434; Towards a climate-resilient and inclusive health system: policy context and climate actions at subnational level in Nepal

Abstract

OP 24: Refugees and Asylum Seekers 2, B210 (FCSH), September 4, 2025, 14:45 - 15:45

Aims

Nepal ranks as one of the most vulnerable countries to climate change, facing extreme weather events and health risks. Limited evidence exists on the understanding and capacity of local health systems regarding climate change and health. Thus, this study aimed to review current policies, explore stakeholders’ and community members’ understanding and assess the preparedness of local health systems to address climate change-related health risks.

Methods

We employed a mixed methods approach, including policy and literature review and qualitative data collection. This involved 24 key informant interviews with stakeholders in three municipalities of Lumbini, Karnali and Bagmati Provinces in Nepal. The informants were from the health, environment, infrastructure, agriculture, and?livestock sectors. We also conducted five focused group discussion?with community members. We analyzed the data thematically.

Results

Nepal has developed policies on climate resilience and adaptation, but they lack clear guidance on building a climate-resilient health system. The stakeholders at subnational level have limited awareness of these policies due to insufficient orientation. Climate change is not a priority in local health plans due to resource constraints and capacity issues, with a focus on response rather than preparedness. The health system showed low resilience to climate risks. Community findings showed that recurrent climate-induced displacement in riverine areas led to economic hardship, forced migration, and increased health disparities, including rising mosquito- mosquito-borne diseases and mental distress.

Conclusions

Despite the existence of federal policies, there is a gap in their translation at the local level, and local health systems are inadequately prepared for the evolving climate crisis. It is crucial to communicate these policies to subnational levels and support local health systems in strengthening preparedness. Further, urgent interventions such as sustainable flood protection, resilient housing, and inclusive health services are essential to address migration-related health inequities and ensure long-term community stability.