Healthcare workers' views and actions on climate change and health in private healthcare facilities in Tanzania: a cross-sectional study

OBJECTIVE: To assess the knowledge and attitudes of clinical and non-clinical healthcare workers related to climate change and health in Tanzania and to explore their roles in supporting sustainable healthcare practices. DESIGN: Multicentre, cross-sectional survey. SETTING: Private healthcare facilities across multiple levels of care in Tanzania. PARTICIPANTS: Healthcare workers employed at participating private healthcare facilities. A total of 216 respondents completed the survey, including both clinical (65.7%) and non-clinical (34.3%) staff. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcomes included healthcare workers' knowledge and attitudes regarding climate change and health, as well as their awareness of the healthcare sector's role in environmental degradation. Secondary outcomes included barriers to workplace climate action and existing engagement in environmentally sustainable healthcare practices. RESULTS: Over 90% of respondents recognised climate change as a significant health threat, and nearly 80% acknowledged that healthcare facilities contribute to environmental impacts. Major barriers to sustainable practices included low awareness among colleagues, budget constraints and a perceived lack of institutional or leadership support. Reported actions included responsible energy use, waste and water management and participation in climate-related education and awareness initiatives. Participants also described contributing to sustainable healthcare practices through lower-carbon clinical approaches, environmentally conscious procurement and cross-disciplinary collaboration. CONCLUSIONS: Healthcare workers in private healthcare facilities in Tanzania demonstrate strong awareness of climate change and motivation to support sustainability efforts. However, institutional and structural barriers limit implementation. Efforts to advance sustainable healthcare systems should focus on strengthening organisational support, increasing awareness and enabling healthcare workers to translate knowledge into action.