustrated in the quotes below. “ We face two main challenges in effectively managing flood risk: thus, waste management and the attitude of local residents. In our markets and trading areas, bulk goods are delivered daily, generating significant waste that’s often left unattended. People frequently dump refuse indiscriminately, especially in areas like Kingsway, and much of this ends up in the drains. When the drains are blocked, flooding is inevitable. At the moment, Accra operates under a polluter-pays principle, but many residents are unwilling to pay for waste collection. Instead, they dump it illegally, making the problem worse. Even when culprits are caught, community members often plead on their behalf, undermining enforcement. For instance, someone gets arrested for dumping refuse at the road side, people always rush in to plead on their behalf” – NADMO Director, Korle Klottey Municipal Assembly. “ Managing flood risk requires substantial resources, especially for constructing storm drains. These are costly and stretch the financial limits of municipal assemblies. The second challenge boils down to residents who ignore building regulations, construct homes in waterways, and dump refuse into drains. These behaviors compound the issue of flooding in the municipality. So, the key challenges are both financial constraints and community behavior.”- Hydromet Officer (NADMO), Ga Central Municipal Assembly. These testimonies reflect broader systemic and behavioral issues that impede effective flood management. Without adequate funding, institutional coordination, and public cooperation, even the most well-intentioned flood mitigation strategies will struggle to yield meaningful results. Thus, addressing both infrastructural deficiencies and public attitudes is essential to improving Accra’s overall resilience to flooding. 4.3. Perceptions of flood insurance 4.3.1. General awareness, uptake and coverage The study revealed a significant gap in awareness and understanding of flood insurance among urban households in Accra. A striking 79.2% of respondents cited a lack of knowledge about insurance options as the main reason for not purchasing flood coverage. This finding is consistent with Buehler and Maas ( 2018 ), who argue that risk management efforts are compromised when consumers are not informed about available insurance solutions. Without adequate knowledge, many households perceive flood insurance as either unnecessary or inaccessible. Only 3.3% of respondents considered flood insurance as unnecessarily expensive, although this perception appears to be rooted in misinformation. A representative from SanlamAllianz countered this assumption, stating: “Insurance penetration is generally low and this trend is not different for Fire Insurance which includes flood coverage. It is perceived that fire/flood insurance is very expensive, but it is actually inexpensive and affordable” . Another 7.5% of respondents considered flood insurance unnecessary, which mirrors general difficulties in flood insurance acceptance. This is aligned with earlier studies (Antwi- Boasiako, 2016) which note that the infrequency of flooding or the perception of low risk often reduces perceived need for coverage. In contrast, Shao et al. ( 2016 ) cautions that such attitudes can leave low-income households vulnerable, particularly in flood-prone environments. The representative from SanlamAllianz revealed that they offer competitive pricing and keep policy wording in simple language to make flood insurance more accessible and appealing to lower-income households. He remarked: “Our goal is to ensure inclusivity, so we keep our premiums competitive and structure our policies in simple, easy-to-understand language. This makes it easier for lower-income households to see the value and confidently subscribe to insurance coverage, especially for climate-related risks like flooding ”. Among the 48.3% who had some form of insurance, most were covered under national health insurance (25%), life insurance (10.8%), or private health insurance (7.5%). Although a sizable portion of respondents have insurance, very few had any policy that specifically addressed flood risks. This gap signals a need for targeted insurance products that address environmental hazards like flooding, as emphasized by Surminski and Eldridge ( 2014 ). During interviews, SanlamAllianz clarified that while they do not offer a standalone “flood insurance” policy, flood-related damage is covered under their standard “Fire and Allied Perils” insurance. Claims are handled according to regulated procedures, yet awareness of such provisions remains low, particularly among vulnerable communities. 4.3.2. Barriers to adoption Regarding the primary reasons for not owning a flood insurance policy, 10.8% of respondents cited the high cost of premiums as the main barrier. Additionally, 9.2% pointed to a lack of awareness, while another 9.2% expressed mistrust in insurance providers (9.2%), and 5% felt that insurance was unnecessary. Another 2.5% indicated inadequate funds as their primary constraint (see Fig. 7 ). These challenges reflect broader trends in developing economies, where trust deficits and affordability constraints hinder insurance market development (Churchill, 2007 ). Mistrust in insurance companies remains a significant obstacle. Some respondents expressed concerns about the transparency of claims processing, past negative experiences, and uncertainty about policy terms. These perceptions indicate the importance of improving customer service, simplifying policy documentation, and building stronger consumer-insurer relationships. In-depth interviews with government officials revealed a policy vacuum regarding the promotion of flood insurance in vulnerable areas. The Hydromet NADMO Officer at Ga Central Municipal Assembly noted that the high-risk classification of many flood-prone areas makes them uninsurable under current market conditions. This sentiment was echoed by the SanlamAllianz representative, who stated: “ Flooding in Accra is a perennial problem. Insurance is meant to cover uncertainties, not certainties. Frequent flood events in certain zones make it difficult to underwrite risk unless mitigation mechanisms are in place ”. To bridge this gap, officials recommended the adoption of flood-proofing techniques to reduce insurability concerns and encourage insurer participation. For instance, installing proper drainage systems, elevating buildings, and enforcing zoning laws can all contribute to risk reduction. The NADMO Director at Korle Klottey Municipal Assembly highlighted a proactive policy initiative aimed at increasing insurance adoption, particularly among trading communities in flood-prone areas. He explained plans to partner with banks and insurers to sensitize these groups: “ We plan to collaborate with banks to organize sessions where financial institutions will explain the insurance policies available to business owners. From these engagements, we will develop a roadmap based on the feedback received. Once we’ve completed these sessions, registration will follow, and interested persons can enrol in relevant policies. The goal is to begin with trading communities who are often the most affected. Once they understand and embrace insurance, we can extend the initiative to residential areas, hotels, restaurants, and other sectors. Many people only recognize the importance of insurance after major losses–like a collapsed building–but by then, it’s too late. Insurance should not only be about floods. We frequently deal with fires too. Our aim is to introduce comprehensive policies that protect businesses against all kinds of emergencies.”- NADMO Director, Korle Klottey Municipal Assembly. The Hydromet Officer from the Ga Central Municipal Assembly echoed concerns about the challenges of insuring high-risk households in flood-prone zones. He emphasized that without adequate mitigation measures, insurers are reluctant to underwrite flood policies: “ I’ve engaged insurance companies in the past about covering homeowners, but the consensus is clear – if there’s no risk control in place, they stand to lose. Insurance is based on maintaining a certain status quo. You can only insure something that is secured. That’s why insurers are skeptical about offering coverage where homes are vulnerable and exposed. The Sendai Framework emphasizes risk reduction over disaster response. In the advanced countries flood risks are minimized through better urban planning. Homes might be located in a flood zone, but because preventive systems are in place, insurers are more confident to provide coverage. Here, however, the lack of control mechanisms makes individual policies financially risky. A national-level community insurance scheme, like the one in the U.S., could help. When the entire community is covered, premiums per person are lower. But when charged individually, costs skyrocket. Insurance is essential–we will get there–but we need to build the right systems first.”- Hydromet Officer (NADMO)- Ga Central Municipal Assembly. Regarding satisfaction with insurance policies, survey responses revealed mixed levels of satisfaction among those currently insured. While 22.5% expressed satisfaction with their policies, 14.2% were dissatisfied primarily due to limited coverage options, unclear terms and conditions, and delays in claim processing (Scherer and Shumba, 2025 ). Further, 47.5% of respondents believed that flood insurance is important, while 10% saw it as unimportant and 3.3% were uncertain. Notably, 69.2% of respondents supported the idea of mandatory flood insurance for residents in high-risk areas – indicating strong public acknowledgement of its role in enhancing disaster preparedness and resilience. Moreover, 59.2% of respondents agreed that flood insurance significantly enhances adaptive capacity, underscoring a shared belief in its value. Only a small proportion – 7.5% were neutral, and just 3.3% believed it had little impact (see Fig. 8 ). A representative from SanlamAllianz, one of Ghana’s leading insurers, emphasized the importance of innovation and strategic partnerships in responding to climate-related risks. He noted: “Innovation is at the heart of our business strategy to enable us to address the changing needs of our clients. As climate change continues to reshape risk patterns, we’re committed to offering bespoke solutions that meet the evolving needs of our clients. We’re open to partnering with government and civil society–within the bounds of regulation–to develop more accessible insurance products. Enforcement of existing laws on compulsory insurance, coupled with targeted subsidies for low-income households, would go a long way in enhancing uptake. Technology will play a key role going forward. Whether it’s digital policy enrolment or mobile claims processing, we believe innovation will transform the industry and help us meet the market’s growing demands” . With regard to the amount respondents are willing to pay for flood insurance and their preferred payment frequency, 13.3% of respondents indicated a willingness to pay GHS 20, while 5% preferred GHS 10, and 7.5% were willing to pay GHS 50. In terms of payment frequency, 50% of respondents preferred to pay on a monthly basis, 8.3% opted for weekly payments, and 5% preferred an annual payment schedule. These preferences are illustrated in Fig. 9 . Table 2 presents a Pearson correlation matrix exploring the relationships between respondents’ perceptions of flood insurance and their willingness to adopt a flood insurance policy. The analysis provides insight into which factors significantly influence household decisions regarding flood risk insurance in flood-prone urban areas of Accra. The correlation between respondents’ principal reason for not having flood insurance and their willingness to sign a flood insurance policy was found to be weak and statistically insignificant (r = .026, p > 0.01). Similarly, no significant correlations were found between ownership of insurance (r = .144, p > 0.01), satisfaction with signed policies (r = .088, p > 0.01), and the willingness to adopt flood insurance, indicating that these variables alone do not strongly predict policy uptake. Interestingly, the perceived importance of having an insurance policy showed a significant negative correlation with willingness to sign a policy (r = –.446, p < 0.01), suggesting that some respondents may value the idea of insurance in principle but remain reluctant to purchase due to other barriers such as cost or trust. In contrast, two perception