A Nationwide Survey Following the Devastating 2022 Floods in Pakistan: Current State of Knowledge, Attitude, and Perception Toward Climate Change and Its Health Consequences.

ABSTRACT

BACKGROUND:  Climate change (CC) persists as a critical public health concern, vividly demonstrated by Pakistan's severe unprecedented flooding from June to October 2022. The interplay between floods and CC highlights the urgent need to comprehend their complex dynamics. Given Pakistan's significant geographical vulnerability to CC events, assessing public awareness of CC becomes essential. This study aims to evaluate public knowledge, attitudes, and perception (KAP) regarding CC and its implications for overall health, reflecting onto governmental policies and community-based guidelines and enhancing preparedness for future natural calamities of similar magnitude. METHODS:  A nationwide cross-sectional survey of Pakistani adults covering all provinces of the country was conducted from January to March 2023 using a prevalidated questionnaire. A purposive sampling strategy was used to enroll participants in the study. Where appropriate, the chi-square test or Fisher's exact test was used to compare KAP among the sociodemographic groups. Multivariate analysis was used to explore predictors of knowledge. Crude and adjusted odds ratios (ORs) were calculated considering a p value of ≤0.05 as significant. RESULTS:  Among the 714 respondents, 265 (37.1%) of the respondents' residential areas were affected by the floods in Pakistan. A total of 663 (92.9%) of the participants had heard of CC, with 302 (42.3%) choosing "social media/WhatsApp" as their source of information. Increased flooding and changes in rainfall patterns were selected by 679 (95.1%) and 661 (92.6%) participants, respectively, as the most recognized CC. "Deforestation" was the most indicated reason for CC by 675 (94.5%) participants. Multivariate analysis revealed that females (OR 1.31, 95% CI 1.16-2.00; p < 0.001), individuals who were affected by recent floods (OR 1.13, 95% CI 1.05-3.34; p = 0.003), and individuals who were medical students/healthcare workers (OR 1.49, 95% CI 1.24-2.48; p < 0.001) had greater knowledge of CC than their counterparts. CONCLUSIONS:  The study reported an encouraging prevalence of knowledge of CC, positive attitudes, and practices toward CC, with an interest in learning and doing more to address the health effects of CC. With the ongoing global CC and a monsoon season forecast of similar intensity for the years to come in Pakistan, identifying groups with less knowledge of CC warrants a targeted education program to maximize awareness. Based on the study findings, social media platforms and interventions in educational institutes should be essential to mitigate the CC events in Pakistan and other vulnerable regions in the area.