A scoping review of climate resilient health system strategies in low-resource settings

Climate change threatens health systems, particularly in low-resource settings, where already vulnerable infrastructure, service delivery, and workforce capacity, likely exacerbate the burdens on public health and health systems. Our objective was to map research related to and present examples of strategies for climate-resilient health systems in resource-constrained settings.

We conducted a scoping review.

Our search strategy included five databases and was supplemented using OpenAlex. We screened studies from 1973 to 2025 using predefined eligibility criteria and extracted key findings across the six health system building blocks using the WHO health systems framework.

We included 67 publications spanning 2006 to 2025, covering 30 countries. Qualitative and mixed-methods study designs were the most common. Most studies addressed strategies related to health workforce and service delivery. Health workforce strategies described increasing climate-related training, task-shifting and building surge capacity while service delivery strategies included infrastructure resilience, facility preparedness, and maintaining continuity of care. Governance and leadership strategies emphasized coordination across governance levels, integrating climate resilience in national health plans, and improving crisis preparedness. Climate-health data integration, early warning systems, and real-time surveillance were strategies related to health information systems. Fewer studies focused on access to essential medicines and technologies, and financing.

We mapped and provided examples of strategies for climate resilient health systems in low-resource settings. As climate-related disasters intensify and global health funding declines, more research is needed to explore the effectiveness, acceptability and feasibility of affordable, scalable, and context-specific solutions to strengthen health system resilience in resource-constrained environments.