variables had a strong positive and significant correlation with willingness to adopt: the belief that flood insurance should be mandatory in high-risk areas (r = .249, p < 0.01), and the belief that flood insurance enhances adaptive capacity (r = .450, p < 0.01). These findings imply that policy frameworks advocating for mandatory insurance and community education on the adaptive benefits of insurance may significantly influence uptake. Table 2 Correlation matrix between perceptions of flood insurance and willingness to adopt a flood insurance policy Principal reason for house not covered by flood insurance Do you own an insurance policy Satisfaction with signed insurance policy How important is an insurance policy Should flood insurance be made mandatory for residents in high- risk areas Importance of flood insurance for enhancing adaptive capacity Willingness to sign a flood insurance policy Principal reason for your house not covered by flood insurance 1 Do you own an insurance policy .072 1 Satisfaction with signed insurance policy .007 .860** 1 How important is an insurance policy − .051 − .201** − .091 1 Should flood insurance be made mandatory for residents in high- risk areas − .050 .099 .082 − .319** 1 Importance of flood insurance for enhancing adaptive capacity .057 .248** .231* − .504** .298** 1 Willingness to sign a flood insurance policy .026 .144 .088 − .446** .249** .450** 1 **Correlation is significant at the 0.01 level (2-tailed) *Correlation is significant at the 0.05 level (2-tailed) 5. Enhancing flood risk adaptation through risk transfer This study examined the adaptive capacity of urban households in Accra through the lens of risk transfer, particularly flood insurance. The findings reveal a complex interplay of knowledge gaps, economic vulnerability, policy inaction, and trust deficits within the flood insurance ecosystem. Together, these dynamics reflect broader challenges in disaster risk reduction and climate adaptation across low- and middle-income urban contexts. 5.1. Awareness and knowledge of flood risk Awareness and risk perception remain pivotal determinants of adaptive behaviour. The study found a moderate level of awareness: nearly half of respondents understood their flood risks, echoing Bubeck et al. ( 2012 ), who link awareness to proactive preparedness. Yet, two-thirds had never received formal flood risk information, highlighting a communication gap between disaster risk reduction (DRR) institutions and households. This disconnect undermines preparedness, since households without risk knowledge tend to adopt reactive rather than preventive measures. While many respondents knew basic protective steps, confidence in their ability to act remained mixed, aligning with Terpstra et al. ( 2009 ), who note that perceived self-efficacy strongly shapes adaptive behaviour. 5.2. Experience with flooding The prevalence of past flood-related damage among respondents underscores the chronic exposure of Accra’s urban poor. With flood events occurring up to three times annually, households face repeated losses from poor drainage, informal settlement growth, and climate variability. This pattern echoes Ghosh et al. ( 2018 ), who highlight how urban expansion without parallel investment in infrastructure worsens flood vulnerability. Beyond material losses, the cumulative psychological and economic toll is severe, eroding long-term adaptive capacity and household wellbeing (Antwi-Boasiako et al., 2016). These findings reinforce the urgency of shifting from reactive emergency response to proactive adaptation planning that integrates financial risk transfer mechanisms. 5.3. Perceptions and barriers to flood insurance A key contribution of this study lies in examining insurance as a non-structural adaptation strategy. Nearly 80% of households reported lacking flood insurance, mainly due to limited awareness. This aligns with Churchill ( 2007 ), who identifies poor understanding of insurance products as a major uptake barrier in low-income contexts. Cost perceptions and mistrust of insurers also deterred participation. Although a representative from SanlamAllianz insisted that affordable products exist, households lived economic precarity suggests even modest premiums may feel unattainable without subsidy (Cashman et al., 2018 ). Another barrier concerns the insurability of high-risk areas. Both insurers and officials admitted that frequent, predictable flooding in parts of Accra makes underwriting difficult. This resonates with Surminski ( 2014 ), who argues that traditional insurance models cannot easily accommodate recurrent risks without state-backed reinsurance or proactive risk reduction measures. Policy actors, including NADMO officials, stressed that Ghana lacks a coherent framework to promote flood insurance for vulnerable groups. One proposed entry point was engaging business and trading communities first to build demand, before scaling to residential areas–an incremental approach consistent with Warner et al. ( 2013 ) on phased climate insurance strategies. 5.4. Enabling conditions and policy directions Beyond barriers, the findings also point to enabling conditions for broader insurance uptake. These include efforts to improve risk literacy, reduce premiums through subsidies, and build trust in insurance systems. Churchill ( 2007 ) stresses that building a culture of insurance requires long-term investment in institutional trust and regulatory oversight. Additionally, policy actors must consider community-based insurance models, which pool risk at the collective level. This approach, commonly used in parts of Asia and Latin America, can make premiums more affordable and foster social cohesion. The Sendai Framework for Disaster Risk Reduction also emphasizes the importance of integrating risk transfer into national disaster planning. In effect, the results highlight how cognitive, economic, institutional, and infrastructural factors converge to shape urban households’ adaptive capacity in Accra. While flood insurance has clear potential to enhance resilience, unlocking this potential requires a coordinated strategy – combining public education, financial inclusion, regulatory reform, and community engagement. By embedding insurance within a broader adaptation framework, Ghana can not only strengthen household-level resilience but also advance its national climate adaptation agenda. 6. Conclusion This study investigated the adaptive capacity of urban households in Accra to flooding, with a focus on flood insurance as a risk transfer mechanism. Drawing on data from 120 household surveys across four flood-prone low-income communities – Adabraka, Asylum Down, Santa Maria, and Glefe – alongside interviews with local government officials and a representative from SanlamAllianz, the study provides important insights into the potential and limitations of insurance in enhancing household resilience to climate-induced flooding. The findings reveal that while floods are a recurrent threat in Accra, there is limited awareness and understanding of flood insurance among the most vulnerable residents. Many households either lacked knowledge of insurance products or misunderstood their function and affordability. This aligns with the conceptual lens of socio-ecological vulnerability, which emphasizes the interplay between environmental hazards, social inequality, and institutional capacity in shaping adaptive outcomes. This information gap, coupled with perceptions of high premiums and mistrust of insurers, has significantly constrained the uptake of flood insurance. These findings reinforce existing literature that identifies financial literacy, cost concerns, and institutional credibility as central barriers to insurance adoption in low-income settings (Churchill, 2007 ). In addition to knowledge and cost-related barriers, structural and systemic issues were also identified. Local government officials and insurance industry representatives pointed to challenges around insurability in high-risk zones, where the frequency and predictability of flooding deter insurance underwriting. This reflects broader debates on “uninsurable risks” in climate-vulnerable contexts and underscores the need for multi-scalar governance approaches that combine public, private, and community-based risk management mechanisms (Surminski, 2014 ; Warner et al., 2013 ). Despite these constraints, the study identifies promising avenues for expanding flood insurance as a climate adaptation tool. These include targeted, community-tailored public education campaigns to improve awareness and risk perception, regulatory reforms and subsidies to lower premium costs, and strengthened public-private-community partnerships to foster trust, transparency, and accountability. Government-led engagement with trading communities, as suggested by NADMO officials, offers a phased and participatory strategy to pilot insurance programs and build momentum for broader uptake. Moreover, integrating flood insurance into Ghana’s national disaster risk management and climate adaptation strategies could catalyse a shift from reactive emergency response to proactive financial preparedness. Insurance is framed here not only as a post-disaster safety net but also as an instrument for proactive risk reduction, incentivizing households to adopt flood-proofing measures and resilient behaviors (Boafo et al., 2025a ; Bonazzi et al., 2025 ). For urban planners and policymakers, this underscores the need to embed risk transfer tools like insurance within spatial planning, building codes, and land-use regulations, particularly in flood-prone areas. Strategic investments in resilient infrastructure, drainage, early warning systems, and risk-informed zoning, combined with participatory urban governance approaches, can ensure that adaptation measures are socially equitable and contextually relevant (Boafo et al., 2025b ). Looking ahead, the implications of this study extend beyond flooding. As Ghana’s urban poor confront compounding climate risks – including heatwaves, droughts, and infrastructure failures – there is an urgent need to design complementary risk transfer mechanisms. These may include microinsurance for informal workers, index-based products for traders, and national catastrophe risk pools that collectively enhance urban resilience and financial inclusion. When integrated with enabling institutional frameworks, such tools can narrow the protection gap for vulnerable populations and support the broader agenda of climate justice and sustainable urban development. In conclusion, while flood insurance alone cannot eliminate the risk of flooding, it remains a critical component of a holistic and inclusive urban resilience strategy. By addressing informational, institutional, and financial barriers (Blay et al., 2023 ) and embedding these mechanisms into urban policy and planning systems (Amankwaa and Blay, 2018 ), Ghana has the opportunity to unlock the potential of insurance not only to safeguard livelihoods but also to empower communities, reduce climate-induced poverty, and enhance adaptive capacity in the face of escalating climate risks. Declarations Acknowledgements The authors are greatly indebted to all our participants who allowed us into their homes and offices to undertake this research. Ethical approval and consent to participate The study protocol was reviewed and approved by the Research Ethics Committee for Basic and Applied Sciences (ECBAS) at the University of Ghana (ref.ECBAS 070/21–22), based on the Ethical Guidelines for Medical and Biological Research Involving Human Subjects provided by the Declaration of Helsinki (World Medical Association) and its later amendments and/or comparable ethical standards. Verbal Informed Consent to Participate was obtained from all individual participants included in the study. Consent to Publish Verbal Informed Consent to Publish was obtained from all individual participants included in the study. Data availability All data generated or analysed during this study are included in this published article. Clinical trial number : not applicable References Addison S, Bharadwaj R, Carthy A, Gallagher C, More C, Nisi N, Shakya C. Addressing loss and damage. Practical insights for tackling multidimensional risks in LDCs and SIDS. 