Towards resilience: investigating resources for enhancing climate resilience in health care facilities in low and middle-income countries. a scoping review

Climate change is increasingly impacting healthcare facilities worldwide, with those in low and middle-income countries generally facing high risks due to higher vulnerability and lower adaptive capacity. This scoping review examines resources to strengthen the climate resilience of healthcare facilities in low and middle-income countries. We used Arksey & O’Malley (2005) and Levac et al. (2010) scoping review methodology to systematically search four academic databases (Scopus, PubMed, CINAHL, and Lilac), as well as Google Scholar, and the grey literature (websites from the World Health Organization, Green Climate Fund, Global Adaptation Mapping Initiative, Health Care Without Harm, and the Global Environmental Facility) between 2015 and 2024. A coding framework guided the data extraction, which was analyzed quantitatively and qualitatively (Braun and Clarke Thematic analysis). We identified 33 resources for building the climate resilience of healthcare facilities in low and middle-income countries. The resources varied in their intended audience, composition, and purpose. They produced various outputs (i.e., guidelines, checklists, or adaptation plans) that are presented in a typology to allow users to select the best resource or tool for their purposes. Our analysis identified 14 domains for building climate-resilient healthcare facilities in low and middle-income countries. We present a range of indicators under each domain for measuring the climate resilience of healthcare facilities to enable monitoring and evaluation of climate resilience-building efforts. There are a growing number of diverse resources that can be used to build climate resilience at the healthcare facilities level in low and middle-income countries. This scoping review offers a comprehensive typology of 33 resources that vary in their focus and application, enabling stakeholders to identify and apply the most appropriate tools for their specific contexts. The 14 key domains identified by this review and associated indicators provide a structured framework for assessing and enhancing climate resilience efforts within healthcare facilities. By offering a range of action-oriented resources and measurable indicators, this review supports ongoing efforts to safeguard healthcare services in low and middle-income countries against the growing impacts of climate change, contributing to the global discourse on sustainable, climate-resilient health systems.