Healthcare professionals at the frontline of Climate Change: knowledge, attitudes, and practices

Muhammad Muneebullah Siddiqui , Zafar Fatmi , Faiz Alam, Anny Dhanwani

Healthcare professionals (HCPs), as trusted cadre of community, play a crucial role advocating climate action to reduce its impact on health. This study aimed to assess the knowledge, attitudes, practices and perceived responsibilities (KAPP), associated factors, of healthcare providers in Karachi, Pakistan, regarding climate change and its associated health effects.
We conducted a cross-sectional study among 486 HCPs from two tertiary care hospitals, one public and one private using a structured questionnaire adopted from previous studies. Composite KAPP scores were calculated for each domain; scores >50% were classified as adequate knowledge, positive attitudes, or good practices, while scores ≤50% were classified as inadequate/poor. Linear regression was used to examine associations between domain scores and co-variates. Variables significant at p ≤ 0.10 in bivariate analysis were included in multivariable models. Results are presented as beta coefficients with 95% confidence intervals.
Overall, 51% of participants demonstrated adequate knowledge, 68% had positive attitudes, 50% reported good climate-related practices and 90% felt responsibility for the issue. Most respondents agreed that climate change harms general health (96.7%) and affects patient health (89%). Key barriers to discussing climate change with patients included time constraints (82.9%) and insufficient knowledge (78.2%). In adjusted analyses, HCPs in private hospitals had significantly lower practice scores compared to those in public hospitals (β = −0.84, p < 0.01). Postgraduate education and House Officer designation were associated with higher knowledge scores, while higher income was linked to better knowledge and attitudes. A significant gap was noted between high intent and low personal practice, with 40% never using public transport/carpool and 46.3% never walking/biking.
We found generally positive attitudes, but substantial gaps exist in knowledge and practice. We recommend integration of climate change into medical curricula, and institutional support to strengthen HCPs capacity to address climate-related health challenges.