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10:17:05","extension":"xml","order_by":21,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":143641,"visible":true,"origin":"","legend":"","description":"","filename":"a4d093babb3d4614a078ef9a960ef00a1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/4d33d1dc318d8cb411ee92b4.xml"},{"id":94010768,"identity":"e9596194-beba-4fd5-aecd-165f8ca08057","added_by":"auto","created_at":"2025-10-21 10:16:51","extension":"html","order_by":22,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":151278,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/3001afca194c44a2f5553f46.html"},{"id":94010860,"identity":"f73f0d14-5500-4b08-ac0c-a0a65ba87cfb","added_by":"auto","created_at":"2025-10-21 10:16:59","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":177986,"visible":true,"origin":"","legend":"\u003cp\u003eMap of Accra Metropolitan Area showing flood prone areas\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/321084707f96ceaf3cf2327c.jpeg"},{"id":94010975,"identity":"8396d0ad-3bfc-489f-a5db-fb5a2ba89edb","added_by":"auto","created_at":"2025-10-21 10:17:06","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":19756,"visible":true,"origin":"","legend":"\u003cp\u003eRespondents’ level of understanding of flood risks\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/1a647258fb08044f9dd35d8f.png"},{"id":94010974,"identity":"418463ec-48c3-41a3-8bb4-5ff9d1915c9b","added_by":"auto","created_at":"2025-10-21 10:17:05","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":17809,"visible":true,"origin":"","legend":"\u003cp\u003eFrequency of accessing flood risks information\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/3b7ca9267092df958941e114.png"},{"id":94010959,"identity":"a4f2a2c0-acee-4d33-9780-bcfa9b7df079","added_by":"auto","created_at":"2025-10-21 10:17:04","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":68245,"visible":true,"origin":"","legend":"\u003cp\u003ePrimary source of information about flood risks and preparedness\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/26430e364d95b4c266980e75.png"},{"id":94010859,"identity":"f90019c8-a8b3-40d6-89b2-76b8b70853ae","added_by":"auto","created_at":"2025-10-21 10:16:59","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":21438,"visible":true,"origin":"","legend":"\u003cp\u003eRespondents ability to respond effectively to a flood\u003c/p\u003e","description":"","filename":"floatimage5.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/75702f513240fbab134cbd6d.png"},{"id":94010899,"identity":"c1958165-730c-4a25-987d-171a72f1d993","added_by":"auto","created_at":"2025-10-21 10:17:00","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":97126,"visible":true,"origin":"","legend":"\u003cp\u003eTypes of damages caused by flooding to household items\u003c/p\u003e","description":"","filename":"floatimage6.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/347ca875a0d1d091f67d28f1.png"},{"id":94010919,"identity":"fd69a722-8921-4075-a687-ae042f36bab7","added_by":"auto","created_at":"2025-10-21 10:17:01","extension":"png","order_by":7,"title":"Figure 7","display":"","copyAsset":false,"role":"figure","size":32829,"visible":true,"origin":"","legend":"\u003cp\u003ePrimary reasons why respondents do not have insurance\u003c/p\u003e","description":"","filename":"floatimage7.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/e642304a31a20174c1b61f95.png"},{"id":94010922,"identity":"00b7c317-1f0b-43fb-b553-b978744b46d6","added_by":"auto","created_at":"2025-10-21 10:17:02","extension":"png","order_by":8,"title":"Figure 8","display":"","copyAsset":false,"role":"figure","size":20673,"visible":true,"origin":"","legend":"\u003cp\u003eImportance of flood insurance for enhancing adaptive capacity of residents\u003c/p\u003e","description":"","filename":"floatimage8.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/f8f700df03d9a7ec51baba98.png"},{"id":94010977,"identity":"40f30498-a6cc-41c0-b470-62d87939605a","added_by":"auto","created_at":"2025-10-21 10:17:06","extension":"png","order_by":9,"title":"Figure 9","display":"","copyAsset":false,"role":"figure","size":23499,"visible":true,"origin":"","legend":"\u003cp\u003eAmount respondents are willing to pay for flood insurance\u003c/p\u003e","description":"","filename":"floatimage9.png","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/bcdb66a34b00f46507000dfb.png"},{"id":94013829,"identity":"3621118d-7abb-4cd7-8e1d-64f8e3c43bea","added_by":"auto","created_at":"2025-10-21 10:41:15","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1542851,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7557493/v1/1a06297b-9f92-408f-8ca0-570b117165e2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Turning risk into resilience through flood insurance uptake and the adaptive capacity of urban households in Accra","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eFlooding remains one of the most critical natural hazards confronting human populations globally, posing a substantial threat to national development and urban resilience. The intensification of climate change and rapid, often unplanned, urbanization continues to exacerbate flood risks, particularly in densely populated areas (Rentschler et al., 2024). Poorly managed urban growth contributes significantly to this challenge by altering natural drainage systems and increasing surface runoff through the proliferation of impermeable structures such as roads and pavements (Amankwaa et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Douglas et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). In urban environments, heavy rainfall, overflowing drainage systems, and storm surges frequently lead to infrastructure and property damage, water pollution, and disruptions to livelihoods and local economies (Gough et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; IPCC, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Kayaga et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Flooding is therefore not merely a hydrological problem but a deeply social and political challenge that reflects inequalities in planning, governance, and access to protection.\u003c/p\u003e\u003cp\u003eRecent global flood events underscore the scale and consequences of the hazard. In the summer of 2021, parts of Germany, Belgium, and the Netherlands experienced catastrophic floods that claimed over 180 lives, injured 750 people, and destroyed infrastructure (Lehmkuhl et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Similarly, the 2022 floods in Pakistan described as the worst in the nation\u0026rsquo;s history \u0026ndash;affected 33\u0026nbsp;million people, destroyed more than a million homes, and resulted in over 1,100 deaths (Clarke et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). African cities, too, have increasingly been impacted by flash floods, overflowing rivers and blocked drainage channels. Between 2008 and 2020, West Africa witnessed recurrent flooding that devastated agriculture, water sources, infrastructure, housing, and health (Amankwaa and Gough, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Codjoe et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Gough et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; UNESCO, \u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Wilby et al., \u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Ghana has encountered some of its worst floods in recent decades, notably in 2007, 2010, 2011, 2015, and 2020, especially affecting large urban centres such as Accra (Owusu and Obour, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In June 2015, a major flood and fire event in Accra claimed over 150 lives; displaced 8000 people, and destroyed built structures to the value of millions of dollars (Amankwaa and Gough, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These examples demonstrate that flooding is not only a recurrent hazard but also a stress-test of cities\u0026rsquo; ability to plan, adapt, and protect their most vulnerable populations. As the frequency and intensity of climate-induced events grow, the imperative for climate adaptation becomes even more urgent (Boafo et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025a\u003c/span\u003e; IPCC, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAdaptive capacity refers to the ability of individuals or systems to design and implement effective adaptation strategies in response to evolving climate-related risks, thereby minimizing harmful outcomes (Boafo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2025b\u003c/span\u003e; Brooks and Adger, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2005\u003c/span\u003e). This capacity is shaped by access to economic and natural resources, social networks, governance structures, human capital and technology. Flood risk mitigation strategies are typically categorised into structural and non-structural measures. Structural interventions include embankments, levees, flood walls, reservoirs, detention basins, drainage improvements, and afforestation, whereas non-structural strategies encompass flood zoning and proofing, early warning systems, land use regulations, and flood insurance as a means of risk transfer (Cashman et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). While structural solutions often dominate urban flood management, non-structural measures like insurance have gained increasing prominence in academic and policy debates because they directly address residual risks that cannot be engineered away.\u003c/p\u003e\u003cp\u003eInsurance has emerged as a vital instrument for building both physical and financial resilience to climate hazards. Jarzabkowski et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) argue that a comprehensive adaptation framework must integrate financial tools like insurance to manage residual risks that cannot be prevented. The lack of accessible insurance solutions often creates a financial protection gap, forcing individuals, governments, and humanitarian organizations to absorb the full cost of disasters \u0026ndash; worsening post-disaster recovery and socio-economic vulnerability. As Cashman et al. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e) note, limited adaptive capacity only amplifies the visible impacts of climate hazards, making vulnerable populations even more susceptible to loss and hardship. In this sense, insurance is not simply a financial product but part of the broader political economy of adaptation, shaping who bears the costs of climate impacts and who is left behind.\u003c/p\u003e\u003cp\u003eIn Ghana, existing literature on household adaptation to flooding has primarily focused on coping strategies, adaptation choices, adaptive governance, and their effectiveness (Boafo et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025a\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2025b\u003c/span\u003e; Owusu and Obour, \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Twerefou et al., \u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, the role of flood insurance as a non-structural risk transfer mechanism has received limited attention. Antwi-Bosiako (2016) examined insurers\u0026rsquo; responses to flood risk mitigation, while Jegede et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) assessed the role of policy frameworks in enabling insurance-based adaptation. Yet, these studies fall short of analysing how risk transfer through flood insurance can build household-level adaptive capacity, particularly among vulnerable urban populations. This gap is significant because financial protection is increasingly recognised as a cornerstone of climate resilience, but its real-world uptake and accessibility in African cities remain poorly understood.\u003c/p\u003e\u003cp\u003eThis study addresses this gap by exploring urban households\u0026rsquo; perceptions of flood insurance in Accra, identifying key determinants of flood insurance uptake, and examining the potential of flood insurance to strengthen the adaptive capacity of vulnerable residents. By highlighting barriers to insurance access and trust, this study contributes to the growing discourse on risk transfer in urban flood management and offers practical insights to improve climate resilience in Ghana\u0026rsquo;s urban centres \u0026ndash; especially among low-income communities most at risk. According to Jarzabkowski et al. (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2019\u003c/span\u003e), insurance fundamentally functions as a financial arrangement in which a specified risk is transferred from the insured to the insurer, thereby enhancing the insured\u0026rsquo;s capacity to withstand financial shocks resulting from disastrous events. In flood-prone urban environments like Accra, insurance offers a potential risk management product that can help vulnerable households absorb and recover from climate-induced losses. By situating flood insurance within broader adaptation debates, this research highlights its dual role as both a financial instrument and a social contract that can either reinforce or reduce existing inequalities in urban resilience.