Article

Why Climate-Resilient Health Facilities are a Critical Business and Development Priority

2026-11-10 · By Abireham Misganaw, Global Climate Resilience Lead: Program, Business Development & Partnership, Pathfinder International

Abireham Misganaw of Pathfinder International explores why climate-resilient health facilities are essential to protecting communities and local economies. Drawing on experience in Bangladesh and Pakistan, he highlights practical preparedness, government ownership, women’s leadership and resilient infrastructure as critical to maintaining maternal, newborn and reproductive health services during climate-related emergencies.

Climate-driven disasters threaten health services at the very moment communities need them most. Bangladesh and Pakistan ranked seventh and eighth globally on the Long-Term Climate Risk Index for 2000–2019 respectively, have experienced the devastating consequences of extreme weather. For communities already facing poverty, weak health infrastructure and gender inequality, the disruption goes far beyond damaged buildings. When health facilities become inaccessible or cease operating, pregnant women, newborns and other people seeking sexual and reproductive health services face heightened risks.

The consequences extend beyond the health sector. Businesses depend on healthy workers, functioning supply chains and stable communities. When climate shocks disrupt access to healthcare, they also undermine livelihoods, workforce productivity and local economic resilience. Investing in climate-resilient health facilities is therefore not simply a development priority; it is an investment in the stability of local economies and the communities that sustain them.

What We Learned: Insights from Bangladesh and Pakistan

From 2022 to 2025, Pathfinder International implemented the Advancing the Leadership of Women and Girls Towards Better Health and Climate Change Resilience program, serving more than 1.2 million people. Drawing on findings presented in the program’s 2026 brief, we examine what changed, which interventions made a difference, and what still stands in the way of resilient frontline health services.

Preparedness Depends more on Practical Systems than Expensive Technology

Baseline assessments, using questions adapted from the WHO’s climate change facility checklist, across 789 facilities revealed that infrastructure and supplies were acutely vulnerable, with few facilities possessing structured emergency plans.

The program focused on addressing these gaps through practical interventions. These included staff training on the Minimum Initial Service Package (MISP) for SRH in crisis situations, facility renovations, and contingency planning. Following these interventions, mean preparedness scores increased significantly (), rising by 10 points in Bangladesh and 18 points in Pakistan. Some of the most impactful changes were highly practical:

Raising power supplies and essential equipment above ground level
Installing emergency backup generators
Establishing written protocols

The experience offers an important lesson: resilience does not always require sophisticated technology or expensive infrastructure. Often, it starts with anticipating predictable risks, protecting essential equipment, putting basic systems in place and making sure everyone knows their responsibilities.

Government Ownership Secures Long-Term Sustainability

Preparedness is difficult to sustain when it depends entirely on individual facilities or externally supported projects. A major lesson from the program is that facility resilience requires deep integration into local governance. By embedding contingency plans into emergency frameworks run by district-level government bodies, facilities gained access to official emergency hotlines, updated stock lists, and cross-referral networks between public and private clinics. Furthermore, supportive supervision visits led by district officials inspired facility managers to proactively take charge of local service improvements.

Women’s Leadership Ensures Continuity of Essential Services

The program also demonstrated why women need to be part of decisions about climate resilience, not simply recipients of emergency support. In both countries, “women climate champions” from local communities actively participated in contingency planning and district decision-making bodies. This is particularly important during emergencies, when these services are often among the first to be disrupted, despite the heightened needs. Women’s participation brought these priorities into local planning and helped connect disaster preparedness with the realities facing communities.

Gaps: Where Facility-Level Action is Not Enough

The improvements were encouraging, but they did not eliminate the underlying vulnerabilities. Yet significant gaps in supplies, energy and infrastructure remained. Two challenges stood out:

Supply chain and commodity security: There was no meaningful improvement in securing a reliable two-month supply of tracer SRH commodities, with 75% of facilities maintaining proper stock at endline.
Reliable power and cold-chain systems: Frequent power failures continued to threaten cold chains and make extreme heat unmanageable. While some facilities acquired generators, many local clinics lacked the capital resources to buy independently.

These gaps point to a fundamental limitation of facility-level preparedness: health facilities cannot build resilience in isolation. Reliable electricity, functioning supply chains and access to essential commodities depend on wider systems and investments beyond the individual facility.

What this Means for Business and System Leaders

Climate-resilient health systems are not just a concern for ministries of health and development organizations. They are also essential to businesses operating in climate-vulnerable markets. Healthy communities sustain productive workforces, local markets and reliable supply chains. When health services fail during emergencies, the effects ripple through households, businesses and entire local economies.

The private sector has an important role to play, working alongside public institutions and civil society to move beyond short-term disaster relief towards investments that strengthen the systems communities rely on Several priorities deserve greater attention:

Make preparedness part of routine health system management: Standardize district-wide protocols across the health system.
Invest in a resilient workforce: Combat high staff turnover by embedding continuous refresher courses
Put local governments in the driving seat: Transition responsibility into local government offices, backed by dedicated budget lines in budget plans
Give women a meaningful role in decision-making: Ensure women leaders remain active on local disaster risk reduction governances and health planning
Strengthen the evidence base: Future resilience initiatives must include comparison groups and track service continuity and health outcomes. This will help establish which interventions work, under what conditions, and where additional investment is needed.