Climate and health capacity building for climate-resilient health systems: a case study of the ASPHER-GCCHE European course

Abstract

Climate change poses growing risks to population health and health system functioning across Europe. Building climate-resilient and low-carbon health systems requires a workforce equipped with appropriate competencies. However, structured climate and health education remains unevenly implemented. This study evaluated the 2025 ASPHER–GCCHE European Climate Resilient Health Systems Course, a large-scale, competency-based online training programme designed to strengthen climate-health capacity among health professionals. We conducted a longitudinal evaluation of a 10-week, open-access, fully virtual course delivered in English between January and April 2025. Participants completed pre- and post-course surveys assessing self-reported confidence across six climate-resilience competency domains using a 10-point Likert scale. Paired Wilcoxon signed-rank tests assessed pre–post changes overall and by geographical region. A total of 4432 individuals from 164 countries registered for the course. Among 1029 participants (1029) from 119 countries, 446 participants were from the WHO European Region, met attendance and assessment criteria and were included in the analysis. Statistically significant improvements were observed across all six competency domains (P < .001), with mean confidence increases ranging from 45% to 59%. Self-reported confidence gains were consistent across European subregions, indicating comparable learning effects despite differing policy and institutional contexts. Nearly half of all registrants were from low- and middle-income countries, highlighting the reach of the open-access model. This evaluation demonstrates that competency-based online education was associated with improved self-reported confidence in climate-resilient health-system competencies. Integrating similar training into formal education and professional development pathways may support implementation of climate-resilient and low-carbon health system policies across Europe and beyond.