\u003c/p\u003e"},{"header":"2. Rethinking Risk Transfer: Innovations and Challenges in Insurance for Urban Flood Resilience","content":"\u003cp\u003eIn an era of escalating climate hazards, insurance-based risk transfer mechanisms are gaining prominence as critical instruments for enhancing resilience to flood-related disasters, particularly in vulnerable urban settings. Traditionally seen as a post-disaster recovery tool, insurance is increasingly framed within a risk governance paradigm that prioritizes anticipatory action, financial preparedness, and inclusive adaptation (Maj et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Wilkinson et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). However, its implementation in developing countries, including Ghana, remains limited due to affordability, poor integration into policy, and weak financial literacy (Antwi-Bosiako, 2016). At its core, climate risk insurance is designed to provide timely, contractually agreed payouts in response to climate shocks. According to Cashman et al. (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), such instruments shift the focus from reactive aid to anticipatory planning, and when combined with reinsurance and risk pooling, offer systemic buffers against widespread losses. Yet the low insurance penetration across much of sub-Saharan Africa points to structural barriers in market development, including lack of data, pricing uncertainties, and limited product relevance to low-income households (Antwi-Bosiako, 2016).\u003c/p\u003e\u003cp\u003eRecent scholarship expands this view by emphasizing parametric insurance and index-based models as innovative responses to these challenges (Attoh and Amarnath, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Scherer and Shumba, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Unlike traditional indemnity insurance, parametric insurance pays out based on pre-agreed triggers (e.g., rainfall thresholds, water levels), enabling faster disbursements and reducing the administrative burden of damage verification. As Bonazzi et al. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) note, parametric insurance has shown promise in African agriculture and is now being piloted in urban flood-prone areas, where data infrastructure can support real-time triggers. Moreover, anticipatory action frameworks, championed by actors like the International Federation of Red Cross and Red Crescent Societies (IFRC) and the World Food Programme (WFP), are increasingly combining forecast-based financing with insurance to enable pre-disaster risk reduction activities (InsuResilience Global Partnership, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). These models, though still experimental, illustrate how risk transfer can be embedded in multi-layered resilience systems that include social protection, early warning, and disaster preparedness (Wilkinson et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe role of national and regional institutions is also expanding. Sovereign risk insurance tools, such as those offered by the African Risk Capacity (ARC), provide African governments with pre-arranged funding for disaster response (Attoh and Amarnath, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; InsuResilience Global Partnership, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). While designed primarily for drought, ARC and other mechanisms are exploring extensions into flood risk coverage. However, critiques by Kousky (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) argue that sovereign insurance must be aligned with broader development goals to avoid disincentivizing local investment in long-term adaptation. In the Ghanaian context, insurance uptake remains fragmented and underleveraged. While Ghana has adopted climate adaptation strategies, the integration of climate insurance as a formal adaptation measure is still minimal (Jegede et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). As Antwi-Bosiako (2016) revealed, market anomalies \u0026ndash; such as charging higher premiums for flood-mitigated properties \u0026ndash; discourage proactive behavior and suggest a disconnect between actuarial models and ground-level realities.\u003c/p\u003e\u003cp\u003eFrom a climate justice perspective, scholars like Bonazzi et al. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e) and Khoo and Yong (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) have cautioned that insurance is not a silver bullet. Poor and marginalized populations \u0026ndash; who often contribute least to climate change \u0026ndash; are also the least able to afford insurance or navigate complex claims processes. Calls for equitable financing models, including subsidies, community-based pooling, and public-private partnerships, are growing louder in both academic and policy circles (Scherer and Shumba, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). This discussion also intersects with the Loss and Damage agenda, particularly as operationalized through the new Loss and Damage Fund agreed upon at COP27 and launched at COP28. As Addison et al. (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2022\u003c/span\u003e) note, there is increasing pressure on multilateral and national institutions to develop complementary risk transfer tools that serve vulnerable communities \u0026ndash; not just governments or corporations. The OECD (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) and related bodies have proposed guiding principles to steer the design of equitable and effective flood insurance systems, including universal access and affordability, integration with development planning, incentives for risk reduction, coordination with social protection systems, and the strategic engagement of public-private partnerships. These principles, though still aspirational in many contexts, offer a valuable blueprint.\u003c/p\u003e\u003cp\u003eIn effect, contemporary literature and policy directions consistently emphasize that risk transfer mechanisms \u0026ndash; particularly climate insurance \u0026ndash; can play a transformative role in enhancing adaptive capacity to flooding. Their success depends not only on technical soundness or market availability, but also on how well they are aligned with national policies, supported by institutional coordination, embedded in local realities, and inclusive of the urban poor and informal communities (Wilkinson et al., \u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). In Ghana, transforming insurance from a marginal or misunderstood product into a robust, socially responsive instrument of resilience will require a deliberate convergence of regulatory reform, market innovation, and community engagement.\u003c/p\u003e"},{"header":"3. Study area and methodology","content":"\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e3.1. Study area\u003c/h2\u003e\u003cp\u003eThis study was conducted in flood-prone communities within the Accra Metropolitan Area (AMA), Ghana\u0026rsquo;s most urbanised zone and the core of the newly designated Accra-City Region\u0026ndash;a functional urban agglomeration of 13 administrative districts. Bounded by Ga West to the north, Ga South to the west, La Dadekotopon to the east, and the Gulf of Guinea to the south, AMA is a magnet for economic activity and migration. With an estimated 2.66\u0026nbsp;million people and a density of 1,300 persons per km\u0026sup2; (World Population Review, 2023), the city embodies the paradox of African urbanisation: while it generates opportunities, infrastructure and services\u0026ndash;especially drainage, housing, and sanitation\u0026ndash;lag far behind. Flooding is a perennial hazard in Accra, particularly during the rainy season. It is driven not only by intense rainfall but also by inadequate stormwater infrastructure, incomplete or poorly maintained drainage systems, and blocked canals choked with waste and silt. The situation is worsened by rapid and often unregulated land conversion, which replaces permeable surfaces with concrete and accelerates runoff. Flood risk in Accra is thus less a natural inevitability than a product of socio-ecological vulnerability and institutional neglect.\u003c/p\u003e\u003cp\u003eTo capture the diversity of urban flood experiences, the study focused on four vulnerable communities: Adabraka, Asylum Down, Glefe and Santa-Maria (see Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Adabraka and Asylum Down, located near the Central Business District, exemplify inner-city flood risk. These densely populated neighbourhoods, with aging infrastructure and poor drainage, are highly exposed due to their proximity to the Odaw River, Accra\u0026rsquo;s largest stormwater channel. Glefe, a coastal settlement in western Accra, faces dual threats: tidal inundation and stormwater flooding. Characterised by unplanned housing and weak sanitation infrastructure, it represents the intersection of sea-level rise and poor urban planning. Santa Maria, on the northwestern fringe, is a rapidly urbanising low-income area. With limited formal drainage and a topography that channels runoff from surrounding highlands, it suffers repeated waterlogging and property damage during intense rains. Together, these communities reveal the multiple faces of urban flood risk \u0026ndash; inner-city exposure, coastal vulnerability, and peri-urban sprawl \u0026ndash; and highlight how poverty, infrastructure deficits, and environmental change converge to make Accra one of West Africa\u0026rsquo;s most flood-prone cities. By grounding the research in these sites, the study situates household adaptation and risk transfer within the lived realities of communities where flooding is both a seasonal certainty and a chronic developmental challenge.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSource: Authors\u0026rsquo; construct (2025)\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e3.2. Methods and analysis\u003c/h2\u003e\u003cp\u003eThis study employed a case study-based mixed methods design to capture both quantitative and qualitative perspectives on flood insurance and household adaptive capacity in urban low-income communities. The rationale for adopting a mixed-methods approach was to triangulate data sources for deeper insights, enhanced validity, and capture both statistical trends and lived experiences. Quantitative data were collected through structured surveys administered to heads of households in the four selected flood-prone communities. The survey instrument captured variables such as awareness of flood insurance, perceptions of its benefits, affordability concerns, and willingness to enrol.\u003c/p\u003e\u003cp\u003eTo ensure representativeness, a systematic random sampling technique was employed. Each community was divided into four spatial clusters to minimise sampling bias and guarantee geographic spread. From each community, 30 respondents were sampled (total N\u0026thinsp;=\u0026thinsp;120), with 7 respondents drawn from Clusters 1 and 2 and 8 from Clusters 3 and 4. Random starting points were used in each cluster to ensure fairness in selection. Survey data were coded and analysed using IBM SPSS version 21. Both descriptive statistics (e.g., frequencies, percentages) and inferential techniques (e.g., chi-square tests, correlations) were applied to examine household knowledge, affordability perceptions, and willingness to adopt flood insurance as a risk transfer mechanism.\u003c/p\u003e\u003cp\u003eTo complement household-level insights, in-depth interviews were conducted with three key informants: the head of an insurance company offering climate-related products, a representative of the National Disaster Management Organisation (NADMO), and a local government official responsible for flood response. Purposive sampling, specifically critical case sampling, was employed to select these informants, given their strategic roles in policy, institutional coordination, and product delivery. Semi-structured interview guides elicited perspectives on regulatory barriers, consumer engagement, institutional preparedness, and the future of climate-related insurance in Ghana. All interviews were manually transcribed and analysed using thematic analysis, which enabled the identification of recurring patterns and emergent issues. Findings from the qualitative and quantitative components were iteratively cross-referenced to generate a comprehensive understanding of household-level adaptive capacity and the role of insurance as a risk transfer mechanism. The study adhered to ethical research standards: verbal informed consent was obtained from all participants, and respondents were assured of confidentiality, anonymity, and the voluntary nature of participation.