Informing climate adaptation for women’s and children’s health: A cross-sectional survey on knowledge, attitudes, and practices in a climate-vulnerable setting

Women in low- and middle-income countries, including Indonesia, are disproportionately affected by climate change impacts. Despite the intersection of these risks with gender inequalities, evidence on women’s knowledge, perceptions, and responses are limited. This study established baseline data on Indonesian women’s knowledge, attitudes, and practices regarding climate change and its health impacts. A cross-sectional 33-item survey adapted from the United Nations Development Programme’s Climate Change Knowledge, Attitudes, and Practices Survey was administered electronically and in person between July 2023 and May 2024. Descriptive statistics summarised responses, and Pearson’s chi-square tests assessed associations between demographic characteristics and knowledge, attitudes, and practices. Among 941 participants, 723 (76.8%) were university graduates, 682 (66.0%) lived near disaster-prone areas, 576 (61.2%) were married, and 556 (59.1%) were employed. Educational level was significantly associated with knowledge of climate change causes and effects (p < 0.001, 95% CI = 0.000–0.000), whereas no demographic variables were associated with knowledge of climate-related health impacts. Awareness of gender-specific health risks remained low, with few participants recognising risks such as preterm birth (n = 256; 27.2%) and increased vulnerability to sexual violence (n = 119; 12.6%). Attitudes toward climate change were associated with education level (p < 0.001, 95% CI = 0.000–0.000) and place of residence (p = 0.003, 95% CI = 0.002–0.004). Engagement in mitigation practices was associated with occupation (p = 0.003), marital status (p = 0.018, 95% CI = 0.015–0.020), and education level (p < 0.001, 95% CI = 0.000–0.000), but not residence (p = 0.661, 95% CI = 0.652–0.670). Although Indonesian women expressed concern and motivation to address climate change, knowledge gaps exist regarding its gendered health impacts. Targeted climate–health communication and locally relevant adaptation strategies are needed to strengthen the resilience of women and children in vulnerable communities.