Perceptions of medical and public health professionals on climate change and emerging health challenges in Pakistan: a multi-scale approach

Abstract

Background and objectives

Climate change is a significant global health threat, disproportionately impacting low- and middle-income countries. Urban centres like Karachi, Pakistan, face rising incidences of vector-borne and waterborne diseases because of changing climate (CC). This study aimed to explore the perceptions of healthcare professionals regarding climate change, its health impacts, and their role in addressing these challenges.

Methods

A qualitative study was conducted using nine focus group discussions with 46 healthcare professionals, including doctors, nurses, and public health experts from three major hospitals and two postgraduate institutions in Karachi. Participants were recruited through snowball sampling, and data were collected using semi-structured interviews. Thematic analysis was conducted to identify both manifest and latent themes in the data.

Results

The analysis revealed seven major themes: awareness of climate change, health impacts, economic and social consequences, environmental and natural disasters, the role of healthcare professionals, mitigation strategies, and policy challenges. Participants demonstrated varied levels of awareness, influenced by their educational background and professional specialization, with public health professionals exhibiting a broader understanding compared to other healthcare workers. Key concerns included the rise of infectious diseases, food insecurity, and urban resource strain. Participants identified barriers such as inadequate training, limited resources, and weak policy enforcement that hinder their ability to address climate impacts effectively.

Conclusions

Healthcare professionals in Karachi play a critical role in mitigating climate-related health impacts. Enhanced education, integration of climate change into medical curricula, and interdisciplinary collaboration are essential. Strengthened policies and systemic investments are needed to empower healthcare workers as leaders in climate adaptation and mitigation efforts.

Introduction

Climate change is one of the most pressing global challenges of the twenty-first century, with far-reaching environmental, social, and health implications. Its adverse effects, ranging from rising temperatures and extreme weather events to ecosystem disruptions, extend beyond the environment to profoundly impact human health and societal well-being [20]. The health consequences of climate change include an increase in vector-borne and waterborne diseases, respiratory and cardiovascular complications from pollution, and mental health challenges exacerbated by extreme heat and natural disasters [7, 22]. Vulnerable populations, such as children, the elderly, and those living in low-resource settings, are disproportionately affected [10, 14, 19].

.According to the 2016 report of World Health Organization, unhealthy environmental conditions were responsible for an estimated 12.6 million deaths in 2012, representing nearly 24% of total global mortality that year. Premature mortality and disability further contributed 22% (95% Confidence Interval: 13–32%) of the global burden of disease [14]. Children under five years are particularly vulnerable, with respiratory infections (32%), diarrheal diseases (22%), and parasitic or vector-borne diseases (12%) comprising the largest proportion of environmentally attributable diseases [21].

 Pakistan experiences a predominantly arid to semi-arid climate, which is increasingly affected by rising temperatures and the growing frequency of extreme weather events. Karachi, the country's largest city, faces severe heatwaves and urban flooding. The 2015 heatwave caused over 1,200 deaths, highlighting its vulnerability. Monsoon rains, though irregular, often lead to flash floods, as seen in August 2020, when the city received a year’s worth of rain in days [3]. Poor drainage worsens the crisis, affecting informal settlements and spreading diseases. Dengue cases surged from 3,204 in 2018 to 45,120 in 2019, while more than 30,000 people were infected with chikungunya in 2017 [12, 15]. Malaria remains a major concern, affecting 22.4% of Karachi’s population. Climate change continues to intensify these challenges, demanding urgent action to protect the city’s residents [17].

It is widely acknowledged that low- and middle-income countries are disproportionately affected by the impacts of climate change, yet these regions receive less research attention despite facing significant challenges [4]. Healthcare and public health professionals are uniquely positioned to address these challenges. As trusted community leaders, they play a vital role in disease prevention, health promotion, and community education, including raising awareness, advocating for policy changes, and implementing preventive measures such as vaccination campaigns and public health initiatives [1, 6, 9]. Framing climate change as a health issue has been shown to enhance public engagement and increase the likelihood of meaningful action [16].