\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Results and discussion","content":"\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e4.1. Key sociodemographic characteristics of respondents\u003c/h2\u003e\u003cp\u003eOut of the total 120 household heads selected from flood-prone communities in Accra for the study, 70.8% were female, and 29.2% were male. The majority of respondents fell within the 30–35–year bracket (18.3%), followed by those aged 50–55 years (17.5%). Respondents aged 65 years and above represented 5.8% of the sample, indicating a generally younger population of household heads particularly in low-income communities. In terms of educational attainment, 41.7% had completed primary education, whereas 34.2% had reached secondary education. Respondents with tertiary education accounted for 17.5%, while those with no formal education made up only 3.3%. This distribution reflects relatively moderate literacy levels, which could influence awareness and uptake of risk reduction strategies such as flood insurance.\u003c/p\u003e\u003cp\u003eRegarding employment status, 47.5% of respondents were self-employed, 30% were formally employed, and 20% were unemployed. Only 2.5% were retired. Income levels varied, with 27.5% earning between GHC100–GHC1,000 monthly. Notably, 26.7% of respondents reported having no monthly income, while 19.25% could not estimate their monthly income – highlighting economic vulnerability that may limit their adaptive capacity to flood risks.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eEstimated monthly income of surveyed respondents\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"3\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEstimated Monthly Income\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNumber of people\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNone\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26.7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCan’t tell\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19.2%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGHC 100-1,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27.5%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGHC1,001–3,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGHC3,001–10,000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8.3%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e120\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e100%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003e4.2. Awareness, knowledge and experience of flood risk\u003c/h2\u003e\u003cdiv id=\"Sec9\" class=\"Section3\"\u003e\u003ch2\u003e4.2.1 Awareness of flood risk\u003c/h2\u003e\u003cp\u003eThe results illustrate the level of understanding of flood risks among respondents from four flood-prone communities in Accra–Adabraka, Asylum Down, Glefe, and Santa Maria–as well as the overall distribution across all areas. The five categories measured are: very low, low, moderate, high, and very high (see Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Across all communities, nearly half of respondents reported either a high (47.5%) or very high (39.2%) level of awareness of flood risks, suggesting relatively strong awareness overall. However, significant variation exists across communities. Adabraka had the highest share of respondents with a ‘very high’ awareness (13%). Asylum Down recorded the highest proportion with a ‘high’ awareness (21%) but none at the very high level. Glefe followed with strong scores in both ‘high’ (16%) and ‘very high’ (9%) awareness. Santa Maria had the highest proportion of respondents recording very high awareness overall (18%), despite lower scores in other categories. This awareness level is critical for enhancing adaptive capacity, as understanding flood hazards has been shown to encourage preparedness and proactive behavior (Bubeck et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe proportion of respondents with ‘very low’ to ‘moderate’ awareness levels remains small (all below 6% in the overall assessment), pointing to potential information gaps that could jeopardize community resilience. Alarmingly, more than two-thirds (67.5%) of respondents across all study areas reported never receiving any information about flood risks (see Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). This lack of communication is particularly pronounced in Glefe (20%) and Asylum Down (20.83%), where ‘Never’ is the dominant response. Only a handful of respondents indicated that they frequently receive flood risk information (7.5% overall), with Santa Maria (6.7%) and Adabraka (6.67%) reporting slightly higher figures than other areas. A moderate percentage of respondents reported receiving information occasionally (18.3%), suggesting some outreach efforts are in place but are not consistent or widespread. This finding underscores a significant gap in local government outreach and public education strategies regarding flood risk communication, especially considering the vulnerability of these urban communities. As Jegede et al. (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) argue, effective dissemination of risk information is central to disaster risk reduction (DRR) efforts, underscoring the need for more regular, and accessible flood risk education and early warning systems to enhance community preparedness and adaptive capacity.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIn terms of the primary sources through which respondents receive information about flood risks and preparedness, a striking 64.2% of respondents overall reported not receiving any information about flood risks, with the highest rates in Asylum Down (22.5%), Glefe (20%), and Adabraka (12.5%) (see Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). This underscores a serious information gap that could compromise household preparedness and community resilience. Among those who do receive information, local news media is the most commonly cited source (19.2% overall), followed by government announcements (5.8%) and friends/family (5.8%). Reliance on social media remains low (3.3%), and community meetings combined with media were the least utilized (1.7%). These results reveal a heavy reliance on passive or indirect information channels, with minimal engagement in structured or official preparedness programs. The low figures for government announcements and community-based platforms highlight an opportunity for local authorities, NGOs, and media outlets to strengthen outreach strategies and engage communities directly through trusted and accessible channels.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAn interview with the NADMO Director for Korle Klottey Municipal Assembly confirmed the existence of a “Disaster Preparedness Action Plan” and community-based risk reduction education efforts.\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e“\u003cem\u003eFlood risk is a recurring challenge in our municipality, primarily because the area is low-lying. Every rainy season, we are saddled with flooding. As the NADMO department within the municipality, we implement an annual Disaster Preparedness Action Plan. At the beginning of each year, we conduct training sessions on disaster risk reduction for staff, relevant agencies, and Assembly officers. Since disaster management is a coordinated effort, we engage these stakeholders to ensure readiness for emergencies. We also reach out to communities directly through public education and sensitization campaigns on disaster risk reduction”\u003c/em\u003e- \u003cem\u003eNADMO Director, Korle Klottey Municipal Assembly.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe statement illustrates that although local authorities have established annual disaster preparedness programs, including community education and inter-agency coordination, the flow of information to households remains limited. The data suggests significant gaps in the effectiveness and reach of outreach initiatives. According to Aerts et al. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), limited access to timely and accurate information significantly impairs communities' ability to respond to and recover from flood events. Only 7.5% of households reported receiving flood related information regularly, and 18.3% reported receiving it occasionally. While this suggests some degree of engagement, the inconsistency in information dissemination likely diminishes the effectiveness of adaptive actions. As Amankwaa et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) argue, inclusive community engagement and participation is critical for fostering public acceptance and implementing successful flood risk management strategies.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section3\"\u003e\u003ch2\u003e4.2.2 Knowledge of flood risk\u003c/h2\u003e\u003cp\u003eOut of the household heads surveyed, 45.8% reported having a clear understanding of the necessary steps to protect their family and property in the event of a flood (see Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). This level of knowledge is essential for effective flood preparedness and response. Prior studies indicate that households with a comprehensive knowledge of flood risks and mitigation strategies are better equipped to take appropriate action, thereby reducing their vulnerability (Maj et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Knowledge of protective measures empowers communities to make informed decisions and implement proactive strategies. In contrast, 23.3% of respondents indicated uncertainty about what actions to take during a flood. This knowledge gap presents a significant risk, as it can result in inadequate preparation and increased exposure to harm. As Amankwaa et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e) argue, insufficient knowledge often results in lower levels of preparedness and a heightened impact during disaster events. Bridging this gap through targeted educational and community-based outreach is therefore crucial for enhancing overall flood resilience.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe study also revealed varied levels of confidence in respondents' ability to respond effectively to flooding. While 34% of respondents expressed confidence in their response capabilities, 13% reported being extremely confident, and 15% admitted to lacking confidence altogether. These variations in perceived preparedness are critical, as confidence has been shown to influence the likelihood of taking precautionary measures. Terpstra et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2009\u003c/span\u003e) found a strong correlation between perceived self-efficacy and preparatory behaviors in flood-prone areas. Individuals who feel capable of responding are more likely to engage in proactive planning, while those with low confidence may delay or avoid action altogether. The findings highlight the need for comprehensive educational interventions that build both knowledge and confidence. Programs that provide clear, actionable guidance and practical training can enhance preparedness across all levels of awareness. This does not only reduces overall risk but also result in more coordinated and effective community responses to flood hazards.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section3\"\u003e\u003ch2\u003e4.2.3 Experience of flood risk\u003c/h2\u003e\u003cp\u003eThe findings indicate that a significant proportion of households (70.8%) in flood-prone areas of Accra have experienced flood-related damage to their property. This high prevalence underscores the critical need for effective flood risk mitigation strategies and highlights the vulnerability of urban residents. As noted by Amankwaa et al. (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), recurrent flooding not only threatens household safety but also undermines community resilience and economic stability. Respondents reported varying frequencies of flood damage: 22.5% experienced damage twice annually, 15.8% once a year, 11.7% three times a year, and 2.5% during major flood events. These differences suggest varying degrees of exposure and vulnerability, likely shaped by location-specific factors such as elevation, drainage capacity, and housing quality. Regarding the types of household items damaged, the data reveals that 7.5% of households experienced damage to everything on the ground, indicating widespread destruction of household items during flood events.