INTRODUCTION:
zambia faces escalating health security challenges from climate-sensitive diseases like cholera and malaria, intensified by floods and droughts. these climate-related disasters strain the primary health care (phc) system, threatening universal health coverage. this study assesses the resilience of zambia's phc system to climate-induced health emergencies and identifies key areas for strengthening.¹

METHODS:
a mixed-methods case study was conducted in two districts: one highly affected by seasonal flooding and one facing drought. the assessment utilized the world health organization health system resilience toolkit. data collection included desk reviews of emergency plans, key informant interviews (n=20) with district health managers and clinic-in-charges, and focus group discussions with community health workers and community members.

RESULTS:
the study revealed fragmented resilience. while national contingency plans exist, operational gaps persist at the phc level. critical vulnerabilities included inadequate cold chain infrastructure during power outages, limited human resource surge capacity, and weak integration of meteorological data with early warning systems. a key strength was the adaptability of community health workers. the lack of a dedicated budget line for climate adaptation within phc was a significant barrier.²

CONCLUSIONS:
zambia's phc system requires deliberate interventions to build systemic resilience against climate emergencies. recommendations include infrastructure hardening with solar-powered refrigeration, developing a protocol for rapid workforce deployment, and mainstreaming climate change adaptation into district-level phc planning and budgeting. strengthening phc resilience is a fundamental investment in safeguarding public health during disasters. Keywords: health system resilience, climate change, primary health care, zambia, health security, universal health coverage