However, healthcare professionals face numerous barriers to engagement, including insufficient education on climate-related health impacts, limited institutional resources, and the politicization of climate issues, which undermines their confidence and capacity to lead mitigation and adaptation efforts [8, 11]. Additionally, the health sector itself struggles to adapt to climate-related crises due to fragmented cross-sectoral collaboration, policy gaps, and inadequate integration of climate change into medical education [16].

Research indicates that context plays a crucial role in shaping perceptions and understanding of climate change and climate action. While previous studies have explored the perspectives of health professionals in various global settings, most have focused on rural or predominantly urban areas in high-income countries, leaving significant gaps in understanding how health professionals in rapidly urbanizing, resource-stressed contexts perceive and respond to these challenges [10, 11]. In Pakistan, urban centers like Karachi face distinct environmental pressures, yet there is limited scholarly research exploring the health impacts of climate change from the perspective of health professionals. As a densely populated metropolitan city with diverse demographics, multiple tertiary care hospitals, and leading academic institutions, Karachi, presents a critical context for investigating how climate change affects health systems and service delivery. This study seeks to fill that gap by capturing the insights of health professionals working at the front line of climate- related health challenges.

Methodology

Research setting

This study was conducted in the largest metropolitan city- Karachi, Pakistan (Fig. 1). Karachi, the capital of Sindh province, spans an area of approximately 3,780 km². The population and demographic distribution of Karachi have changed significantly over its history. From a small coastal trading port 150 years ago to a city of 450,000 in 1947, at the time of Pakistan's independence, Karachi has grown into one of the world’s largest megacities, with a population of about 20 million and a population density of 55,390.01 residents per square kilometre [3, 13]. It plays a vital role in Pakistan’s economy and serves as the industrial, financial, commercial, and manufacturing hub of the country. Karachi’s economic dominance has made it a magnet for large-scale and continous in-migration [5]. Karachi’s urbanization, similar to other cities in South Asia, has been described as"messy"and"hidden,"partly due to challenges in coping with population pressures on infrastructure, basic services, land, housing, and the environment. These dynamics constrain the potential benefits of agglomeration economies, limiting faster improvements in prosperity and liveability. Furthermore, Karachi experienced one of the deadliest heatwaves in 2015, underscoring the city's vulnerability to climate-related challenges [2]. The study was conducted among healthcare professionals working in outpatient and inpatient departments of Jinnah Postgraduate Medical Center (JPMC), Civil Hospital, and Korangi District Hospital. Public health professionals were recruited from two postgraduate medical institutions: Jinnah Sindh Medical University and Dow Medical University, Karachi.

Fig. 1

Distribution of hospitals and public health institutes across Karachi, Pakistan

Data collection

Participants were recruited through snowball sampling to encompass a variety of occupations, experiences, and viewpoints among health professionals in the study area. Leveraging previously established connections and reviewing recent publications, presentations, and reports, health professionals engaged with general and specialist medicine practice and public health were identified as potential participants. The recruitment process began by contacting key informants within each facility (e.g., senior physicians, nurses, or faculty members), who then referred other professionals meeting the study criteria. Additionally, at the conclusion of each interview, participants were asked to recommend further potential interviewees, thereby employing a snowball sampling approach. While snowball sampling can introduce selection bias, we mitigated this risk by engaging multiple “seeds” from varied professional backgrounds, clinicians, educators, and public health practitioners, and encouraging them to refer colleagues who differed in years of experience, gender, and areas of specialization. Participants within the same occupational category were selected from different hospitals to account for geographical variation and to capture a broad spectrum of roles, resulting in a rich diversity of perspectives. This approach aimed to create a more representative sample and mitigate response bias. All healthcare workers who consented to participate were included, comprising doctors with a basic medical or dental degree, doctors with postgraduate qualifications, nurses, paramedics and those working in public health departments. This study aimed to conduct 6 focus group discussions, with two groups each from Jinnah post graduate medical center (JPMC), Civil hospital and Korangi district hospital in Karachi. These groups comprised health professionals (general and specialist medicine practitioners, dentists and doctors with post graduate qualification) and allied health professionals (nurses and midwives). Additionally, 4 focus group discussions were planned with public health professionals from two postgraduate medical institutions Jinnah Sindh Medical University and Dow Medical University Karachi. However, the study concluded with a total of 9 focus group discussions (n = 46), after which the point was observed where the data collection process was not contributing any new or significant themes.

