This study looks at how women and men farmers in rural Pakistan understand climate change and what they believe is needed to protect health, especially women farmers’ health. We spoke with smallholder farmers in South Punjab and asked them to rank statements about climate change, its causes, effects, and possible responses, allowing us to see where views overlap and where they differ. Women often described climate change as part of daily life (hotter days, shifting rainfall, sick animals, rising costs, and more pressure on food and care work) and highlighted barriers to adaptation such as poor roads and clinics, slow or missing support, and limited access to timely information, with many linking these problems directly to risks for mothers and children. Men showed a wider mix of views: some placed hope in technology and markets, others felt climate change is in God’s hands or that current impacts are manageable; these perspectives were less likely to focus on the structural barriers raised by women. Faith mattered for both groups, providing strength and meaning for some, but reducing the urgency to act for others. For policy and practice, climate plans should be designed with women, not just for them, and should invest in local health services, nutrition support, early warning systems, and usable information while respecting cultural and faith perspectives and improving access to resources and decision-making. By addressing both daily needs and broader system barriers, communities can build fairer and healthier paths to climate resilience.