“The first person to reach you becomes dearest to you”: Mapping health information diffusion in Myanmar's polycrisis through digital strategies, networked pathways, and innovative solutions

Polycrisis (intersections of multiple, compounding crises) fracture health communication. Despite rising frequency in Southeast Asia, empirical evidence on how health information is adapted and diffused is scarce. Myanmar's 2025 earthquake, amid armed conflict and internet shutdowns, offered a critical case. Participatory mind-mapping was conducted with 24 stakeholders, including humanitarian and health workers, media actors, and community leaders, representing a diverse range of experts and implementors involved in the crisis response. In each session, participants mapped how health information flowed across actors, channels, and barriers. Reflexive thematic analysis of maps, transcripts, and notes identified diffusion pathways and adaptive strategies. Diffusion spanned assessment, planning, and delivery but was seldom linear. Actors shifted among messaging apps, satellite links, radio, and in-person relay as connectivity, censorship, and security changed. Credibility increased when messages were community-verified, paired with aid, and localized to resource constraints (e.g., substituting supplies assumed available in global protocols with local alternatives). Communities organized their own coordination arrangements, such as household ledgers, that sometimes outperformed formalized systems. Digital innovations shaped operations: Starlink restored connectivity during blackouts; Virtual Private Networks (VPNs) and platform switching (Telegram, Viber) bypassed censorship; and verification networks sought to counter misinformation. Reliance on digital channels alone was inadequate given limited literacy, surveillance, and displacement; radio, printed flyers, and religious or community gatherings remained essential for many groups. In Myanmar's polycrisis context, and potentially in comparable settings, findings suggest resilient diffusion may benefit from hybrid approaches combining new connectivity tools (satellite internet, VPNs, mesh networks) with trusted offline and community-led practices, attending to equity, safety, and appropriateness.