C4 EcoSolutions completed a pre-feasibility assessment and developed a concept note for a climate-resilient health system initiative in the Maldives. 

The work examines infrastructure vulnerabilities affecting healthcare delivery, analyses projected shifts in disease vector ecology and identifies adaptation measures to strengthen health sector resilience against climate-related hazards including coastal flooding, extreme heat and water scarcity.

The Maldives comprises ~1,200 low-lying islands with an average elevation of 1.5 m above sea level, distributed across 188 inhabited islands. Projected temperature increases of 1–2°C by 2050 are expected to intensify health risks through expanded vector-borne disease transmission, contamination of water sources and increased frequency of heat-related illnesses. Health facilities are highly exposed, with over 47% of coastal infrastructure located within 100 m of shorelines. Geographic dispersion complicates service delivery, whilst power systems reliant on diesel generation and limited water storage capacity increase vulnerability during climate events.

The pre-feasibility study and concept note identifies adaptation interventions across four strategic areas:

• Retrofit health facilities with elevated floor levels, waterproofed electrical systems and climate-adapted design standards to maintain operations during flooding events.
• Expand renewable energy capacity with adequate battery storage to ensure continuous power supply for diagnostic equipment and vaccine cold chain systems.
• Integrate climate forecasts into disease surveillance platforms to enable anticipatory response and early detection of climate-sensitive health risks.
• Strengthen governance mechanisms for climate-health integration through institutional capacity building and intersectoral coordination frameworks.
• Enhance water security infrastructure including expanded rainwater harvesting systems and desalination capacity to sustain healthcare operations during extended dry periods.

By combining infrastructure resilience with institutional strengthening and climate-informed surveillance systems, the proposed interventions are expected to reduce service disruptions during extreme weather events, safeguard healthcare access for vulnerable populations and strengthen emergency response capacity across dispersed island communities.