Empowering Nurses for Climate Resilience: Opportunities and Challenges in Philippine Nursing Education

Abstract

By integrating climate change concepts and skills in the nursing curriculum, regulatory bodies, faculty development, resources, and models of nursing education in the Philippines, Filipino nurses can emerge as climate-resilient and competent healthcare professionals—capable not only of delivering care but also leading community adaptation, advocating for policy change, and fostering environmental sustainability. This aligns with the global shift toward planetary health, ensuring that nurses in the Philippines remain relevant, competent, and prepared to act in a changing climate. Given their significant presence in domestic and international healthcare systems, they can become global leaders in climate and health advocacy. By doing so, Filipino nurses not only protect their communities but also make meaningful contributions to global health resilience. Moving forward, Filipino nurses and nursing educators may need additional focus on vulnerable populations, including LGBTQ + individuals, indigenous people, women, and those with disadvantaged socioeconomic backgrounds. Likewise, they can investigate the factors influencing health outcomes related to climate change. They can also develop culturally appropriate interventions to improve the health outcomes amidst climate-related events.

Introduction

Mulu and Kivuva (2025) highlighted that low- and middle-income countries lag behind high-income countries in making progress toward integrating climate change education in health professions education. Thus, it was suggested that a multipronged approach is necessary to equip health professionals, such as nurses, with the knowledge to address climate change-related events. Integrating climate change education into health professions curricula is not merely an academic issue—it is a public health urgency, especially in climate-vulnerable nations like the Philippines (Alibudbud, 2023d; Guinto et al., 2021).

Brief Review

The Philippines ranks among the top 10 countries in the Climate Risk Index, which indicates a high disaster risk from climate-related events (Alibudbud, 2023d; German Watch, 2025; Guinto et al., 2021). This highlights the country's need to improve its disaster preparedness and its health and psychosocial support systems (Alibudbud, 2023b, 2023d; Guinto et al., 2021). The country faces about 20 strong typhoons annually, resulting in adverse impacts on Filipino communities (Alibudbud, 2023d).

This need is exemplified by Typhoon Haiyan, one of the strongest typhoons to have ever made landfall in recorded history (Alibudbud, 2023b). Its aftermath has resulted in the devastation of cities, destruction of livelihoods and homes, displacement of over a million, and death of about 6,000 Filipinos (Alibudbud, 2023b). The WHO estimated that almost a million Filipinos needed mental healthcare in its aftermath (Alibudbud, 2023b). Therefore, the Philippines has a critical need for effective education on climate-health issues, particularly for Filipino nurses who serve as community frontliners.

While the Philippine health system suffers from a shortage of nurses, a significant number of nurses are employed in other sectors and abroad (Alibudbud, 2023a). This is because the Philippine nursing education is geared towards an export model, making the country a large supplier of nurses globally (Alibudbud, 2022, 2023a). The country's nursing curriculum aims to develop professionals who deliver safe, compassionate, and holistic care to individuals, families, and communities, promoting wellness, with no particular emphasis on climate change (CHED, 2017).

Given the scale, importance, and reach of the nursing workforce in the Philippines and internationally, nurses can be empowered in the face of worsening climate-related events (Alibudbud, 2022, 2023a; Balinbin et al., 2020). By doing so, Filipino nurses can advance the position of the International Council of Nurses [ICN] and contribute to the WHO's climate change objectives by promoting patient education, advocacy, and leadership, while building resilient health systems that prioritize climate-informed, equitable healthcare (ICN, 2024; WHO, 2023). Mulu and Kivuva (2025) suggested that five key areas can be leveraged to empower Filipino nurses amidst climate change. This article highlights the opportunities and challenges within these areas that the nursing education system can strengthen, including the curriculum, regulatory bodies, faculty development, resources, and models.

Current Insights and Interpretations

Models of Integration

Models of integration are significant for the Philippines, where diversity in geography, culture, and socioeconomic conditions requires flexible and context-sensitive approaches. There is a need for adaptable models, and for the Philippines, this means integrating climate change into existing nursing frameworks, not as a standalone subject but as a cross-cutting issue. For example, climate-related health impacts can be taught during community health rotations, where student nurses engage with families affected by flooding, food insecurity, or postdisaster trauma (Diallo et al., 2023; Gaudreau et al., 2024; Mulu & Kivuva, 2025). In clinical settings, students can be trained to identify climate-sensitive conditions, such as heatstroke, leptospirosis, or malnutrition exacerbated by extreme weather (Diallo et al., 2023; Gaudreau et al., 2024; Mulu & Kivuva, 2025). Filipino nurses are known for their compassion and adaptability, which are invaluable in a climate crisis (Balinbin et al., 2020; Borbolla & Nkansa-Dwamena, 2025).

Curriculum

Globally, health curricula often omit or underrepresent climate-health concepts (Mulu & Kivuva, 2025). A review by Roberge et al. (2025) examined documents from nursing associations, such as the ICN and the Canadian Association of Schools of Nursing, and found growing interest and approaches that raise awareness of climate-related health impacts among nurses. However, gaps remain, including that climate topics are minimally embedded within nursing curricula, a lack of a standardized competency framework to guide nurses on climate change, and teaching methods that limit student engagement. Thus, embedding climate education across all levels of nursing training and faculty development is essential (Roberge et al., 2025).

