Building climate resilience in health systems: a climate vulnerability and capacity assessment in a rural hospital in Chad

<h2>Abstract</h2><h3>Background</h3> Chad is highly vulnerable to climate change, with rising temperatures, irregular rainfall, droughts, and resource scarcity driving food insecurity, malnutrition, and vector-borne diseases. In Ngouri, in the Lac Region, these climate stressors have led to worsening health outcomes and strained health-care services. Without adaptation measures, facilities will struggle to sustain essential services. In this case study, we present a facility-adapted climate vulnerability and capacity assessment (VCA) for a rural hospital, identifying key risks and prioritising solutions for climate resilience. <h3>Methods</h3> This study used a participatory mixed-methods design including a literature review on climate hazards and vulnerabilities; facility audit of infrastructure and service delivery gaps; focus groups to refine risk identification; solution-matrix development with costs and feasibility analysis; and participatory prioritisation to produce a multiyear improvement plan. <h3>Findings</h3> The VCA identified elevated malarial mortality and power outages disrupting oxygen supply as key risks. 35 solutions were generated, with 22 priority actions selected for implementation, including anticipatory planning, community sensitisation, supplementary feeding programmes, and improved waste management. The process highlighted the importance of community engagement, multidisciplinary collaboration, and staff motivation for climate-resilient and sustainable health care. <h3>Interpretation</h3> The adapted VCA offers a replicable approach to assess climate-related vulnerabilities and capacities in health-care facilities. The approach used in Ngouri hospital informed feasible adaptation measures and showed relevance for similar contexts, supporting health system resilience and alignment with global sustainability goals. <h3>Funding</h3> None.