Development of the interview guide

The interview guide was developed to align with the study's objectives, focusing on exploring perceptions of climate change and its impacts on infectious diseases, particularly waterborne and vector-borne illnesses. The guide aimed to facilitate an in-depth understanding of participants’ insights and experiences of climate change.

The development process began with a comprehensive review of existing literature on climate change and its health impacts, complemented by consultations with subject matter experts in medical education and environmental Sciences to identify key thematic areas. The guide was designed to cover four broad domains:

• Perceptions of climate change: Questions were framed to explore participants’ understanding of climate change, including its causes, observable changes in their environments, and the broader implications for human health and well-being.

• Consequences of climate change: Participants were asked about specific impacts of climate change on their communities, particularly changes in weather patterns, flooding, or droughts, and their perceived effects on public health

• Climate change and infectious diseases: This section probed into participants’ views on the relationship between climate variables and the prevalence or patterns of infectious diseases, with a particular focus on waterborne diseases (e.g., diarrhea, cholera) and vector-borne diseases (e.g., malaria, dengue). Participants were also asked to share their observations of disease trends and any potential links to climatic factors.

• Role of healthcare professionals: Questions explored participants’ opinions on the role healthcare professionals and public health workers play in mitigating the impacts of climate change on infectious diseases. This included discussing strategies for prevention, community education, Medical and public health curriculum and strengthening healthcare systems to enhance climate resilience.

The interview guide underwent pre-testing with a small subset of participants to assess its clarity, relevance, and comprehensiveness. After conducting a pre-test with a small group of healthcare professionals, we integrated their feedback to enhance both the cultural appropriateness and clarity of the questions. Specifically, we revised certain terms to ensure they resonated with local contexts and simplified complex scientific language where necessary. For example, after discovering that some participants found the term “environmental determinants” unclear, we rephrased it as “factors in the environment, like rising temperatures or changing rainfall patterns, that may affect health.”

Moreover, to capture perceptions of climate change’s impact on infectious diseases, we introduced questions such as, “Have you noticed changes in the occurrence or severity of infectious diseases in your practice that you believe may be linked to shifting climate patterns?” and “How do you think extreme weather events like heatwaves or heavy rainfall have influenced disease outbreaks in your community?” These adaptations ensured that participants could more readily connect climate change concepts to their day-to-day professional experiences, thereby enhancing the overall rigor and relevance of the interview guide.

Data collection and analysis

To ensure consistency and enhance rigor, the lead author conducted all interviews in person. Interviews and FGDs were audio recorded with participants'consent, and written notes were taken to supplement the recordings. Transcripts were translated into English and analyzed using thematic content analysis by two independent qualitative research experts. Both manifest content (visible, explicit themes) and latent content (underlying meanings) were analyzed to ensure a comprehensive understanding.

The analysis followed an inductive approach to systematically explore the data. Initially, open coding was performed, where the text was examined to identify and label discrete concepts, ideas, and patterns emerging directly from the data. This was followed by axial coding, where connections between the initial codes were explored to group them into broader categories based on their relationships and relevance to the study's objectives. Finally, selective coding was conducted, integrating and refining these categories into meaningful overarching themes that captured both the explicit (manifest content) and underlying (latent content) meanings within the data.

To ensure rigor and credibility, the analysis was conducted independently by two qualitative research experts. This dual analysis not only enhanced the credibility of the findings but also minimized potential biases through independent verification. The iterative coding process and thematic synthesis provided a structured yet flexible framework for capturing participants’ perceptions, experiences, and insights into climate change and its impacts on infectious diseases.