Similarly, while elements like disaster nursing are taught in the Philippines, they can lack a structured lens on climate change. Integrating climate-related concepts relevant to the local context, such as heat-related illnesses, climate-sensitive vector ecology, eco-anxiety, and eco-friendly clinical practices into nursing coursework can be vital in empowering nurses to respond to climate change (Alibudbud, 2023b; Estoque et al., 2020; Guinto et al., 2021).

The nursing curriculum can also incorporate intervention topics for the social and health consequences of climate change. As the Philippines is prone to climate-related disasters, such as flooding, Filipino nurses have expressed concerns about their limited disaster preparedness (Alibudbud, 2023b; Labrague et al., 2015). Thus, nursing schools can incorporate disaster preparedness and risk reduction as examples of possible areas of practice for community and public health nursing competencies. Filipino children also experience greater climate-related anxiety than their global counterparts (Aruta & Simon, 2022; Hickman et al., 2021). Hence, incorporating psychological first aid and psychosocial support training into psychiatric nursing education can equip nurses to address mental health concerns across various contexts, including climate-related events.

Regulatory Bodies

In the Philippines, the Commission on Higher Education (CHED), the Professional Regulation Commission (PRC), and the Board of Nursing (BON) are the primary regulators of the nursing profession and curriculum. However, they have yet to require climate-health competencies (Faba-An & Felipe-Dimog, 2024; Peralta et al., 2024). Including climate change-related concepts and skills in Nurse Licensure Exam content and nursing education outcomes could compel schools to prioritize them, signaling that climate literacy and competencies are a necessity in the face of the worsening climate-related events (Gaudreau et al., 2024). For instance, CHED require schools to include climate-health competencies for nursing graduates. Likewise, these topics can be incorporated into community and psychiatric nursing licensure exam subjects of the PRC.

Faculty Development

Nursing educators can lack the confidence and expertise in teaching climate-health issues (Mulu & Kivuva, 2025). This can be pronounced among Filipino nursing faculty, who trained before climate change became a global health focus. Therefore, the Philippine nursing education system should invest in faculty training through continuing professional development units and partnerships with environmental and health agencies (e.g., Department of Health and Department of Environment and Natural Resources), nongovernmental organizations, and environmental scientists and planetary health experts to enhance teaching capacity. Equipping faculty with localized data, examples, and teaching strategies can help make climate education more accessible and relevant, empowering them to translate climate science into practical, context-sensitive learning experiences (Diallo et al., 2023; Gaudreau et al., 2024; Mulu & Kivuva, 2025).

Resources

Disparities in access to context-specific teaching materials hinder climate education (Mulu & Kivuva, 2025). In the Philippines, there could be an uneven distribution of learning resources across nursing schools, especially between urban and rural institutions (Labrague et al., 2018; Ortiga, 2014). Localized and culturally relevant resources, such as case studies from health burden of Filipino communities affected by typhoons, dengue outbreaks during wet seasons, or displacement due to flooding, are scarce (Alibudbud, 2023b, 2023d; Chua et al., 2019; Guinto et al., 2021). This can create a disconnect between theoretical concepts and real-world applications. Addressing this gap requires investment in educational tools that reflect the experiences of Filipino communities. Thus, government units and universities can collaborate to develop open-access materials, videos, case simulations, and modules that incorporate Philippine climate-health realities.

Moving Forward and Future Directions

Moving forward, Filipino nurses, nursing educators, policymakers, nursing associations, and international partners may need to place greater emphasis on caring for vulnerable populations, including LGBTQ + individuals, Indigenous peoples, women, and socioeconomically disadvantaged people (Alibudbud, 2023c; Guinto et al., 2021). For instance, reports indicate that LGBTQ + individuals in the Philippines often face discrimination in the provision of typhoon relief assistance (Alibudbud, 2023c). Therefore, these inequities must be addressed through inclusive disaster response. As a start, existing subjects like psychiatric nursing can include discussions about LGBTQ + mental health and stressors (e.g., gender-based discrimination) that may be experienced during disasters. Likewise, they can explore the socio-environmental factors (e.g., floods) that influence health outcomes in climate change contexts. Developing culturally appropriate interventions to address the health impacts of climate-related events is also essential.

Conclusion

Integrating climate change concepts and skills into the nursing education system can help shape Filipino nurses into climate-resilient and capable professionals. They will not only be prepared to deliver quality care but also to lead community adaptation efforts, advocate for climate-informed policies, and promote environmental sustainability. This shift reflects the global move toward planetary health, ensuring that Filipino nurses stay relevant, well-equipped, and responsive to the changing climate. With their presence in local and international healthcare systems, Filipino nurses are well-positioned to be advocates for climate and health. In doing so, they can protect their communities and advance global health resilience.