\u003c/p\u003e\u003cp\u003eAdditionally, 3.3% of household heads reported damage to mattresses, which are particularly vulnerable due to their proximity to the floor. A further 2.5% experienced damage to clothes, fans, and mattresses, reflecting the multi-faceted impact of floodwaters on both personal belongings and electrical appliances (see Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). These findings highlight the economic and emotional toll of flooding on urban households and underscore the need for proactive flood risk management and protective measures at the household level. As Codjoe et al. (\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) emphasize, repeated exposure to floods can elevate stress levels, impose financial burdens, and reduce household capacity to recover or adapt.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eSeveral structural and environmental factors contribute to these recurring impacts. Poor drainage systems, rapid and unregulated urban expansion, and changing climate patterns have exacerbated flood risks in Accra. According to Ghosh et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), weak urban planning, particularly the inadequate development of drainage infrastructure, has made flood-prone areas more susceptible to damage. Investing in resilient infrastructure and adopting integrated urban planning strategies are therefore essential for long-term flood risk reduction. While most flood-related damages were linked to frequent, smaller events, some respondents (2.5%) attributed their losses to large-scale floods. These major events often cause extensive property damage, displace communities, and overwhelm emergency response systems (Boafo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2025b\u003c/span\u003e). The experiences of households affected by these extreme events underscore the need for robust emergency preparedness and rapid response mechanisms.\u003c/p\u003e\u003cp\u003eIn-depth interviews with key officials from NADMO in the Korle Klottey and Ga Central Municipal Assemblies revealed persistent institutional challenges in managing flood risk. The Hydromet Officer at the NADMO department of the Ga Central Municipal Assembly revealed two central issues: poor waste management and public attitudes toward flood risk and prevention, as illustrated in the quotes below.\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e“\u003cem\u003eWe face two main challenges in effectively managing flood risk: thus, waste management and the attitude of local residents. In our markets and trading areas, bulk goods are delivered daily, generating significant waste that’s often left unattended. People frequently dump refuse indiscriminately, especially in areas like Kingsway, and much of this ends up in the drains. When the drains are blocked, flooding is inevitable. At the moment, Accra operates under a polluter-pays principle, but many residents are unwilling to pay for waste collection. Instead, they dump it illegally, making the problem worse. Even when culprits are caught, community members often plead on their behalf, undermining enforcement. For instance, someone gets arrested for dumping refuse at the road side, people always rush in to plead on their behalf” – NADMO Director, Korle Klottey Municipal Assembly.\u003c/em\u003e\u003c/p\u003e\u003cp\u003e“\u003cem\u003eManaging flood risk requires substantial resources, especially for constructing storm drains. These are costly and stretch the financial limits of municipal assemblies. The second challenge boils down to residents who ignore building regulations, construct homes in waterways, and dump refuse into drains. These behaviors compound the issue of flooding in the municipality. So, the key challenges are both financial constraints and community behavior.”- Hydromet Officer (NADMO), Ga Central Municipal Assembly.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThese testimonies reflect broader systemic and behavioral issues that impede effective flood management. Without adequate funding, institutional coordination, and public cooperation, even the most well-intentioned flood mitigation strategies will struggle to yield meaningful results. Thus, addressing both infrastructural deficiencies and public attitudes is essential to improving Accra’s overall resilience to flooding.\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003e4.3. Perceptions of flood insurance\u003c/h2\u003e\u003cdiv id=\"Sec13\" class=\"Section3\"\u003e\u003ch2\u003e4.3.1. General awareness, uptake and coverage\u003c/h2\u003e\u003cp\u003eThe study revealed a significant gap in awareness and understanding of flood insurance among urban households in Accra. A striking 79.2% of respondents cited a lack of knowledge about insurance options as the main reason for not purchasing flood coverage. This finding is consistent with Buehler and Maas (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), who argue that risk management efforts are compromised when consumers are not informed about available insurance solutions. Without adequate knowledge, many households perceive flood insurance as either unnecessary or inaccessible. Only 3.3% of respondents considered flood insurance as unnecessarily expensive, although this perception appears to be rooted in misinformation. A representative from SanlamAllianz countered this assumption, stating:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e“Insurance penetration is generally low and this trend is not different for Fire Insurance which includes flood coverage. It is perceived that fire/flood insurance is very expensive, but it is actually inexpensive and affordable”\u003c/em\u003e.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAnother 7.5% of respondents considered flood insurance unnecessary, which mirrors general difficulties in flood insurance acceptance. This is aligned with earlier studies (Antwi- Boasiako, 2016) which note that the infrequency of flooding or the perception of low risk often reduces perceived need for coverage. In contrast, Shao et al. (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) cautions that such attitudes can leave low-income households vulnerable, particularly in flood-prone environments. The representative from SanlamAllianz revealed that they offer competitive pricing and keep policy wording in simple language to make flood insurance more accessible and appealing to lower-income households. He remarked:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e\u003cem\u003e“Our goal is to ensure inclusivity, so we keep our premiums competitive and structure our policies in simple, easy-to-understand language. This makes it easier for lower-income households to see the value and confidently subscribe to insurance coverage, especially for climate-related risks like flooding\u003c/em\u003e”.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eAmong the 48.3% who had some form of insurance, most were covered under national health insurance (25%), life insurance (10.8%), or private health insurance (7.5%). Although a sizable portion of respondents have insurance, very few had any policy that specifically addressed flood risks. This gap signals a need for targeted insurance products that address environmental hazards like flooding, as emphasized by Surminski and Eldridge (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). During interviews, SanlamAllianz clarified that while they do not offer a standalone “flood insurance” policy, flood-related damage is covered under their standard “Fire and Allied Perils” insurance. Claims are handled according to regulated procedures, yet awareness of such provisions remains low, particularly among vulnerable communities.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section3\"\u003e\u003ch2\u003e4.3.2. Barriers to adoption\u003c/h2\u003e\u003cp\u003eRegarding the primary reasons for not owning a flood insurance policy, 10.8% of respondents cited the high cost of premiums as the main barrier. Additionally, 9.2% pointed to a lack of awareness, while another 9.2% expressed mistrust in insurance providers (9.2%), and 5% felt that insurance was unnecessary. Another 2.5% indicated inadequate funds as their primary constraint (see Fig.\u0026nbsp;\u003cspan refid=\"Fig7\" class=\"InternalRef\"\u003e7\u003c/span\u003e). These challenges reflect broader trends in developing economies, where trust deficits and affordability constraints hinder insurance market development (Churchill, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Mistrust in insurance companies remains a significant obstacle. Some respondents expressed concerns about the transparency of claims processing, past negative experiences, and uncertainty about policy terms. These perceptions indicate the importance of improving customer service, simplifying policy documentation, and building stronger consumer-insurer relationships.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIn-depth interviews with government officials revealed a policy vacuum regarding the promotion of flood insurance in vulnerable areas. The Hydromet NADMO Officer at Ga Central Municipal Assembly noted that the high-risk classification of many flood-prone areas makes them uninsurable under current market conditions. This sentiment was echoed by the SanlamAllianz representative, who stated:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e“\u003cem\u003eFlooding in Accra is a perennial problem. Insurance is meant to cover uncertainties, not certainties. Frequent flood events in certain zones make it difficult to underwrite risk unless mitigation mechanisms are in place\u003c/em\u003e”.\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTo bridge this gap, officials recommended the adoption of flood-proofing techniques to reduce insurability concerns and encourage insurer participation. For instance, installing proper drainage systems, elevating buildings, and enforcing zoning laws can all contribute to risk reduction.\u003c/p\u003e\u003cp\u003eThe NADMO Director at Korle Klottey Municipal Assembly highlighted a proactive policy initiative aimed at increasing insurance adoption, particularly among trading communities in flood-prone areas. He explained plans to partner with banks and insurers to sensitize these groups:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e“\u003cem\u003eWe plan to collaborate with banks to organize sessions where financial institutions will explain the insurance policies available to business owners. From these engagements, we will develop a roadmap based on the feedback received. Once we’ve completed these sessions, registration will follow, and interested persons can enrol in relevant policies. The goal is to begin with trading communities who are often the most affected. Once they understand and embrace insurance, we can extend the initiative to residential areas, hotels, restaurants, and other sectors. Many people only recognize the importance of insurance after major losses–like a collapsed building–but by then, it’s too late. Insurance should not only be about floods. We frequently deal with fires too. Our aim is to introduce comprehensive policies that protect businesses against all kinds of emergencies.”- NADMO Director, Korle Klottey Municipal Assembly.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eThe Hydromet Officer from the Ga Central Municipal Assembly echoed concerns about the challenges of insuring high-risk households in flood-prone zones. He emphasized that without adequate mitigation measures, insurers are reluctant to underwrite flood policies:\u003c/p\u003e\u003cdiv class=\"BlockQuote\"\u003e\u003cp\u003e“\u003cem\u003eI’ve engaged insurance companies in the past about covering homeowners, but the consensus is clear – if there’s no risk control in place, they stand to lose. Insurance is based on maintaining a certain status quo. You can only insure something that is secured. That’s why insurers are skeptical about offering coverage where homes are vulnerable and exposed. The Sendai Framework emphasizes risk reduction over disaster response. In the advanced countries flood risks are minimized through better urban planning. Homes might be located in a flood zone, but because preventive systems are in place, insurers are more confident to provide coverage. Here, however, the lack of control mechanisms makes individual policies financially risky. A national-level community insurance scheme, like the one in the U.S., could help. When the entire community is covered, premiums per person are lower. But when charged individually, costs skyrocket. Insurance is essential–we will get there–but we need to build the right systems first.”