Ethics approval and consent to participate

This study was conducted in full compliance with the ethical principles outlined in the Declaration of Helsinki, which govern research involving human participants to ensure their safety, dignity, and rights. Ethical approval for the study was obtained from the Ethical Review Board of Jinnah Sindh Medical University (Reference: JSMU/IRB/2022/685).

Before participation, the study objectives, procedures, and potential benefits or risks were clearly explained to all participants in a language they could understand. Participants voluntarily provided written informed consent, ensuring their understanding of the study and their rights, including the right to withdraw at any time without consequences.

The confidentiality and anonymity of all participants were strictly maintained throughout the research process. Personal identifiers were removed during data collection, storage, and analysis to protect participants’ privacy. Access to the data was restricted solely to the principal investigator and the research team. Additionally, all data was securely stored and will be retained for a specified period, in accordance with institutional and national data protection policies, before being safely destroyed.

Results

The study included healthcare professionals from diverse backgrounds and age groups (Table 1). Eight to nine participants from each category were selected to ensure equal representation.

Table 1 Distribution of study participants by occupation and age range (n = 46)

The focus group discussions (FGDs) provided insights into the participants'understanding of climate change, Environmental pollution, Natural disasters, the impact on economy, and society, as well as the role of healthcare professionals in addressing these challenges. The analysis revealed seven major themes: awareness and understanding of climate change, health impacts, economic and social consequences, environmental and natural disasters, the role of healthcare professionals, mitigation strategies, and challenges in policy and implementation (Fig 2).

Fig. 2

Thematic framework of climate change derived from the perceptions of healthcare workers and public health professionals

Awareness and understanding of climate change

The theme reveals that both healthcare workers and public health professionals recognize climate change as a significant issue, though their understanding varies considerably. Healthcare workers often described climate change in localized terms, associating it with immediate weather changes, seasonal shifts, or extreme temperature variations, reflecting a more surface-level awareness. In contrast, public health professionals demonstrated a broader and more systemic understanding, linking climate change to global drivers such as greenhouse gas emissions, industrialization, and deforestation. However, misconceptions were present across both groups, with some attributing climate change to unrelated phenomena like earthquakes or overly associating it with health crises. Participants believed that many people dismiss climate change as an illusion due to limited education and exposure to reliable information. Also some participants attributed the rise in vector-borne diseases solely to urban pollution, overlooking the role of changing rainfall patterns in creating breeding grounds for vectors. Another common misconception was that only coastal areas would be significantly affected by climate change, thus diminishing the perceived urgency for preparedness measures in inland regions.

“Climate change is like changes in seasons, like now winter season is going on, then, autumn and summer; so changes in the season is called climatic change I think” 28-year-old nurse

“According to me, climate change is basically normal environmental change, extreme temperature, extreme weather in form of winds, rains or anything.” 35-year-old doctor

“Climate change is basically the changes in the eco system in the world; as we see how the emissions of green gases are happening now, the most important thing is global warming, due to which the entire world is changing, and the climate change is happening in our world.” 40 year-old-public health professional.

“It's still illusions for some people, where there's no education, people don't have awareness and living in villages and rural areas.” 28-year-old nurse

“Earthquakes can be seen as a main cause of climate change in natural disaster.” 55 year old consultant

“Environmental changes will occurs; like disaster, rains and drought so all these will have an effect” 32 year old nurse

“If we talk about global warming, there are emissions of greenhouse gases from industrials emissions, our transportation vehicles emissions, carbon monoxide, so all these gases disturb our environment and therefore its having changes in our weather” 32- year -old public health professional.

