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Climate Resilience and Environmental Sustainability of Healthcare Facilities in a Rural District of Pakistan: A Mixed‐Methods Assessment Using the WHO Framework

Humaira Nazir, Lala-Rukh Matties, Jai K. Das, Z. Bhutta

Climate Resilience and Sustainability, 2026

Abstract

Climate change increasingly threatens healthcare facilities (HCFs), especially in low‐ and middle‐income countries. This study assessed climate vulnerabilities in 12 HCFs (9 primary and 3 secondary) in a rural district Matiari in Sindh, Pakistan, and proposed sustainable interventions. This mixed‐methods study (April–July 2025) combined four components, including a quantitative survey with doctors and patients, an HCF assessment using the World Health Organization (WHO) checklists for climate‐resilient and environmentally sustainable HCF, environmental simulations of wind and solar exposure, and Quantum Geographic Information System (QGIS)‐based spatial flood analysis. All HCFs had a medium level of preparedness (33.4%–66.6% range) with workforce scoring lowest (37%), water, sanitation, and waste management (WASH) (41.3%), infrastructure (48.3%), and energy (51.0%). Doctors reported inadequate climate preparedness training (50%) and poor waste management (80%). Patients’ responses were mixed, with high access to clean water (80%), but frequent power outages (60%). The environmental analysis identified poor ventilation and excessive heat exposure, and spatial flood analysis identified 42% of the HCFs as highly susceptible. No facility met WHO climate‐resilience standards, as no specific domain reached a “high” level of preparedness. There is a need for greater attention and investment across all domains to make the HCFs in Pakistan climate resilient.

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