"Climate Change and Health?": Knowledge and Perceptions among Key Stakeholders in Puducherry, India.

Climate change has far-reaching impacts on human health, with low- and middle-income countries, including India, being particularly vulnerable. While there have been several advances in the policy space with the development of adaptation plans, little remains known about how stakeholders who are central to the strengthening and implementation of these plans perceive this topic. We conducted a qualitative study employing key interviews with 16 medical doctors, researchers, environmentalists and government officials working on the climate change agenda from Puducherry, India. The findings were analysed using the framework method, with data-driven thematic analysis. We elucidated that despite elaborating the direct and indirect impacts of climate change on health, there remains a perceived gap in education and knowledge about the topic among participants. Knowledge of the public health burden and vulnerabilities influenced the perceived health risks from climate change, with some level of scepticism on the impacts on non-communicable diseases, such as cardiovascular diseases. There was also a felt need for multi-level awareness and intervention programmes targeting all societal levels along with stakeholder recommendations to fill these gaps. The findings of this study should be taken into consideration for strengthening the region's climate change and health adaptation policy. In light of limited research on this topic, our study provides an improved understanding of how key stakeholders perceive the impacts of climate change on health in India.