“Due to the destruction of the ozone layer, the sunlight is getting more and more, it is also affecting us.” 33-year old doctor

Health impacts of climate change

The theme highlights participants'observation of a rise in vector-borne and waterborne diseases, such as malaria, dengue, and cholera, which they attributed to changing environmental conditions, poor sanitation, and population growth. Healthcare workers often linked disease patterns to seasonal variations, while public health professionals highlighted the role of climate-related factors, such as floods and rising temperatures, in exacerbating outbreaks. Participants also expressed concerns about the impact of pollution, particularly in urban areas, on respiratory and cardiac health, noting that vulnerable populations, such as children and the elderly, are disproportionately affected. However, many participants did not explicitly connect these health implications to climate change, reflecting a gap in understanding its broader influence. Some also discussed how heatwaves and temperature fluctuations contribute to mental health issues, including stress and fatigue, further diminishing the quality of life. While participants recognized these health challenges, there was a need for greater awareness of the underling role of climate change in driving these patterns.

“Pollution, especially in Karachi the peak pollution time is in the morning when vans are going and that effects the respiratory health of Children.” 45-year-old consultant

“The ratios of many diseases increase like malaria, typhoid and entire society is affected. When Sindh faced flooding; many diseases were increased in community, as well as scarcity of food”. 35-year-old public health professional.

“Floods have a very negative effect on maternal child health” 42-year-old Consultant

“When winter comes, everywhere you can see viral infections, in every house, everyone is sick. Everyone says I am under the weather,.. it's flu. Same happens in summer, stomach problems will increase like everyone will be facing diarrhea …this is seasonal change. 25 year old doctor.

“One thing is that cases of dengue and malaria were not seen as much before. There has been a lot of outbreaks in Karachi in the last year or in the last one or two years. Earlier, there was no dengue, chikungunya, etc. they need warmest atmosphere which Karachi developed.” 28 year old nurse.

“The climate is changing, and new diseases are emerging which have not been identified yet.” 27 year old nurse

“Climate change has increased the vector bone diseases and respiratory diseases because there is pollution everywhere in the air” 28 year old public health professional

“Anti microbial resistance is on rise, because of climate change, threat of water borne and vector borne disease occur and then the unregulated use of anti-biotics.” 36 year old doctor

Economic and social consequences of climate change

Economic instability and social challenges were key concerns raised during the FGDs. Participants, particularly those from the public health group, spoke about the damaging effects of climate change on agriculture, leading to food insecurity and inflation. Urbanization and displacement were also identified as significant social consequences of climate change. Participants noted that as rural areas become less viable for farming due to extreme weather, populations are increasingly migrating to cities, causing overcrowding and placing additional strain on resources.

“When there is a flood so it’s an extreme situation, and due to this disaster there will be scarcity of resources; like crops have been destroyed, agriculture and land loss; which will lead to its economic impact”. 30 year old public health professional.

Environmental and natural disasters

Participants linked climate change to the increasing frequency and intensity of natural disasters such as floods, droughts, and earthquakes. These disasters were seen as major contributors to both health crises and infrastructural damage. The public health participants also expressed concern about the lack of preparedness for such disasters, which exacerbates their impact on human health and the economy. They called for better disaster management strategies to mitigate these effects.

“We’ve seen floods and earthquakes become more frequent, which lead to disease outbreaks and displace entire communities” 33 year old doctor.

Role of healthcare professionals in climate change mitigation

A central theme in the discussions was the critical role of healthcare professionals in addressing climate change. Participants highlighted their current role in leading public health efforts, such as vaccination campaigns and health education initiatives, particularly during disease outbreaks. They expressed that with proper training and knowledge about climate change, healthcare workers could expand their impact by effectively raising awareness and educating communities about climate-related health risks. Some participants suggested that climate change should be included in medical and public health education to better prepare future professionals for this growing challenge. However, they also pointed out gaps in resources, such as insufficient technology and monitoring systems, that limit their ability to address climate-related health issues. Overall, participants recognized the potential of healthcare professionals to serve as key advocates for both prevention and adaptation in the context of climate change.

“Adaptation should be done to inform the people if something like heat stroke happen, the people would know what to do about it.” 28-year-old nurse

“Our health professionals like doctor, as a community, our role will be to give health education, we will conduct awareness programs, and we will take sessions on how to prevent these diseases.” 45-year-old Consultant.

