Framework-informed analysis of practice: A qualitative study on climate resilience in primary care in Austria

The World Health Organization's (WHO) 2023 Operational framework for building climate resilient and low carbon health systems supports health systems in climate-sensitive capacity building but offers limited guidance for primary care (PC). This qualitative study uses WHO's framework as conceptual scaffold to map measures, needs and gaps in Austrian PC through a multiprofessional perspective, thereby enriching the research scope by local-level climate resilience strategies.

Online focus groups and individual interviews were conducted with 21 Austrian primary care professionals (PCPs). Qualitative content analysis was guided by the structure of components grouped into building blocks as defined in WHO's framework.

Participants focused primarily on the WHO building blocks "Health workforce" and "Essential medical products and technology". They demonstrated awareness of climate-related health impacts, especially heat, and addressed needs for profession-specific training as well as barriers to implementing climate-sensitive health counseling. Infrastructural adaptations were limited by structural constraints, yet air conditioning was deemed indispensable in practice settings, despite being maladaptive. The need for process adjustments, especially in mobile work settings, became apparent. Climate-related emergency preparedness seems underdeveloped. Severe gaps were identified especially concerning building blocks "Health information systems", "Service delivery", and "Financing".

PCPs play a vital role in local climate resilience but require tailored, context-specific guidance aligned with PC's integrated, small-scale, multiprofessional nature. Strategic macro-level objectives are required to support low-barrier implementation of resilience measures. Prioritizing emergency preparedness and addressing structural limitations in PC is essential to ensure the transition to a climate resilient, low-carbon health system, fulfilling WHO's vision.