- Hydromet Officer (NADMO)- Ga Central Municipal Assembly.\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eRegarding satisfaction with insurance policies, survey responses revealed mixed levels of satisfaction among those currently insured. While 22.5% expressed satisfaction with their policies, 14.2% were dissatisfied primarily due to limited coverage options, unclear terms and conditions, and delays in claim processing (Scherer and Shumba, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). Further, 47.5% of respondents believed that flood insurance is important, while 10% saw it as unimportant and 3.3% were uncertain. Notably, 69.2% of respondents supported the idea of mandatory flood insurance for residents in high-risk areas – indicating strong public acknowledgement of its role in enhancing disaster preparedness and resilience. Moreover, 59.2% of respondents agreed that flood insurance significantly enhances adaptive capacity, underscoring a shared belief in its value. Only a small proportion – 7.5% were neutral, and just 3.3% believed it had little impact (see Fig.\u0026nbsp;\u003cspan refid=\"Fig8\" class=\"InternalRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eA representative from SanlamAllianz, one of Ghana’s leading insurers, emphasized the importance of innovation and strategic partnerships in responding to climate-related risks. He noted:\u003c/p\u003e\u003cp\u003e\u003cem\u003e“Innovation is at the heart of our business strategy to enable us to address the changing needs of our clients. As climate change continues to reshape risk patterns, we’re committed to offering bespoke solutions that meet the evolving needs of our clients. We’re open to partnering with government and civil society–within the bounds of regulation–to develop more accessible insurance products. Enforcement of existing laws on compulsory insurance, coupled with targeted subsidies for low-income households, would go a long way in enhancing uptake. Technology will play a key role going forward. Whether it’s digital policy enrolment or mobile claims processing, we believe innovation will transform the industry and help us meet the market’s growing demands”\u003c/em\u003e.\u003c/p\u003e\u003cp\u003eWith regard to the amount respondents are willing to pay for flood insurance and their preferred payment frequency, 13.3% of respondents indicated a willingness to pay GHS 20, while 5% preferred GHS 10, and 7.5% were willing to pay GHS 50. In terms of payment frequency, 50% of respondents preferred to pay on a monthly basis, 8.3% opted for weekly payments, and 5% preferred an annual payment schedule. These preferences are illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig9\" class=\"InternalRef\"\u003e9\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents a Pearson correlation matrix exploring the relationships between respondents’ perceptions of flood insurance and their willingness to adopt a flood insurance policy. The analysis provides insight into which factors significantly influence household decisions regarding flood risk insurance in flood-prone urban areas of Accra. The correlation between respondents’ principal reason for not having flood insurance and their willingness to sign a flood insurance policy was found to be weak and statistically insignificant (r = .026, p \u0026gt; 0.01). Similarly, no significant correlations were found between ownership of insurance (r = .144, p \u0026gt; 0.01), satisfaction with signed policies (r = .088, p \u0026gt; 0.01), and the willingness to adopt flood insurance, indicating that these variables alone do not strongly predict policy uptake.\u003c/p\u003e\u003cp\u003eInterestingly, the perceived importance of having an insurance policy showed a significant negative correlation with willingness to sign a policy (r = –.446, p \u0026lt; 0.01), suggesting that some respondents may value the idea of insurance in principle but remain reluctant to purchase due to other barriers such as cost or trust. In contrast, two perception variables had a strong positive and significant correlation with willingness to adopt: the belief that flood insurance should be mandatory in high-risk areas (r = .249, p \u0026lt; 0.01), and the belief that flood insurance enhances adaptive capacity (r = .450, p \u0026lt; 0.01). These findings imply that policy frameworks advocating for mandatory insurance and community education on the adaptive benefits of insurance may significantly influence uptake.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cdiv class=\"gridtable\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelation matrix between perceptions of flood insurance and willingness to adopt a flood insurance policy\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"8\"\u003e\u003c/colgroup\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrincipal reason for house not covered by flood insurance\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDo you own an insurance policy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSatisfaction with signed insurance policy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eHow important is an insurance policy\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eShould flood insurance be made mandatory for residents in high- risk areas\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eImportance of flood insurance for enhancing adaptive capacity\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eWillingness to sign a flood insurance policy\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrincipal reason for your house not covered by flood insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDo you own an insurance policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.072\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSatisfaction with signed insurance policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.007\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.860**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHow important is an insurance\u003c/p\u003e\u003cp\u003epolicy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e− .051\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e− .201**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e− .091\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eShould flood insurance be made mandatory for residents in high- risk areas\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e− .050\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.099\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e− .319**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eImportance of flood insurance for enhancing adaptive capacity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.057\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.248**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.231*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e− .504**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.298**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWillingness to sign a flood insurance policy\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e.026\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e.144\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e.088\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e− .446**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e.249**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e.450**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003e**Correlation is significant at the 0.01 level (2-tailed)\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003cem\u003e*Correlation is significant at the 0.05 level (2-tailed)\u003c/em\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003c/div\u003e"},{"header":"5. Enhancing flood risk adaptation through risk transfer","content":"\u003cp\u003eThis study examined the adaptive capacity of urban households in Accra through the lens of risk transfer, particularly flood insurance. The findings reveal a complex interplay of knowledge gaps, economic vulnerability, policy inaction, and trust deficits within the flood insurance ecosystem. Together, these dynamics reflect broader challenges in disaster risk reduction and climate adaptation across low- and middle-income urban contexts.\u003c/p\u003e\u003ch2\u003e5.1. Awareness and knowledge of flood risk\u003c/h2\u003e\u003cp\u003eAwareness and risk perception remain pivotal determinants of adaptive behaviour. The study found a moderate level of awareness: nearly half of respondents understood their flood risks, echoing Bubeck et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e), who link awareness to proactive preparedness. Yet, two-thirds had never received formal flood risk information, highlighting a communication gap between disaster risk reduction (DRR) institutions and households. This disconnect undermines preparedness, since households without risk knowledge tend to adopt reactive rather than preventive measures. While many respondents knew basic protective steps, confidence in their ability to act remained mixed, aligning with Terpstra et al. (\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2009\u003c/span\u003e), who note that perceived self-efficacy strongly shapes adaptive behaviour.\u003c/p\u003e\u003ch2\u003e5.2. Experience with flooding\u003c/h2\u003e\u003cp\u003eThe prevalence of past flood-related damage among respondents underscores the chronic exposure of Accra’s urban poor. With flood events occurring up to three times annually, households face repeated losses from poor drainage, informal settlement growth, and climate variability. This pattern echoes Ghosh et al. (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), who highlight how urban expansion without parallel investment in infrastructure worsens flood vulnerability. Beyond material losses, the cumulative psychological and economic toll is severe, eroding long-term adaptive capacity and household wellbeing (Antwi-Boasiako et al., 2016). These findings reinforce the urgency of shifting from reactive emergency response to proactive adaptation planning that integrates financial risk transfer mechanisms.\u003c/p\u003e\u003ch2\u003e5.3. Perceptions and barriers to flood insurance\u003c/h2\u003e\u003cp\u003eA key contribution of this study lies in examining insurance as a non-structural adaptation strategy. Nearly 80% of households reported lacking flood insurance, mainly due to limited awareness. This aligns with Churchill (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e), who identifies poor understanding of insurance products as a major uptake barrier in low-income contexts. Cost perceptions and mistrust of insurers also deterred participation. Although a representative from SanlamAllianz insisted that affordable products exist, households lived economic precarity suggests even modest premiums may feel unattainable without subsidy (Cashman et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAnother barrier concerns the insurability of high-risk areas. Both insurers and officials admitted that frequent, predictable flooding in parts of Accra makes underwriting difficult. This resonates with Surminski (\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2014\u003c/span\u003e), who argues that traditional insurance models cannot easily accommodate recurrent risks without state-backed reinsurance or proactive risk reduction measures. Policy actors, including NADMO officials, stressed that Ghana lacks a coherent framework to promote flood insurance for vulnerable groups. One proposed entry point was engaging business and trading communities first to build demand, before scaling to residential areas–an incremental approach consistent with Warner et al. (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2013\u003c/span\u003e) on phased climate insurance strategies.