Aware but Unprepared: The impact of climate change on healthcare workers and service delivery in Africa - A Scoping Review

Adelaide M Lusambili^1,2Britt Nakstad^3*Sharon Ochieng²Isioma Igweike⁴Babatope O Adebiyi⁵Sadiq Bhanbhro⁶Ogechukwu Igweike⁷Julian Natukunda⁸

• ¹African International University, Nairobi, Kenya
• ²NextGen For Earth, Kenya, Nairobi, Kenya
• ³University of Botswana, Gaborone, Botswana
• ⁴United Lincolnshire Hospitals NHS Trust, Boston, United Kingdom
• ⁵University of Calgary, Calgary, Canada
• ⁶Sheffield Hallam University, Sheffield, United Kingdom
• ⁷The University of Manchester, Manchester, United Kingdom
• ⁸University of Oxford, Oxford, United Kingdom

Introduction: Climate change is an urgent global crisis, placing a growing strain on health systems and overwhelming healthcare workers' ability to respond. Africa is especially vulnerable due to its limited resources and infrastructure. Healthcare workers face climate impacts directly, yet their preparedness is poorly understood. This scoping review assessed how climate change affects healthcare workers and service delivery across the continent. Methods: A scoping review methodology was followed. A systematic literature search was conducted across six electronic databases, including Scopus, CINAHL, Dimensions, PubMed, Web of Science, and Google Scholar. Additional studies were identified via hand searching. Eligible studies included primary research on healthcare professionals' perceptions, preparedness, and the systemic challenges climate change poses. They were included if published between 2005 and July 2025, conducted in Africa, and written in English. Data were extracted and synthesised to identify common themes and gaps in the current understanding and response to climate-related health issues. Results: This scoping review synthesised evidence from 18 studies conducted across 17 African countries— including Ghana, Nigeria, South Africa, Namibia, Ethiopia, Kenya, Egypt, Uganda, the Democratic Republic of Congo, Zimbabwe, Sudan, Rwanda, Zambia, Botswana, Malawi, Somalia, and Burkina Faso. The review included 10 quantitative, 5 qualitative, and 3 mixed-methods studies examining healthcare workers' perceptions, preparedness, and experiences in addressing climate-related health challenges. Results show that healthcare workers in Africa recognise rising climate-related health problems, including vector-and heat-related diseases, respiratory conditions, and malnutrition. However, they feel unprepared to address these challenges, citing insufficient training and inadequate infrastructure. Heavy patient loads contribute to stress and burnout, while gaps in knowledge about causes and adaptation limit prevention. At the facility level, resource shortages and weak climate-health policies further constrain effective and sustainable responses. Conclusion: Climate change is intensifying healthcare demands, straining limited resources, and burdening health professionals. Targeted policies, resilient infrastructure, effective surveillance systems, and comprehensive training programs are needed to enhance service delivery, reduce strain, and build resilience against climate-related health impacts.