Barriers to Climate-Health Communication Among Physicians in Pakistan and Bangladesh: A Mixed-Method Pilot Study

Abstract

Background: Physicians play a critical role in communicating climate-related health risks to patients; however, barriers to such communication in low- and middle-income countries remain insufficiently understood. This study aimed to explore physicians’ perceptions, practices, and barriers related to climate–health communication in Pakistan and Bangladesh.

Methodology: A mixed-method pilot study was conducted using a cross-sectional survey and semi-structured interviews. A total of 124 physicians were surveyed, and 14 physicians participated in in-depth interviews. Quantitative data were analyzed to identify perceived responsibilities and barriers, while qualitative data were thematically analyzed to explore underlying perspectives.

Results: Most physicians (89.6%; 95% CI: 82.8–94.4) believed it was their responsibility to educate patients about climate-related health risks. The most commonly reported barriers included lack of knowledge (66.9%), time constraints (65.3%), and perceived patient disinterest (54.0%). Physicians with prior climate-related training were significantly more likely to identify patient skepticism as a barrier (adjusted odds ratio [aOR] = 3.81; 95% CI: 1.36–10.70; p = 0.011). Qualitative analysis identified three key themes: awareness of climate change and health, barriers to effective communication, and recommendations for improving practice. Time limitations and knowledge gaps were consistently emphasized across both data sources.

Conclusion: Although physicians recognize their role in climate–health communication, multiple systemic and individual barriers limit effective engagement with patients. As a pilot study using convenience sampling, these findings are exploratory and warrant further validation. Strengthening medical curricula, developing standardized consultation frameworks, and implementing supportive policies may enhance climate–health communication in South Asian healthcare systems.