Climate change poses significant public health challenges globally, particularly in vulnerable regions such as The Gambia. Despite growing recognition of environmental impacts, limited research has examined community-level awareness of climate change health effects in West African settings. This study aimed to assess household awareness and perceptions of climate change impacts on public health among vulnerable communities in the North Bank Region, The Gambia and identify socio-demographic determinants of climate change awareness.

In this study, we conducted a community-based cross-sectional study. Using multistage sampling, we selected 35 communities across seven districts. Data were collected via structured questionnaires administered in local languages (Mandinka, Wolof, Fula) using KoboToolbox.

This study was conducted among 868 residents aged ≥18 years in the North Bank Region between January and February 2024.

Overall, 85.7% (n=744) of respondents had heard about climate change, with radio (53.6%) being the primary information source. Participants demonstrated high awareness of certain climate hazards, such as excessive heat (76.4%) and altered rainfall patterns (55.2%), but less so for other hazards, such as flooding (30.3%). Respondents correctly identified multiple health impacts to health and livelihoods, including heat stress (65.8%), dehydration (57.3%), respiratory diseases (73.6%), waterborne diseases (59.0%) and crop failure (86.4%). Multivariable analysis revealed that older age (>39 years: adjusted OR (aOR)=2.50, 95% CI 1.49 to 4.21) and tertiary education (aOR=3.93, 95% CI 1.50 to 10.30) were independent predictors of climate change awareness. Approximately 77% of participants reported experiencing climate change effects in their communities within the past 5 years.

This first comprehensive assessment of climate-health awareness in the North Bank Region of The Gambia reveals substantial community recognition of climate change and its health consequences. Significant disparities in awareness by age and educational attainment indicate that targeted educational interventions focused on younger populations and those with limited formal education are warranted.