\u003c/p\u003e\u003ch2\u003e5.4. Enabling conditions and policy directions\u003c/h2\u003e\u003cp\u003eBeyond barriers, the findings also point to enabling conditions for broader insurance uptake. These include efforts to improve risk literacy, reduce premiums through subsidies, and build trust in insurance systems. Churchill (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e) stresses that building a culture of insurance requires long-term investment in institutional trust and regulatory oversight. Additionally, policy actors must consider community-based insurance models, which pool risk at the collective level. This approach, commonly used in parts of Asia and Latin America, can make premiums more affordable and foster social cohesion. The Sendai Framework for Disaster Risk Reduction also emphasizes the importance of integrating risk transfer into national disaster planning.\u003c/p\u003e\u003cp\u003eIn effect, the results highlight how cognitive, economic, institutional, and infrastructural factors converge to shape urban households’ adaptive capacity in Accra. While flood insurance has clear potential to enhance resilience, unlocking this potential requires a coordinated strategy – combining public education, financial inclusion, regulatory reform, and community engagement. By embedding insurance within a broader adaptation framework, Ghana can not only strengthen household-level resilience but also advance its national climate adaptation agenda.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eThis study investigated the adaptive capacity of urban households in Accra to flooding, with a focus on flood insurance as a risk transfer mechanism. Drawing on data from 120 household surveys across four flood-prone low-income communities \u0026ndash; Adabraka, Asylum Down, Santa Maria, and Glefe \u0026ndash; alongside interviews with local government officials and a representative from SanlamAllianz, the study provides important insights into the potential and limitations of insurance in enhancing household resilience to climate-induced flooding. The findings reveal that while floods are a recurrent threat in Accra, there is limited awareness and understanding of flood insurance among the most vulnerable residents. Many households either lacked knowledge of insurance products or misunderstood their function and affordability. This aligns with the conceptual lens of socio-ecological vulnerability, which emphasizes the interplay between environmental hazards, social inequality, and institutional capacity in shaping adaptive outcomes. This information gap, coupled with perceptions of high premiums and mistrust of insurers, has significantly constrained the uptake of flood insurance. These findings reinforce existing literature that identifies financial literacy, cost concerns, and institutional credibility as central barriers to insurance adoption in low-income settings (Churchill, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2007\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn addition to knowledge and cost-related barriers, structural and systemic issues were also identified. Local government officials and insurance industry representatives pointed to challenges around insurability in high-risk zones, where the frequency and predictability of flooding deter insurance underwriting. This reflects broader debates on \u0026ldquo;uninsurable risks\u0026rdquo; in climate-vulnerable contexts and underscores the need for multi-scalar governance approaches that combine public, private, and community-based risk management mechanisms (Surminski, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Warner et al., \u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Despite these constraints, the study identifies promising avenues for expanding flood insurance as a climate adaptation tool. These include targeted, community-tailored public education campaigns to improve awareness and risk perception, regulatory reforms and subsidies to lower premium costs, and strengthened public-private-community partnerships to foster trust, transparency, and accountability. Government-led engagement with trading communities, as suggested by NADMO officials, offers a phased and participatory strategy to pilot insurance programs and build momentum for broader uptake.\u003c/p\u003e\u003cp\u003eMoreover, integrating flood insurance into Ghana\u0026rsquo;s national disaster risk management and climate adaptation strategies could catalyse a shift from reactive emergency response to proactive financial preparedness. Insurance is framed here not only as a post-disaster safety net but also as an instrument for proactive risk reduction, incentivizing households to adopt flood-proofing measures and resilient behaviors (Boafo et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025a\u003c/span\u003e; Bonazzi et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). For urban planners and policymakers, this underscores the need to embed risk transfer tools like insurance within spatial planning, building codes, and land-use regulations, particularly in flood-prone areas. Strategic investments in resilient infrastructure, drainage, early warning systems, and risk-informed zoning, combined with participatory urban governance approaches, can ensure that adaptation measures are socially equitable and contextually relevant (Boafo et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2025b\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eLooking ahead, the implications of this study extend beyond flooding. As Ghana\u0026rsquo;s urban poor confront compounding climate risks \u0026ndash; including heatwaves, droughts, and infrastructure failures \u0026ndash; there is an urgent need to design complementary risk transfer mechanisms. These may include microinsurance for informal workers, index-based products for traders, and national catastrophe risk pools that collectively enhance urban resilience and financial inclusion. When integrated with enabling institutional frameworks, such tools can narrow the protection gap for vulnerable populations and support the broader agenda of climate justice and sustainable urban development.\u003c/p\u003e\u003cp\u003eIn conclusion, while flood insurance alone cannot eliminate the risk of flooding, it remains a critical component of a holistic and inclusive urban resilience strategy. By addressing informational, institutional, and financial barriers (Blay et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) and embedding these mechanisms into urban policy and planning systems (Amankwaa and Blay, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2018\u003c/span\u003e), Ghana has the opportunity to unlock the potential of insurance not only to safeguard livelihoods but also to empower communities, reduce climate-induced poverty, and enhance adaptive capacity in the face of escalating climate risks.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are greatly indebted to all our participants who allowed us into their homes and offices to undertake this research.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by the Research Ethics Committee for Basic and Applied Sciences (ECBAS) at the University of Ghana (ref.ECBAS 070/21–22), based on the Ethical Guidelines for Medical and Biological Research Involving Human Subjects provided by the Declaration of Helsinki (World Medical Association) and its later amendments and/or comparable ethical standards. Verbal Informed Consent to Participate was obtained from all individual participants included in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eVerbal Informed Consent to Publish was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analysed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u003c/strong\u003e: not applicable\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAddison S, Bharadwaj R, Carthy A, Gallagher C, More C, Nisi N, Shakya C. Addressing loss and damage. Practical insights for tackling multidimensional risks in LDCs and SIDS. 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University of Reading and WISER; 2020. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://media.odi.org/documents/202004_odi_anticipatory_action_bn_revised.pdf\u003c/span\u003e\u003cspan address=\"https://media.odi.org/documents/202004_odi_anticipatory_action_bn_revised.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-cities","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Cities](https://www.springer.com/journal/44327)","snPcode":"44327","submissionUrl":"https://submission.springernature.com/new-submission/44327/3","title":"Discover Cities","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Flood risk, risk transfer, flood insurance, adaptive capacity, urban resilience","lastPublishedDoi":"10.21203/rs.3.rs-7557493/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7557493/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eFlooding in Accra is a recurrent hazard, intensified by rapid urbanization, inadequate infrastructure, and climate variability. Enhancing the adaptive capacity of urban households is essential for reducing vulnerability, with insurance emerging as a key but underutilized risk transfer mechanism. This study investigates household perceptions of flood insurance in Accra, explores determinants of uptake among vulnerable populations, and assesses its potential to strengthen resilience. Using a mixed-methods approach, data were collected through 120 household surveys in flood-prone communities and three in-depth interviews with local government officials and an insurance executive. Results reveal low awareness and limited understanding of flood insurance, with many respondents unaware of available products or their benefits. Key determinants of uptake included awareness of flood risk and the perceived affordability of premiums. Despite low penetration, respondents recognized the potential value of insurance in reducing post-disaster losses. The study highlights that for flood insurance to contribute meaningfully to adaptive capacity, targeted interventions are required: increased public education, policy incentives to make premiums affordable, improved access to flood risk information, and efforts to build trust between insurers and communities. By framing insurance as a complement to other adaptation strategies, this research underscores its potential to strengthen urban resilience in Ghana and comparable African contexts. These findings provide evidence for designing inclusive, context-sensitive flood risk management strategies that integrate financial instruments into broader adaptation planning.\u003c/p\u003e","manuscriptTitle":"Turning risk into resilience through flood insurance uptake and the adaptive capacity of urban households in Accra","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-21 09:57:27","doi":"10.21203/rs.3.rs-7557493/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-05T08:13:31+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-03T22:18:50+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-29T18:19:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"218143691536358572101459468231229595345","date":"2025-11-29T17:40:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"87259559268893480870941835509558077351","date":"2025-11-23T17:29:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-11-06T15:59:32+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"186614662134903450344091552772905978890","date":"2025-10-23T15:18:17+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"54975593678306537016675722160508294011","date":"2025-10-23T12:14:22+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-08T12:34:27+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-10-07T11:39:25+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-09-30T04:36:27+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-09-19T14:41:33+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Cities","date":"2025-09-19T14:37:14+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-cities","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"","sideBox":"Learn more about [Discover Cities](https://www.springer.com/journal/44327)","snPcode":"44327","submissionUrl":"https://submission.springernature.com/new-submission/44327/3","title":"Discover Cities","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"e4e1ad59-2f46-4f4d-8dd8-0cb8803f0c16","owner":[],"postedDate":"October 21st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-08T07:23:43+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-21 09:57:27","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7557493","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7557493","identity":"rs-7557493","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}