“It should be started from the grass root level as our MBBS, community medicine course etc. 35-year-old doctor

“We don't have the technology, we don't have the sufficient system to monitor the data, and not enough work has been done on climate change” 27 -year-old nurse

“I think we have learnt about climate change in one chapter in MSPH, so I think that it’s a very huge public health issue so it should be taught in a little more depth” 28 year old public health professional.

Mitigation strategies and solutions

The participants highlighted a range of proposed actions identified by participants to address environmental degradation. Reforestation, reducing industrial emissions, and adopting clean energy sources were frequently mentioned as essential steps to mitigate climate change. Participants stressed the importance of public health campaigns to promote sustainable practices, such as conserving water, reducing carbon footprints, and planting trees, with an emphasis on the need for broader awareness among communities, including children and parents. Several participants called for multidisciplinary approaches, including bio-engineering and climate engineering, as well as the development and implementation of effective public health policies. They also pointed out the role of improving industries, transportation systems, and solid waste management to reduce pollution. Urban strategies like creating green spaces and promoting walkability were also seen as key ways to reduce emissions while enhancing quality of life. Overall, participants advocated for a combination of individual, community, and systemic efforts to address climate change comprehensively.

“The bio- engineering and climate engineering is also a field that should be worked on. Most of the people don’t know about this. Lack of awareness in children’s and parents as well.” 26- year-old dentist.

“Experts should suggest and articulate the public health policies first, which should be well implemented and we require a multidisciplinary approach for climate change” 40 year old public health professional.

“Our industries, transport and vehicles, they all need to be improved and other factors like solid waste management also needs to be looked into.” 29 year old nurse

“Planting trees and promoting green spaces in cities will not only help reduce pollution but also provide much-needed oxygen” 35-year-old public health professional

“It’s not just about planting trees; we also need to reduce industrial emissions and promote the use of clean energy sources” 38 year old public health professional.

“Going by walk, not by car, will also reduce carbon emissions” 52 year old cardiologist

Challenges in policy and implementation

The barriers faced in effectively addressing climate change through structured action was reported by participants. They repeatedly highlighted the lack of government commitment and the poor implementation of existing policies as major obstacles. While some policies and frameworks exist, their enforcement remains weak, leading to minimal impact. Healthcare professionals expressed frustration with the absence of cross-sectoral collaboration and the slow pace of governmental response to climate-related issues. Additionally, participants emphasized that education gaps compound these challenges, as the lack of widespread public awareness and grassroot involvement hinders policy acceptance and effectiveness. They stressed that without stronger policy enforcement, accountability, and public education campaigns, meaningful progress in combating climate change will remain out of reach.

“We should reduce the green house effects and make a policy for it. At least the list will be placed in front of the government, to work on.” 30 year old public health professional

“We have policies, but without proper implementation, nothing will change” 37 year old nurse

Discussion

The findings of this study offer insights into healthcare professionals'perceptions of climate change and its implications for health in Karachi, Pakistan. These perceptions reveal a complex interplay of awareness, professional roles, and systemic challenges, reflecting broader trends observed globally. While healthcare workers demonstrated some understanding of climate change, their perceptions often focused on immediate, localized phenomena such as seasonal shifts and extreme weather events. This aligns with studies suggesting that limited exposure to climate science and health-related climate impacts contributes to a narrow framing of climate change among professionals, particularly in low- and middle-income countries [10, 14]. Public health professionals in this study, however, exhibited a more nuanced understanding, linking climate change to systemic drivers like greenhouse gas emissions and deforestation. This disparity highlights the need for tailored educational interventions, as suggested by Adlong and Dietsch [1], to bridge gaps in awareness and foster a cohesive understanding among all healthcare stakeholders.

