Introduction: Climate change poses severe consequences, particularly in sub-Saharan Africa, where poverty rates may escalate by 2050 without significant climate and development action. The health impacts are diverse, encompassing communicable and non-communicable diseases. Mozambique, has experienced significant natural disasters in the past 42 years, impacting its health system.

Objective: This study aims to assess Mozambique's health sector vulnerability and adaptation needs to climate change.

Methodology: Following a methodology proposed by the World Health Organization and Intergovernmental Panel for Climate Change, the process involved defining the scope, identifying indicators, obtaining data, conducting vulnerability analysis, and validating findings. The assessment utilized historical climate, epidemiological, and socio-economic data (1979-2016) at the district level (n=162). A Health Vulnerability Index was computed, combining data on exposure, sensitivity, and adaptive capacity.

Results: The exposure dimension revealed diverse spatial patterns across the country for climate variables such as temperature, rainfall, and relative humidity. Mozambique experiences high exposure to tropical cyclones (coastal provinces), droughts (southern region), and floods (main river basins in the center). Sensitivity exhibited a spatial pattern of low sensitivity in the northern region and moderate sensitivity in the central and southern regions. The adaptive capacity dimension showed a relatively higher index in the southern region and moderate to low indices in the central and northern regions. Urban areas, particularly the capital provincial cities, demonstrated higher adaptive capacity. Among districts with a high vulnerability index, four were in Zambezia province, three in Tete and Sofala province, and two in Gaza province.

Conclusion: These findings highlight the country's vulnerability to climate change and underscore the potential for adverse impacts on livelihoods, the economy, and human health. The study provides a foundation for developing strategies and adaptation actions.

Keywords: vulnerability, adaptation, health, climate change