INTRODUCTION:
Climate change impacts on water quality and availability represent a major challenge to public health, disproportionately affecting vulnerable populations. This study investigates the integration of climate change risk assessments and social equity principles into community-level Water, Sanitation, and Hygiene (WASH) programs to improve sustainable health outcomes. The objective is to identify how rights-based approaches can enhance WASH resilience against climate-related environmental stress. ​Methods A qualitative and quantitative literature review was conducted using social science methods, analyzing humanitarian and environmental policies, and case studies of WASH interventions in Sub-Saharan Africa. The study utilized data collection frameworks, including ODK-based tools, to analyze real-time monitoring and evaluation data from past projects focused on clean water access and hygiene education. The analysis focused on metrics of equity, inclusion, and the adoption of climate adaptation strategies, such as water safety planning. ​Results Findings indicate that programs integrating climate change risk into operational plans and prioritizing gender equality and social inclusion (GEDSI) in their design show higher rates of sustainability and public health improvement. Specifically, community training on maintenance and equitable repair initiatives were crucial in ensuring uninterrupted access to clean water during climate shocks. The research confirms that addressing social determinants is key to achieving health equity in environmental risk management. ​Conclusions Sustainable health requires that climate change and equity are not addressed as separate issues but are structurally integrated into WASH and public health policy. Advocating for policies that mandate rights-based, inclusive, and climate-informed operational planning is essential for building community resilience and ensuring health without borders.