Participants consistently reported a rise in vector-borne and waterborne diseases such as malaria, dengue, and cholera, which they attributed to environmental changes exacerbated by climate change. These findings echo global patterns documented by Watts et al. [20], who reported increased incidences of such diseases in regions experiencing rising temperatures and changing precipitation patterns. However, while the healthcare professionals recognized these health challenges, there was a notable gap in explicitly linking them to broader climatic trends. This reflects a limitation also identified by Hathaway and Maibach [8], who found that healthcare workers often lack the interdisciplinary frameworks needed to connect health outcomes with climate science effectively. Similar findings were reported in a study conducted in India, which assessed multiple stakeholders, including healthcare workers, and revealed varying levels of knowledge regarding climate change and health [18].

Economic and social vulnerabilities were central themes in participants’ discussions, with many emphasizing the detrimental effects of climate change on agriculture, food security, and urban sustainability. Similar observations have been made in other rapidly urbanizing regions where environmental displacement and migration from rural to urban areas compound resource strain and social inequality [2, 9, 18]. Participants highlighted how floods and other climate-related disasters in Pakistan disrupt livelihoods, displace communities, and exacerbate health crises. This aligns with findings by Frumkin et al. [6], who emphasized the cascading effects of climate change on health, infrastructure, and socio-economic stability, particularly in resource-stressed settings.

The role of healthcare professionals in mitigating climate-related health impacts emerged as a critical but underutilized dimension. Participants expressed a willingness to engage in public health education and awareness campaigns but cited barriers such as inadequate training and resources. This reflects a broader challenge noted in the literature, where healthcare workers are often positioned as key advocates for climate action yet are hindered by institutional and systemic constraints [16]. Participants called for integrating climate change into medical curricula and improving access to technology and data systems to enhance their capacity to respond to climate-induced health challenges. Such recommendations are consistent with international guidelines, including those from the World Health Organization [22], which advocate for the mainstreaming of climate change in health education and practice.

Policy gaps and implementation challenges were recurring concerns. Despite existing frameworks, participants expressed frustration over weak enforcement and insufficient government commitment, echoing similar critiques in the global south [4]. The slow pace of governmental response to climate-related health issues, compounded by limited cross-sectoral collaboration, hinders progress. Participants’ calls for stronger policy enforcement and grassroots involvement reflect the findings of Moser [11], who highlighted the importance of participatory governance and community engagement in fostering effective climate action.

Limitation

While the study provides valuable insights into the perceptions of healthcare professionals on climate change and its health impacts, these perceptions may not be representative of all stakeholders involved in the healthcare system. Also the qualitative nature of the research limit the generalizability of the findings.

Recommendations

This study highlights the urgent need for a targeted and practical approach to address the health impacts of climate change in Karachi. Based on participants’ insights, immediate and actionable steps include integrating Continuing Medical Education (CME) courses and short courses on climate change for healthcare professionals at all medical colleges, universities, and hospitals to enhance their understanding of climate change-related health risks. Strengthening healthcare infrastructure resilience through localized adaptation strategies and fostering small-scale interdisciplinary collaborations can improve climate-responsive healthcare delivery. Additionally, community-driven public health campaigns tailored to local contexts can raise awareness and promote sustainable practices. Also, pilot initiatives focusing on data collection and early warning systems can serve as foundational steps toward larger systemic improvements.

Conclusion

As climate change accelerates, the healthcare sector’s role in mitigation and adaptation will become increasingly critical. By addressing identified barriers and leveraging the unique position of healthcare professionals as trusted community leaders, it is possible to build a more resilient and adaptive health system capable of meeting the multifaceted challenges posed by climate change. This study highlights an urgent need to bridge gaps in climate-related health education among healthcare professionals in Karachi; policymakers and educational institutions can respond by integrating relevant modules into medical and nursing curricula, allocating resources for ongoing professional development, and strengthening intersectoral collaborations. Future research could benefit from a longitudinal approach, assessing changes in perceptions and practices following the implementation of these educational initiatives or policy reforms. Such efforts will be instrumental in promoting sustained climate awareness and actionable health interventions within the healthcare system.